The COVID-19 lockdown has affected all areas of our lives. The impact on higher and further education has been no exception. In the UK and many other high income countries the availability of internet based platforms such as Zoom has played a major role in helping to mitigate the cessation of face to face teaching on campuses. In the Dental School at Glasgow we were able to rapidly transition to on-line teaching and assessment methods which allowed us to complete the 2019/2020 academic session for all of our students in May / June 2020. The steep learning curve for both staff and students was challenging, and it is remarkable what has been achieved.
Whilst it may have been challenging we were fortunate to have access to the necessary digital technologies. Sadly, the same cannot be said for many low- and middle-income countries. At the University of Malawi College of Medicine the campuses were closed to students from the middle of March 2020, with no delivery of undergraduate teaching since then and no assessments undertaken.
There have been two major challenges. One of these is the wide geographic variation in WiFi availability within Malawi. Many of the students have gone home to their villages in rural areas and are without readily accessible WiFi. Purchase of data bundles is relatively expensive and beyond the means of many students. The second major challenge is that many students do not have access to suitable digital devices on which to download teaching materials and undertake their studies. It would be very unfair for any university or college to deliver on-line teaching if some of the students were unable to access it, merely adding to inequalities within the student body.
The College of Medicine identified that 267 of its 1076 students did not have access to suitable digital devices for on-line teaching. In mid-June it therefore launched an appeal called #267forCOM to “bridge the digital divide”.
This digital access issue and appeal were of immediate relevance to the MalDent Project. The students on the BDS 1 course, which had commenced in August 2019, were severely affected along with all the other undergraduate programmes, including the foundation course which also included students keen to join the next cohort of dental students. However, regardless of their course of study, this challenge of digital access was impacting all students across the College of Medicine, and required an urgent partnership response.
By chance, I had been speaking about digital delivery of education to health care workers with my good friend Shaenna Loughnane, who is CEO of the charity Bridge2Aid, with whom we are working on the project to up-skill Medical Assistants in Malawi to deliver emergency dentistry. Shaenna is engaged in projects that use digital delivery for education of healthcare workers in Tanzania, and she was instantly keen to help.
We set up a Zoom meeting with Dr Mwapatsa Mipando, Principal of the College of Medicine and Dr Emma Thomson who leads the College of Medicine Education & Training Office, to consider possibilities. A number of options were discussed including fund-raising in the UK, an approach to the Turing Trust by Shaenna and an approach by myself to the Scottish Government to enquire whether some re-purposing of a small amount of the MalDent Project budget may be possible.
It soon became clear that fund-raising would be too slow to provide the urgent support needed to bring teaching back on track. Shaenna had a very productive discussion with the Turing Trust which raised the possibility of purchasing, at low cost, up to 50 laptop computers from a consignment which, at the time, was in a container en route to Malawi and bound for distribution to schools via their partnership organisation the Centre for Youth and Development.
For my part, I worked with Deirdre Kelliher, our MalDent Grant Manager, and identified that in the 2020/2021 budget estimate we had costed in £20K for ‘Flying Faculty’ teaching which would not be used because of the travel restrictions, which are anticipated to be in force until at least 31 March 2021. However, much of that education and instruction could be delivered in a modified way by the ‘Flying Faculty’ volunteers if all the students had access to on-line teaching. Accordingly, we prepared a short briefing paper which was followed up by a very positive Skype call with the Scottish Government International Development Team. Our request was to re-purpose the £20k towards purchase of 100 suitable digital devices, as a contribution to the #267forCOM appeal. It was agreed that this request would be taken to the Minister for International Development, Ms Jenny Gilruth MSP.
I was delighted when we were informed recently that our request to re-profile the £20K towards the purchase of digital devices had been approved. What I had not been prepared for, nor was expecting, was the offer of additional funding from the Scottish Government of up to £33K to support purchase of 230 of the digital devices required. I was completely overwhelmed by this generous response, the impact of which will be immense.
Through their own local fund-raising, the College of Medicine had sufficient monies to cover the cost of an additional 37 devices. The following photograph shows the Principal receiving MWK 6,000,000 (approximately £6000) from one of its supporters, NICO Holdings plc, which is helping with purchase of devices.
Reaching this milestone, which now enables purchase of the 267 devices required to satisfy the #267for COM appeal, in effect unlocks the delivery of on-line learning and, potentially, assessment for 1076 healthcare students in Malawi. It represents a massive step forward and will have a lasting impact even beyond the COVID-19 pandemic.
Following the award of this additional funding, Malawi’s Public Procurement and Disposal Authority (PPDA) allowed the University of Malawi College of Medicine to use an emergency but transparent procurement process. The advert was floated on the PPDA website and two companies tendered their bids. Subsequently the College’s Internal Procurement and Disposal Committee met to identify the preferred bidder and it is anticipated that the devices will be delivered within a matter of days.
The other piece of the jigsaw is the access to affordable data bundles and there has been success on this front too. The Principal, DrMipando, has been interacting with the Malawi Government and with telecommunications companies to identify a way forward.
Through negotiations involving the Malawi Government and Telekoms Network Malawi (TNM), Dr Mipando has secured a reduced rate on data bundles, which the College of Medicine will purchase on behalf of the students.
For the MalDent Project, there is relief and excitement that we can now move forward with delivery of on-line learning and once more engage fully with the students on the BDS and foundation programmes. However, on a much broader scale this outcome provides the opportunity for all the students at the College of Medicine to revert to their studies and, we hope, obviate the need for them all to face lengthy extensions to their degree programmes. The generosity of the Scottish Government and Malawian sponsors in facilitating this major step forward will have a lasting impact on the lives of many young healthcare workers and, ultimately, the patients they look after, for many years to come.
The last word should come from Dr Mwapatsa Mipando, Principal of the University of Malawi College of Medicine, who established the #267for COM appeal and has worked tirelessly to see it succeed:
“ As a Principal of COM and as a Malawian, I am thankful for the support that we have received from Scottish People, our local companies and our alumni. This support will allow us to purchase Tablets for all our needy students. This is really the spirit of UBUTHU!! This UBUTHU has surmounted the digital divide that was amongst our students. The cherry on top, is the partnership that the COM has entered with Telekom Networks Malawi PLC (TNM) resulting in the College providing 10Gbs of internet data every month to every student. COM is a trailblazer in Malawi through the above support and we hope to release more health care workers into our already overstretched health system!”
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