The MalDent Project: taking stock and planning ahead

As a result of the impact of the COVID-19 pandemic and associated restrictions, it is now two years since I last visited Malawi. On reflection, we were extremely fortunate to have been able to hold the National Oral Health Policy Workshop in Lilongwe in February 2020, just before the lock downs commenced, as that meeting laid the foundations for establishing the Task Force and our subsequent policy development work.

Delegates at the National Oral Health Policy Workshop, Lilongwe, February 2020

However, as regular readers of this blog will be aware, we have managed to maintain the momentum of many strands of the MalDent Project despite the challenges of the past two years. In this post, I will provide updates on some more recent events and activities, before providing a taster for what we are planning over the next few months.

1. The National Oral Health Policy

The Task Force that was established in 2020 met every fortnight on-line to develop the policy. A Concept Paper, Literature Review and Situation Analysis were undertaken to inform the subsequent drafting of the policy document itself. The work was presented to the Ministry of Health Technical Working Group on two separate occasions and their feedback taken into account as the final draft was prepared. The Policy was accepted by the Ministry of Health Senior Management Team on 13th December 2021 and has now been officially signed off by the Minister of Health and Secretary for Health

This represents a major milestone for the MalDent Project, as it was one of the key objectives. A formal launch of the Policy is currently being planned and attention now turns to its implementation. Access to the full text of the Policy will be provided to readers following the formal launch.

The MalDent Project team was delighted to hear of the recent appointment of Enock Phale MP as Deputy Minister of Health. As a trained dental therapist and former Coordinator for Oral Health at the Ministry, Enock Phale has been campaigning for improvements to oral health in Malawi for many years and it is very fitting that his recent appointment coincides with the oral health policy launch. We all send warmest congratulations and good wishes in his new role.

Enock Phale MP speaking at the National Oral Health Policy Workshop, Lilongwe, February 2020

2. Phase 2 of equipment upgrade at Kamuzu Central Hospital Dental Department

The pandemic has significantly delayed the installation of the refurbished, donated dental chairs and phantom head units at KCH. However, the loaded container finally left Dentaid’s HQ in Southampton in July 2021…

Uplift of container in Southampton

… and arrived safely in Lilongwe in October:

Offloading items from the container of dental equipment and materials

This is a container that we have purchased with support of the Royal College of Physicians & Surgeons HOPE Foundation so that we can use it as a storage facility for the MalDent Project and for our partner organisations including Smileawi and Bridge2Aid. This particular load included a Dentaid portable dental chair which Smileawi was providing for Edward Hara, a dental therapist with whom they have worked for several years in the Northern Region of Malawi. The chair was picked up and has now been delivered safely to Edward.

Now, the ambition is to arrange a visit to Lilongwe this Spring with colleagues from Dentaid and Henry Schein to install the dental chairs and other equipment in the KCH Dental Department.

3. Publications and presentations

There have been a number of opportunities in recent months to publicise the activities of the MalDent Project. The first was an article in Voice, the quarterly magazine of the Royal College of Physicians & Surgeons of Glasgow.

This was the first in an ongoing series of articles that are to be submitted through the RCPSG Global Health Group covering a range of activities in global health across the five faculties of the College. If you would like to read the article it can be found here.

The second article was a piece we submitted about our new charity, MalDent Student Aid, in Scottish Dental magazine

This article followed an excellent piece in the same edition in which one of our Glasgow BDS students, Katie Read-Challen, provided a summary of the project she undertook for her intercalated BSc in Global Health, which examined the work of Scottish charity Smileawi through the lenses of partnerships, collaboration and sustainability. Nigel and Vicky Milne, who founded Smileawi, were co-authors and you can read the article here.

On Wednesday 20th October 2021, Peter Chimimba and I were delighted to have the opportunity to present a summary of the MalDent Project at the Scotland Malawi Partnership (SMP) Health Forum and 15th Covid-19 Co-ordination meeting. We each produced a short video clip ahead of the meeting which Jade Stein, the fantastic Media and Communications Officer at SMP, edited into a short on-line announcement about the forthcoming presentation:

Unfortunately, on the day of the meeting Peter was having problems in Malawi with internet connectivity. We therefore agreed that I would present the slides and that we would answer questions jointly at the end. This meeting provided a tremendous opportunity for us to speak to a large audience in both Scotland and Malawi and we are very grateful to Stuart Brown, Deputy CEO of the SMP, for all his help and support. A recording of the entire meeting on 20th October can be viewed here and the section on the MalDent Project commences at 1 h:06 mins on the time bar.

A further opportunity arose in conjunction with a three day University of Glasgow COP26 satellite event that I co-organised with my friend and colleague Julian Fisher, who is based at the Charite University in Berlin and who has previously written for the MalDent Project blog. The event was entitled ‘Sustainability in Healthcare and Education – Global Challenges and Solutions’ and we were delighted that Jenny Gilruth MSP, then Scottish Government Minister for Europe and International Development, delivered a pre-recorded welcome message as the meeting opened. Over the course of the three days more than 1500 delegates participated from over 80 countries.

The first two days centred on Global Oral Health, and provided an opportunity for the MalDent Project to illustrate the application of many of the principles embodied in the WHO 2021 Oral Health Resolution that had been accepted at the World Health Assembly in May 2021. In the session on Day 1 entitled ‘Scotland-Malawi partnership working – putting the WHO Oral Health Resolution into Practice’, there were presentations from Dr Mwapatsa Mipando and I …

… from Dr Jones Masiye (Deputy Director of Clinical Services – NCDIs and Mental Health) at the Ministry of Health …

… and from Dr Queen Dube, Chief of Health Services at the Ministry of Health, who spoke about raising the profile of Oral Health as a political priority in Malawi:

This session was followed by a round table discussion entitled ‘Oral health policy development in Malawi and the Region’. The discussion was co-chaired by Dr Benoit Varenne (Oral Health Programme Officer at the World Health Organisation) and Dr Yuka Makino (Technical Officer for Oral Health, WHO Regional Office for Africa), both of whom were also delivering presentations in other sessions of the meeting.

Representatives from Malawi, Rwanda, Zambia and Zimbabwe participated in the facilitated discussion. Noel Kasomekera, based in the NCDI Unit of the Malawi Government Ministry of Health, represented Malawi. Noel has played a major role in the development of the National Oral Health Policy over the past two years and will be a key figure in the implementation phase.

Noel Kasomekera

Zimbabwe was represented by Cleopatra Matanhire-Zihanzu, who has recently written in this blog about her visit to Malawi to contextualise the University of Glasgow Masters degree project that she had recently completed on the Malawi Oral Health Policy Development.

Cleopatra Matanhire-Zihanzu

For those interested in reviewing the presentations, all of the recorded content from the three days is available here. The material specific to the MalDent Project is in the first recording from Day 1 with the time stamp 1h:12m:40s to 3h:10m:01s.

4. Looking ahead

Whilst it remains the case that the COVID-19 pandemic is far from over from a global perspective, we hope that moving into 2022 we will be able to regain ground on some of the work packages which have been delayed. There are a number of activities that I hope we will be able to report on during future posts this year:

  1. Progress on moving the new student hub / clinical dental teaching facility on the Blantyre campus of KUHeS from the design into the construction phase.
  2. Undertaking a national child oral health survey in Malawian schools following the WHO Pathfinder model.
  3. First steps in delivering the Implementation Plan following launch of the National Oral Health Policy, including aspects such as task-shifting, in conjunction with Malawian and UK partners.
  4. Establishing educational modules on dental equipment installation, maintenance and repair in conjunction with stakeholders in the charitable, academic and commercial sectors.

Much work has been underway in planning these initiatives throughout the past year and the improved opportunities for travel should now assist with progressing them.

Finally …

Whilst the availability of Zoom and related platforms has been a lifesaver during the pandemic, together with its very positive impact on carbon footprints through reduced travel, partnership working such as the MalDent Project does benefit from at least some degree of true face-to-face interaction. Having not visited Malawi since February 2020, I have really missed seeing so many of the friends that I have made there. When Peter Chimimba and his wife Frider let me know that they would be visiting family in Leeds over the recent festive season it was just too good an opportunity to miss. Accordingly I travelled down from Glasgow early in the New Year and enjoyed coffee, lunch and a 10 item MalDent Project agenda with Peter:

Coffee and a good catch up – just the job!

It was an extremely valuable meeting and we both thoroughly enjoyed the wide-ranging discussions that ensued, without any fear of WiFi dropout or other technical mishaps.

During discussion with the barman, Kenzo Chiumia, it turned out that he also was from Malawi, which stimulated much chat and laughter, particularly when Peter’s wife Frider joined us:

Kenzo, Frider, Peter and I enjoying some banter!

Peter and his wife are now safely back in Malawi and I very much hope that our next meeting will be soon – and in the Warm Heart of Africa!

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