I was last in Malawi in November 2022, to participate in a Kamuzu University of Health Sciences (KUHeS) BDS curriculum workshop and a meeting to discuss implementation of Malawi’s National Oral Health Policy, which had been launched in April 2022. On 23rd January 2024 I set off from Glasgow to begin a visit lasting about one month, during which a wide range of activities would be undertaken. The next few posts will describe those activities and the progress being made on our MalDent Project journey.
The weather in the UK had been very stormy over the first part of the year and I was slightly concerned that Storms Isha and Jocelyn may impact on my flight to London. My concerns were heightened by a text message from British Airways early on 23rd January, warning of delays, but I need not have worried. We left Glasgow on time and my connecting flights to Addis Ababa and then to Blantyre were also on schedule. After a hassle-free journey, therefore, I was soon gazing out at a familiar Malawian landscape, as we made our approach into Blantyre’s Chileka Airport.
I was met at the airport by my good friend and colleague Peter Chimimba and driven to the hotel, where I enjoyed a rest before meeting up in the bar with Peter and another good friend of mine, Nelson Nyoloka, who is a Lecturer in Pharmacy at KUHeS. We had a very enjoyable catch up and discussed some of the logistics around my visit. After dinner I retired early and slept very soundly after the 24 hour journey from Scotland.
The next day, Peter and I left with a University driver for Lilongwe. I have made this journey many times, but one change I noticed was the introduction of two sections of toll road.
The purpose of our visit was to review the state of the equipment, instruments and dental consumable supplies at the Kamuzu Central Hospital (KCH) Dental Department, in preparation for a week long Flying Faculty visit, starting on Monday 19th February, to be delivered by a team of clinical dental academics from Glasgow and Newcastle. The team had been asked by James Mchenga, Head of the BDS programme, to deliver an intensive week of advanced restorative dentistry training to the senior students (BDS 4 and 5).
Our inspection, supported by Mirriam Chipinga, one of the Assistant Lecturers on the BDS programme, revealed a number of issues that required action and we put in place appropriate measures to ensure that when the team arrived, they would have available the resources needed to deliver the teaching.
We returned to Blantyre on Saturday 27th January. In the evening I had a very enjoyable meal with a new friend of the MalDent Project, Ruthie Markus, about whom you will be hearing much more in the next post.
On the Sunday of that weekend, I met with Nelson for lunch. Nelson was sporting a Celtic football shirt which he had been given by my friend Frank Bonner and his family when Nelson was in Glasgow studying for his MSc in Clinical Pharmacology. After lunch we enjoyed a long walk, taking in Blantyre Sports Club where Nelson’s attire was very fitting! Whilst out and about, Nelson also organised a new SIM card for my Malawian phone, so that I could communicate easily with all my Malawian friends and colleagues.
On the Monday morning, I had a long meeting with James Mchenga and Peter Chimimba about a variety of issues pertaining to the MalDent Project. We were joined towards the end of the morning by Mwapatsa Mipando, whose vision and guidance has been so critical to the MalDent Project.
Mwapatsa took me for lunch to Café Mandala in a beautiful building called La Caverna. The building was constructed in 1882 and is now commonly known as the Old Manager’s House. A number of businesses formerly operated out of this building, including the Nyasaland Branch of the Standard Bank of South Africa. The steel vault door for the bank was cast in Glasgow by William Paterson & Sons and is now incorporated as part of the existing building.
On the Tuesday morning, James and I met with two of the Assistant Lecturers, Tasneem Chikwatu and Nathan Lungu. We covered a wide range of issues relating to BDS course management and quality assurance, Standard Operating Procedures, course manuals and dental student electives. After lunch, I spent time with Peter preparing a presentation for meetings due the following week when Peter Lee, from John McAslan & Partners, would be visiting – this will form the bulk of a future post.
On the morning of Wednesday 31st January, James, Peter and I had a long meeting with the Executive Dean of the School of Medicine and Oral Health, Dr Wakisa Katepela Mulwafu. Dr Mulwafu, an ENT surgeon by training, was fairly recently appointed, so we spent some time briefing him about the background and current status of the MalDent Project. We then discussed in detail the various issues around dental equipment, consumable supplies and staffing which make running BDS programmes so expensive.
After our meeting with the Executive Dean, I spent the rest of the morning with Tasneem and Nathan, delivering a seminar on Oral Medicine, a subject I taught and practised in Cardiff for eight years before moving to Glasgow. James would like Tasneem to undertake specialty training in Oral Medicine and Periodontology, whilst Nathan will be starting specialty training in Oral & Maxillofacial Surgery at Wits University in April this year. Oral Medicine is therefore a subject of interest to them both.
In the afternoon, James, Tasneem, Nathan and I visited the Dental Department at the Queen Elizabeth Hospital, where the dental students undertake some of their training. We were keen to identify whether there were any items of equipment that we could take to Lilongwe for the duration of the forthcoming Flying Faculty visit. We also met some the interns working there, prior to full registration with the Medical Council of Malawi.
I had become concerned about the cost of my accommodation in a hotel, and after discussions with colleagues at KUHeS I moved to The Leslie, a beautiful lodge that is considerably less costly and within easy walking distance of the KUHeS Blantyre campus. I thoroughly recommend it to anyone visiting Blantyre.
Much of my activity on Thursday 1st and Friday 2nd February was with the charity AMECA, and will be described fully in the next post. However, James, Peter and I had a very important meeting at 3pm on the Friday with Professor Macpherson Mallewa, Vice-Chancellor of KUHeS. Professor Mallewa met with us for over an hour and we had a very positive, fruitful exchange. The potential for Malawi to graduate its first ever home-trained dentists in one year’s time was part of the subject matter covered, including the need to be thinking ahead now to organising the internships for those new graduates and providing high quality facilities in which they can work once they have achieved full registration with the Medical Council of Malawi.
On the morning of Saturday 3rd February I spent time at The Leslie reading project outlines for four KUHeS MPH students who are working with the MalDent Project to undertake research projects that will provide valuable information as we work towards developing a child oral health programme for Malawi. At midday I joined a Zoom call with the Christian Dental Fellowship at which Mwapatsa delivered the devotion
At about 2pm, Mwapatsa and his family arrived at The Leslie to pick me up for a trip to Mount Mulanje. It was a memorable outing. Initially we headed out through the suburbs of Blantyre…
… but soon we were driving through acres and acres of tea plantations. The scenery was beautiful.
After a wonderful drive we arrived at Mulanje, next to the famous Mulanje Mountain, the third highest peak (3002 m) in Africa. Our first stop was at a fruit market, where pineapples and other produce were piled high. I was fascinated watching Mwapatsa as he chose the fruit carefully and bartered over the prices.
Next we headed up into the foothills of the mountain and parked at the Kara O’Mula hotel.
We ordered some food and while it was being prepared we took a walk up to a beautiful waterfall cascading down the mountain. It was a perfect spot for relaxation and for photography…
On the way back to the restaurant we were drawn to the sound of music from beside the swimming pool and stopped for a while to enjoy the performance.
We then enjoyed a splendid meal before the drive home to Blantyre. It had been a truly memorable trip.
On the Sunday morning I began to sort through the many photographs I had accumulated since my arrival. Later in the day I met again with Nelson for another interesting walk around Blantyre. This took in the Independence Arch:
… and the pharmacy where Nelson had worked immediately after he graduated.
Towards the end of our walk we met two of Nelson’s friends from his childhood days in the social club at the Malawi University of Business and Science (MUBAS), formerly the Polytechnic. Both now work as academic staff at MUBAS and Nelson regularly plays pool with them
It transpired that one of these friends, Alick, is Acting Head of the Department of Biomedical Engineering. We became engrossed in a discussion about the challenges of medical / dental equipment installation, maintenance and repair in Malawi. I explained to Alick the work we had done with Medical Aid International and we have agreed to meet for dinner and a longer conversation on possible collaborations before I return to Scotland.
That evening, at dinner, I met four staff from the University of Stirling who had recently arrived for meetings related to a project they are engaged upon with the Malawi Police relating to road traffic accidents. Edward Duncan (Professor of Applied Health Research), Liam Dillon (Research Fellow), Jen Dickie (Senior Lecturer in Environmental Geography) and Greg Mannion (Professor of Education), together with Malawian colleagues, have geo-spatially mapped literally tens of thousands of RTA’s, which is allowing hot-spots to be identified and subsequently the design of mitigations. I had already heard Edward give a summary of the work at the Scotland Malawi Partnership Annual General Meeting in November 2023 and it was a pleasure and privilege to meet the team. Our discussions moved on to the work completed by the MalDent team with colleagues at Strathclyde University in which data we had gathered on dental fluorosis complemented research by the hydrogeologists on hidden underground springs and fluoride in groundwater.
We agreed to meet in Scotland upon our return – there is some unfinished business here!
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