Introducing Wisdom Maiza – delivering dental care at Chilomoni Health Centre

This post has been written in conjunction with Wisdom Maiza and Ruthie Markus

One of the posts that I published whilst I was visiting Malawi recently related to our newly established partnership with the charity AMECA. Since then, we have been making significant progress with plans to develop an exemplar dental clinic in the health centre at Chilomoni, located in Blantyre District. Much of this progress has resulted from the enthusiasm of Ruthie Markus, the CEO of AMECA. Another key player in the plans is Wisdom Maiza, the dental therapist based at Chilomoni Health Centre, who had originally contacted Ruthie about the state of his surgery in November 2023, prompting her to contact the MalDent Project.

Whilst development of the physical infrastructure needed to deliver high quality dental care in Malawi is a priority, equally important are the oral health professionals who deliver that care. This post will introduce readers to Wisdom, who will no doubt be featuring in future posts as the Chilomoni Health Centre project progresses.

Wisdom, now 33 years old, was born in Mzimba District in the Northern Region of Malawi. It is the largest district in Malawi, with its western boundary lying along the Malawi-Zambia border. After leaving school, Wisdom trained for three years as a Dental Therapist at Malawi College of Health Sciences in Lilongwe, graduating in 2013. He undertook his internship in the Dental Department at Kamuzu Central Hospital (KCH) Lilongwe, gaining full registration with the Medical Council of Malawi in 2014. Wisdom then held a series of posts at Mzuzu Central Hospital, KCH, Queen Elizabeth Hospital in Blantyre, and health centres in Mzimba North, Dedza and Ntcheu, before joining Chilomoni Health Centre in 2015.

The population within the catchment area for Chilomoni Health Centre numbers approximately 63,000 and many suffer from dental problems. Wisdom estimates that he treats 350 – 400 patients per month. Because the donated dental chair is not installed, the only treatments Wisdom can currently provide are dental extractions and a few other procedures, including management of dental trauma and tongue tie, with patients seated on the wooden chair in his surgery. All treatments are recorded in a handwritten register and the patient numbers are reported back to the office of the District Health Officer.

A typical day for Wisdom begins when his alarm sounds at 4am. He leaves his home at 5.15am, arriving at Chilomoni Health Centre by 5.30am. 

When Wisdom arrives, patients are already waiting for him. Many of the patients travel long distances on foot to reach the clinic, some starting as early as 2am. One of the reasons for opening the clinic so early is to allow the patients to receive their treatment and still have time for their return journey home by foot before it is too late. Furthermore, many patients are unable to afford three meals a day and prefer to attend in the morning when they typically have a higher blood sugar. 

Wisdom finishes his morning clinic at about 11am and spends much of the remainder of the day performing his administrative role as the Dental Coordinator for Blantyre District. This involves a variety of activities including, for example, organizing supplies of drugs such as local anaesthetic solution, antibiotics, and analgesics, together with consumable items such as local anaesthetic needles. These items are often in short supply, leading to significant challenges for delivery of high-quality dental care.

The two things that Wisdom most likes about his job are working with children and reaching out to the poor. His long-term ambition is to work in a dental clinic where the rich pay for their treatment and the poor receive their dental care free of charge.

Wisdom has a list of changes that he would like to see implemented to enhance his professional role:

• A functional dental chair and surgery that would allow him to sit down to deliver dental treatment, including restorative dentistry, using all the clinical skills within his scope of practice, instead of being restricted to extractions.
• A reliable supply of drugs and consumables.
• An increased number of hand instruments to maximise treatment capacity. 
• A digital system for registration of patients.

Many of these points are covered in Malawi’s National Oral Health Policy, launched in April 2022. Wisdom was one of a group of dental health professionals from across Malawi who participated in a workshop in November 2022 to develop an action plan for implementation of the Oral Health Policy and he was one of the authors of the report that followed the meeting.

Since my visit to Malawi in February, an alternative much larger space has been identified that we can develop as an exemplar dental surgery. 

There is capacity for two dental chairs, a radiography facility and a local decontamination unit. Whilst a refurbishment of this space will not immediately satisfy all of Wisdom’s requirements, it will be a significant start.

Wisdom has a favourite saying:

We make a living by what we get,

But we make a life by what we give.

Sir Winston Churchill

That is a philosophy that AMECA and the MalDent Project can get behind and we look forward with excitement to establishing this exemplar dental clinic in collaboration with Dr Kawalazira the District Health Officer, Wisdom and the wider team.