Chig’s induction to the worlds of AMECA and the MalDent Project

Chig Amin, who runs a dental practice in Surrey, has provided dental care for Ruthie Markus, CEO of AMECA, for many years. As explained at the end of the previous post, he had travelled with me from the UK to Malawi to gain an insight into the work of AMECA and to see some of the activities underway on the MalDent Project.

We were staying at The Leslie, a beautiful lodge close to Kamuzu University of Health Sciences (KUHeS). On arrival, we relaxed on the khonde and in the evening had dinner with Ruthie, Dr. Peter Chimimba (MalDent Project Malawian Lead) and Mr. Nelson Nyoloka (Lecturer in Pharmacy) before turning in early after the 24 hour journey from the UK.

The next day, after breakfast, Chig and I headed to the main campus of KUHeS.

We met with Dr Peter Chimimba and Dr James Mchenga (Acting Head of the Bachelor of Dental Surgery [BDS] degree course) before driving to the Dental Department at the Queen Elizabeth Hospital, where the BDS 5 students were working.

James and Peter showed Chig around the dental facility, including the recently re-painted surgery for children:

Chig also had an opportunity to speak with some of the BDS 5 students during his visit:

We left the Dental Department…

… and took Chig to show him the site where the new dental clinical teaching facility and student hub will be built …

Our next stop was in the Pharmacy Department where we met with my good friend Nelson Nyoloka and two of his BSc students, Roadwell Kapela and Churchill Henry Mwamwatembe. These two students are undertaking a research project that will measure the concentration of fluoride in toothpastes that are sold in Malawian markets, such as the following:

In addition to hearing about the methods that are under consideration for their laboratory work, Chig, Peter and I were able to provide some dental context to the project that Roadwell and Churchill are doing under Nelson’s supervision.

I was keen that Chig be shown some of the private dental clinics in Blantyre. Accordingly, following our meeting with Nelson and his team, James drove Chig and I to the Seventh Day Adventist Hospital Dental Clinic.

We were shown around this state of the art facility by the senior dentist, Dr Jesse Agra, who runs the clinic with his wife, Sheila.

James also took us on a tour of the Seventh Day Adventist Hospital situated directly behind the Dental Clinic.

Our next stop was at the dental clinic owned and run by Dr Shabana Yusuf:

Shabana is a graduate of Kings College, London and provides general dentistry but has a special interest in orthodontics. She has enhanced her skills in orthodontics through undertaking further training, both on-line and in-person in the UK. It became clear through discussion that Chig and Shabana had previously worked in clinics in the UK that were situated very close together and had possibly even referred patients to one another – what a small dental world we operate in!

Shabana is involved in teaching the BDS students at KUHeS, focusing on orthodontics. Regular readers of the blog will recall that she played a major role in the recent welcoming event for the new BDS students entering the Foundation Year.

‘Dental Chic’ is a beautiful practice. Patients and other visitors are first greeted by Chikondi, the receptionist:

The surgery was very well equipped …

… and the practice tastefully decorated:

We look forward to continuing collaboration with Shabana as the BDS course develops.

We drove from Shabana’s practice back to the KUHeS campus and met with one of the librarians who showed us some of the dental text books that had been purchased with the Scottish Government MalDent Project grant. Some of the books had been sent to the KUHeS Library at the Lilongwe Campus, to provide access for the BDS 3 and 4 students who are currently based there.

Chig and I then headed to Mijn Kitchen, a restaurant near to the KUHeS campus, where we enjoyed lunch in the beautiful gardens attached to the property. The sign on the restaurant counter seemed very apt for a couple of dentists:

On the Friday morning we set out with Ruthie for Majete Wildlife Reserve. It was very hot and sunny with beautiful views out over the escarpment. The road took us down to the River Shire where we stopped to stretch our legs. A local trader tried hard to sell Ruthie a live chicken …

… before Chig took a selfie of us, with the river in the background:

After about 90 minutes of driving from Blantyre we reached the large sign heralding the entrance to Majete Wildlife Reserve:

From the sign we drove along an unmetalled road to Thawale Lodge, which would be our base for the next 24 hours.

We were given a short history of African Parks, the organisation which manages Majete, along with many other reserves throughout Africa. We were then shown to our individual tents …

… where we left our bags before returning to the main lodge building for lunch. Whilst we were relaxing there one of the guides, Samuel, appeared. Samuel is a friend of Ruthie’s and they enjoyed a chat whilst Chig and I sipped our coffee.

Before lunch was served we enjoyed an amazing spectacle. Initially, one of the other guests spotted a small number of buffalo in the distance. They were walking towards the watering hole that is situated immediately in front of the balcony at Thawale Lodge. Slowly the initial group turned into a massive line of buffalo all walking in file towards us. Ultimately a herd of at least 200 buffalo arrived to drink, directly in front of us. It was quite a sight!

We enjoyed a delicious lunch and then relaxed until the game drive that was scheduled for 4pm.

We were well rested when Samuel called us at 4pm and we headed out to our safari vehicle, a converted Toyota Land Cruiser.

Samuel was soon driving us along dusty roads in the bush:

As we travelled, Samuel pointed out various flora and fauna. At one point we went up into a hide and saw lions in the distance, together with a variety of animals at a watering hole close by:

Sunset arrives quite early in Malawi and as it came closer Samuel parked the Land Cruiser beside the river …

… and prepared a picnic table for sundowners:

The sunset itself was glorious, throwing the trees and vehicle into silhouette against a fiery backdrop:

On arrival back at Thawale Lodge we had dinner and then retired to our tents. A strong wind had developed during the evening which had my mosquito net billowing! We were up early in time for a morning game drive which commenced at 6am. Once again, Samuel was our guide and he was soon pointing out footprints of specific animals:

As the drive progressed, Samuel was convinced there were elephants in the vicinity. He followed a variety of signs, including chewed branches and footprints, until his persistence paid off and there were elephants right in front of us.

As our drive was nearing a close, Samuel spied a couple of giraffes near a water hole, which rounded off our trip nicely.

It had been a real pleasure and privilege to see these magnificent animals at close range in their natural habitat. I also really enjoyed seeing the variety of shrubs and trees, especially the baobabs.

On return to Thawale Lodge we enjoyed a large cooked breakfast before heading off to a second nearby establishment called Ngona Lodge, on the bank of the River Shire. Much of the signage featured crocodiles, reflecting the large number of these reptiles in the river.

We enjoyed a drink together on arrival …

… before taking our bags to our rooms. We were all too full of Thawale Lodge breakfast to eat lunch, and spent the afternoon relaxing, some in the sun and pool, myself in the shade of the lodge itself. It is a beautiful place to chill in peace.

The following day the weather changed dramatically, becoming much colder, on account of a chiperoni. The weather in South Africa at the time was very cold, with snow in Johannesburg, and this was apparently a contributory factor. When the wind blows from south south east, clouds are forced to rise over Chiperoni mountain in Mozambique, bringing cold, rainy conditions to the Shire Highlands. This was especially evident as we drove back to Blantyre after breakfast. A very dense fog hung over the escarpment making the driving conditions extremely difficult for Ruthie. However, once we reached the outskirts of Blantyre the fog lifted, though the weather remained cool.

Chig and I spent the afternoon at The Leslie, and in the evening we were picked up by Ruthie to go to the Bombay Palace for dinner. We had a lovely meal, including the famous speciality, a rumali basket, as a starter.

On the Monday morning we were up early to attend a meeting with Dr Gift Kawalazira, the District Health Officer (DHO) for Blantyre. I had met Dr Kawalazira previously, but we had a great deal to update him about, including progress with the development of a dental clinic at Chilomoni – largely a result of efforts by Ruthie and AMECA – and our plans to establish a Child Oral Health Improvement Plan for Malawi. Dr Kawalazira had much useful advice for us and kindly agreed to arrange for me to meet some of his team later in my visit to Malawi.

We left the DHO’s office and headed to Chilomoni Health Centre, where a large amount of demolition and construction work was underway. AMECA is undertaking improvement works for both physiotherapy and maternity services at Chilomoni Health Centre, as well as funding the building works required to set up the new dental clinic.

First, we visited the recently completed physiotherapy unit, where patients are already receiving treatment.

The decor is really beautiful and a variety of items of equipment have been made locally to support the work of the physiotherapists employed there:

Peter Chimimba had now joined us for the visit and we were amazed at the transformation of the space into a bright, airy and functional physiotherapy unit:

We next moved on to the maternity unit, which is undergoing a massive redesign and renovation. Jan Sonke, the architect, had now arrived and the head of the construction company, Mr Mbewe, was also present.

The inside of the building was largely reduced to a shell prior to the new interior being built:

Whilst discussions continued inside the maternity unit with one of the senior nurses, Chig, Wisdom and I enjoyed a dental conversation outside:

We next moved to the space that has been identified to establish a new dental clinic. Jan Sonke explained the plan and there followed a series of discussions over some of the finer detail. It was especially valuable that Chig was present, since his technical knowledge, based on years of developing and running a dental practice in the UK, allowed us to make some well informed, final decisions on the project plans.

This is the space as it looks currently:

Watch out for later blogs that will show the transformation that is to come.

Chig was keen to see the original small room that is still being used by Wisdom as his surgery, including the Belmont dental chair that has never been properly installed:

After leaving Chilomoni Health Centre, we headed to Caffe Grazia, both for some lunch but also for Chig to see the shop which has many beautiful Malawian memorabilia for sale. Whilst there, friends of Ruthie’s from Amsterdam appeared, and shared lunch with us:

We spent the afternoon at Ruthie’s house and then at 6pm were joined by Ruthie’s friend Saira, who had prepared an oxtail stew which was really tasty, served with a variety of vegetables.

Chig was due to leave for the UK in the early afternoon of the Tuesday. After breakfast, once he had checked out of The Leslie, Ruthie drove us to the AMECA Clinic at Chilaweni. I have written about this amazing place before. Chig was given a full tour of the facility and was very impressed with all he saw.

Ruthie had kindly arranged for the Group Village Headman, Chief Makwelani, to meet us. Once we had finished the tour of the clinic, we went on a walk through Chilaweni village with the Chief. He showed us the remains of a bridge which had been largely washed away during Cyclone Freddy, causing significant logistical challenges for those villagers on the other side of the river, who are cut off during the rainy season. It is also a major problem for ambulance access to the AMECA Clinic during the rainy season, when the alternative access road is impassable on account of its steep gradients and unmetalled surface.

We spoke to Chief Makwelani about the work we have planned to examine ways of improving child oral health through working with schools and he was keen that we consider Chilaweni when we are ready to start the pilot studies.

Sadly it was finally time to drop Chig at Chileka Airport to catch his flight to Johannesburg. It had been a wonderful few days for Ruthie and I, sharing our various Malawian activities with Chig. Thanks to Chig’s interest and enthusiasm we have some ideas to take forward, but they are for a future post!

Acknowledgement

Some of the photographs in this post were taken by Ruthie and Chig, to whom due acknowledgement is given.