As indicated in the previous blog post, our friend and valued colleague Professor Lorna Macpherson, a stalwart of The MalDent Project, stayed on in Malawi for a few more days following the conclusion of the recent Flying Faculty week. As Lorna continues her work with us to develop a Child Oral Health Improvement Plan for Malawi, we agreed that it would be very helpful for her to see at first hand a variety of health care and educational facilities in Malawi.
After an early breakfast on the Saturday following the Flying Faculty week, Lorna, Peter Chimimba and I set out by road to return to Blantyre. However, we took a detour to include Salima, the beautiful spot on Lake Malawi that Amir and Anneze had visited the week before. There is a Sunbird Hotel and Conference Centre at Salima which we are considering using for an international child oral health conference next year, so this was an excellent opportunity for Lorna to view the facility.
In addition to the existing meeting facilities in the Sunbird Hotel, a new conference centre is being built on adjacent land, which would also be an excellent venue for our planned conference.
After the long journey from Lilongwe we reached Blantyre and dropped Lorna at her base for the next few days – a beautiful lodge called ‘The Leslie’, very close to the Blantyre Campus of Kamuzu University of Health Sciences. I have stayed there on several occasions and know the staff well.
On the Monday morning, with Ruthie Markus, the CEO of AMECA, we set out early to show Lorna the health centre at Chilomoni, recently refurbished by AMECA, as described in previous blog posts. Of particular interest was the new dental clinic, where we were joined by Emmanuel Bravoe Kapininga, one of the recent dental graduates. At the dinner hosted by the Vice-Chancellor after the BDS graduation, Emmanuel explained to me that his home is in Chilomoni and he was keen to see the new dental clinic.
Once inside, we met with Prince Kanyerere, the dental therapist who is currently based at the clinic, and enjoyed a lengthy discussion about the further equipping and service developments planned for the facility.
From Chilomoni Health Centre we drove to the Dental Department at the Queen Elizabeth Central Hospital, where Emmanuel provided a tour of the facility for Lorna.
From the Queen Elizabeth Hospital, Lorna and I drove to the main campus of Kamuzu University of Health Sciences. We had arranged a meeting for Lorna with Professor Tracy Morse (Strathclyde University) and Dr Kondwani Chidziwisano (Malawi University of Business and Applied Sciences), both of whom have a long history of research and development work in the WASH sector. On a previous visit to Malawi, I had accompanied Kondwani on a visit to a CBCC to observe the handwashing and feeding activities of the centre, with a view to consideration of incorporating a supervised toothbrushing component into the daily activities of the children. Lorna, Tracy and Kondwani had a very useful discussion whilst I spent time in a pre-arranged meeting with Chad Morse (Deputy CEO of the Scotland Malawi Partnership) and Ruth Malluwa (Malawi Scotland Partnership).
On the Monday afternoon, Lorna and I were both interviewed on camera for a documentary that is being prepared by Kamuzu University of Health Sciences about The MalDent Project.
On the Tuesday morning we had a scheduled meeting with Professor David Mkwambisi from Malawi University of Science & Technology to discuss the ambitions we have around toothpaste manufacture in Malawi. Lorna and I were joined by Nelson Nyoloka, Lecturer in Pharmacy at Kamuzu University of Health Sciences. The work underway also involves Strathclyde Institute of Pharmacy and Biomedical Sciences. The meeting provided useful direction for our next steps.
In the afternoon, we had a very valuable meeting with Dr Lot Nyirenda, Senior Lecturer in the School of Global and Public Health at KUHeS. Lot is involved with the teaching of public health to the BDS students and also oversees the Masters in Public Health programme. We covered a lot of ground that was of direct relevance to the ongoing review of the KUHeS BDS curriculum.
That evening, Ruthie and I decided to take Lorna to The Bombay Palace, a wonderful Indian restaurant opposite Ryalls Hotel. As always, the food was delicious.
On the Wednesday morning we headed to the Health Centre at Zingwangwa, where AMECA has an ongoing project to re-develop the physiotherapy clinic and to install a ramp to improve access from the road.
It was an opportunity for Lorna to meet Young, the artist who paints all the murals on the walls of healthcare facilities that have been built or refurbished by AMECA. Lorna had already seen his artwork at Chilomoni and would see it again at Chilaweni the following day.
From Zingwangwa we headed to meet Dr Shabana Yusuf in her private dental clinic, Dental Chic. Shabana is closely involved in the BDS degree programme at KUHeS as well as running her own practice. It was an opportunity for Lorna to see a state of the art private dental clinic in Malawi.
After our visit, Lorna, Shabana and I enjoyed lunch together at La Caverna. Lorna and I then headed to The Leslie for a long meeting with Dr Wellington Chikuni to work on Malawi’s WHO oral health road map. Wellington is a dentist based at the Queen Elizabeth Hospital Dental Department, but also has a role with the Ministry of Health working alongside Dr Innocent Lanjesi, the Oral Health Coordinator at the Ministry. In total we worked for five hours …
… breaking for 30 minutes to enjoy some dinner:
On the Thursday morning we set out early to drive to the AMECA Clinic at Chilaweni, which has featured previously in this blog. The approach to the clinic along a dirt road takes in some beautiful scenery:
On arrival, Lorna was shown around the Out Patient Department by Gaston, who was the ‘in charge’ that morning:
We were honoured to be joined by the Village Chief, Mr Makwelani, who we greeted outside the Maternity Unit. Whilst Lorna was shown the facilities in maternity, I sat outside and enjoyed a chat with Chief Makwelani, explaining our ambitions around child oral health improvement in Malawi and how we would be keen to engage with local nurseries and schools as we assess the feasibility of interventions such as supervised toothbrushing. Mr Makwelani was very interested and keen to help.
After Lorna had been shown around the health centre, we walked across to the nearby Joshua Community Based Childcare Centre (CBCC). This visit had been set up through Ruthie and her friend Sue Cabon, who now runs the Joshua Orphan and Community Care charity. In earlier discussions with me, Sue had shown great interest in the potential for incorporating supervised toothbrushing into the CBCCs run by Joshua.
Sue had arranged for us to be shown around the CBCC and have its functions described by one of Joshua’s Field Officers, Steve Malasa. Steve gave a us a terrific description of the work undertaken by the CBCCs, of which Joshua has a total of seventeen, including five in the Chilaweni area.
Initially, we spent some time in the classroom where the children were engaged in activities with the carers. Some of the children were very excited to see two mzungus in their midst!
Steve then showed us the kitchen where the porridge is prepared. The volunteers who undertake the preparation and serving of the food arrive early at the CBCC to set the fire and cook the porridge. The food is usually served at about 10am and serves as breakfast since many of the children will not have eaten before leaving home.
We then watched the children pour out of the classroom to wash their hands before eating.
The children formed an orderly queue …
… and the younger ones were given assistance at the hand washing station when necessary:
Large tarpaulins had been spread out on the ground beside the CBCC and the children sat to enjoy their porridge. Lorna and I were invited to assist with the distribution of the plates to the children which was an unexpected and welcome honour.
As each child finished eating, they brought their plate to a collection point next to the kitchen, ready to be washed by the volunteers. The discipline of these young children was extraordinary.
Lorna and I were each given a plate of porridge to taste and it was very good indeed. It was much sweeter than I had imagined it would be and as someone who likes honey rather than salt on my porridge, I cleared my plate with ease!
This had been a fantastic opportunity for Lorna to see at first hand how a CBCC operates and to consider whether a feasibility study of supervised toothbrushing would be possible. As I indicated above, I had already visited another Joshua CBCC with Kondwani Chidziwisano from MUBAS last year, and this visit to Chilaweni strengthened my own view that introducing toothbrushing as a third activity following handwashing and feeding would be feasible. We were very grateful to Steve for hosting our visit so well and to the staff and volunteers at the CBCC for making us so welcome.
Later that day, Sue Cabon caught up with us for a debrief with Lorna on our visit to the Chilaweni CBCC. Many thanks are due to Sue for her interest and enthusiasm. We feel very optimistic about the possibilities and I hope to be writing a follow-up blog post on next steps in due course!
The week had passed very quickly. It had been intensive but gave Lorna a much better perspective on the Malawian environment than had been possible on her three previous visits, all of which had been relatively brief and focused on academic meetings and activities. To round off Lorna’s visit, we enjoyed a meal on the Thursday evening with Ruthie, Peter and his wife Frider. It was a great celebration of two very successful weeks, and the laying of foundations for future work to improve child oral health in Malawi.
Nice
Wonderful to finally meet Lorna in person, (having only seen Lorna during on line sessions), and to be able to show her around AMECA’s projects. Lorna, you were a fantastic sport, enduring some challenging moments on our roads in rural southern Malawi!! Your input and interest was so very much appreciated and moreover, it was great fun. Thank you for all your time. and as Jeremy commented, we greatly look forward to your next visit and to your ongoing collaboration with Oral Health improvements in Malawi.
Hopefully she has enjoyed her visit to Malawi? All the best.