Community Engagement and Involvement: Paediatric Oral Health. An elective experience in Malawi.

This is a guest blog written by Anna Smith, a Final Year Bachelor of Dental Surgery student at the University of Birmingham. For her dental elective project between BDS 4 and BDS 5, Anna spent a month in Blantyre, Malawi. This blog post describes some of her experiences.

Introduction

My name is Anna, and I am a Final Year dental student at the University of Birmingham. Public health has always been my favourite subject at dental school, and a lecture delivered on The MalDent Project by Professor Jeremy Bagg from the University of Glasgow as part of our Dental Public Health course in BDS 4 inspired me to come to Malawi.

For my elective, I undertook a community engagement and involvement (CEI) research study focused on paediatric oral health in Blantyre. The aim of my project was to learn through observations, conversations and interviews, and to document my experiences along the way.

First Impressions of Malawi

Arriving at Chileka International Airport, I was immediately struck by the stunning mountain views surrounding Blantyre. On my first day, I made time for both food and culture: a delicious meal at the Coffee House, where I tried grilled chambo (a local freshwater fish) for the first time.

Over the following days, I visited Kamuzu View, a breathtaking vantage point over Blantyre. The drive up and down the steep mountain roads was a little nerve-wracking, but the scenery was unforgettable.

Early Experiences in Blantyre

My first task was meeting two key stakeholders in The MalDent Project: Dr James Mchenga, who is Acting Head of the BDS degree programme at Kamuzu University of Health Sciences (KUHeS), and Dr Peter Chimimba, who has led the new Dental School programme since 2017 and is the Malawi lead for The MalDent Project. Together, we discussed my plans and began mapping out the road for my elective.

Outside of dentistry, I immersed myself in the city’s atmosphere, including attending my first-ever football match at Kamuzu Stadium, which was an exciting and engaging experience.

Early in the project, I recorded a video interview with Dr James Mchenga. We discussed the new dental course in Malawi, the first cohort of graduates, and the challenges and opportunities in paediatric oral health and prevention. I thoroughly enjoyed the experience and felt like a journalist.

Clinical and Community Visits

At Queen Elizabeth Central Hospital I was warmly welcomed by Dr Wellington Chikuni, one of the dental surgeons, who introduced me to the staff, including the recently graduated dental interns. We agreed that I would visit twice a week to observe paediatric appointments, gather information, and film interviews. Although nervous at first, I quickly grew comfortable and deeply valued the experience. On my final day, with the help of Dr Emmanuel Kapinanga, we shared samosas with the staff – a very special farewell.

I also visited Chilomoni Health Centre, where it was inspiring to see the improvements made possible by the joint working between the charity AMECA and The MalDent Project.

There, I met Wisdom Maiza Mkandawire, who had been the dental therapist for many years at Chilomoni and who has now embarked on his BDS studies at KUHeS. Wisdom was a great support throughout my research.

Another highlight was meeting Father Felix Nyallo, who is Educational Director (Mary Queen of Peace Catholic Campus) at the Beehive Centre for Social Enterprise. Father Felix kindly connected me with the Beehive Outreach team. With their help, I conducted outreach activities at children’s feeding programmes and parenting meetings. I am especially grateful to Lubanji and Wadadie for their generous support.

Community Engagement Research

Conversations and Interviews

The heart of my elective project was conversations with parents, teachers, and health workers. Thanks to Beehive, I attended feeding programmes at St James Church on multiple occasions, conducting surveys and interviews, delivering oral hygiene demonstrations, and answering questions from children and parents alike.

With the support of Mutoni Biseto and Benjamin Williams (both BDS 5 students at KUHeS), I also visited Queen Mary Centre to lead an oral health session with mothers. Mutoni translated, allowing us to have rich discussions on topics such as the “worm theory” of dental pain which remains widely held, the cost of extractions, periodontal disease, when to begin brushing children’s teeth, and the use of adult toothpaste for children. These sessions were both impactful and insightful.

After the session, we took a group photo outside:

Pilot Study at Chilomoni Primary School

I was able to conduct a pilot study and an oral health session with 50 children aged 6–14 at Chilomoni Primary School. Assisted by Dr Emmanuel Kapinanga and Benjamin Williams (a BDS 5 student), we began with a survey, followed by an oral health tutorial, quiz questions, and a toothbrushing demonstration.

The children were enthusiastic and engaged, and the teachers provided excellent support.

However, one challenging but important question arose: “What can we do when toothbrushes and toothpaste are not available?” This difficult reality left me momentarily speechless but highlighted a critical issue that must be addressed. There is little point in teaching toothbrushing with fluoride toothpaste if the necessary items are not available, and sadly in many sub-Saharan African countries, including Malawi, they are too expensive to be affordable for many families. This is challenge that requires urgent attention.

A Breath of Adventure

Outside of the project, I explored Malawi’s culture and cuisine. My favourite restaurant was Pamudzi (“At Home”), which specialised in local dishes, where I shared a wonderful meal with Mutoni Biseto.

I also went horse riding in Bvumbwe, enjoyed Blantyre’s cafés, and tried many new foods,  all experiences that added colour and joy to my elective.

A highlight was being invited to join the PREMED welcoming event for all the new entrants to the BDS course, which was a lovely experience. I was even given the opportunity to be a panel member on one of the activities during the evening, which was a great honour.

Reflections

Through this elective, I learned the power of listening first, asking for help, and being open to change.

Community engagement is not about imposing solutions but co-designing with those most affected. Developing my Community Advisory Board early on was especially valuable, as they supported me throughout every step.

On a personal level, I grew in confidence delivering oral hygiene advice and learned new skills. I witnessed first-hand the gaps in access to oral health care, as well as the extraordinary resilience of communities. This experience deepened my commitment to preventive dentistry and strengthened my desire to pursue a career in public health.

Looking Ahead

I am currently working on a documentary situational analysis of paediatric oral health in Blantyre, Malawi. Once completed and loaded onto YouTube, a link will be provided to the video in a follow-up blog post. I hope my work contributes, even in a small way, to improving preventive care for children.

Personally, this elective confirmed my desire to devote my future career to public health and global oral health, and I plan to pursue a PhD. I have also been selected for the Alliance of Oral Health Across Borders Student Leadership in Global Oral Health Class 2026, where I will focus on establishing community-based paediatric dental care –  a pre-implementation study using school-based interventions to empower non-dental health workers to provide preventive care, including the roles of silver diamine fluoride (SDF) and fluoride varnish (FV).

I look forward to returning to Malawi next summer!

Acknowledgements

I would like to thank my supervisor at the University of Birmingham, Dr Vahid Ravaghi, Professor Jeremy Bagg of the University of Glasgow / KUHeS, and The MalDent Project team. My gratitude also goes to the Kamuzu University of Health Sciences Department of Oral Health Sciences, the staff at the Dental Department of Queen Elizabeth Central Hospital, and Father Felix Nyallo and the Beehive Centre for Social Enterprise outreach team. Thanks are due to Mutoni Biseto, Benjamin Williams, Wisdom Mkandawire and Emmanuel Kapinanga for their friendship and support. Finally, many thanks are due to Nelson Nyoloka, Lecturer in Pharmacy at KUHeS and a close friend of Professor Bagg, who provided so much support in arranging the logistics associated with accommodation and travel during my visit.