Planning gets underway for Malawi’s first national child oral health survey

The MalDent Project has at its core a philosophy of prevention of oral and dental disease. This under-pinning mantra of ‘prevention, prevention, prevention’ which was coined at the National Oral Health Policy Workshop, is emerging strongly in the ongoing work of the Oral Health Policy Task Force. Prevention of dental caries in children will be central to Malawi’s Oral Health Policy and Ronald Manjomo’s PhD project is focusing on this area.

It will be very important to be able to measure the impact of any interventions that are introduced as part of a programme to prevent dental caries in children. However, in order to do so it is essential to establish the baseline level of disease. At present, this is unknown but work is now underway to design and plan a national child oral health survey. This component of the MalDent Project benefits from funding granted by the Borrow Foundation in addition to our core funding from Scottish Government.

A multi-disciplinary team has been established to deliver this survey and the first meeting was held on Friday 23rd April:

The oral health survey team members meet for the first time

The team includes representation from the Malawi Government Ministry of Health, University of Malawi College of Medicine, WHO Africa, Strathclyde University, University of Glasgow, Smileawi and the UK Community Dental Service.

Following general introductions, Nigel and Vicky Milne gave a presentation about the pilot child oral health survey that they had completed with Glasgow and Dundee University elective students in 2019.

Nigel and Vicky Milne illustrate the collaborators in their pilot child oral health survey in 2019

They took us through the various stages of the process …

… including illustrations of their interactions with teachers and pupils …

… and of the dental examinations being undertaken…

The data generated have now been submitted to the African Journal of Public Health and we are awaiting responses from the referees.

One of the most important aspects of the pilot study was to identify specific challenges of undertaking oral health surveys in Malawian schools. A number of lessons were learned, particularly in relation to collecting socio-demographic data from the children and this will help to inform the definitive study design.

One of the other aspects of the Smileawi pilot study related to fluoride content of local water supplies and the prevalence of dental fluorosis among the children examined. This work was undertaken in collaboration with Strathclyde University and provided fascinating data which have now been published in the journal Water:

A copy of the paper can be accessed here.

Professor Bob Kalin, who heads the group at Strathclyde University with which we collaborated, gave a fantastic summary of the joint work and of the wide variation in fluoride concentration of groundwaters in different geographic areas of Malawi. He also described the amazing technology that this group uses to map the boreholes with extensive information on each individual water source. His knowledge and experience will be of great value to our team moving forward.

Bob Kalin showed examples of the on-line detailed data capture systems used by his team

We continue to collaborate closely with Dr Yuka Makino, the WHO Technical Officer for Oral Health in Africa. We are delighted that Yuka has agreed to be part of our team and she gave a presentation on the oral health indicators which the WHO recommends for Africa. We will ensure that the survey design we use maps onto the principles espoused by WHO.

Yuka Makino described the WHO Africa approach to oral health surveys

This first meeting, which introduced the team members to one another and began to lay down the foundations of the survey, will be the first of many. Our intention, COVID-19 permitting, is to complete the planning and ethical approval application this calendar year, with a view to undertaking the survey in the first half of 2022.

John McAslan + Partners take dental teaching facility and student hub a step closer to construction

Following the completion of Stage 1 of the design programme for the new dental teaching facility / student hub on the Blantyre campus of the University of Malawi College of Medicine, the design team, led by John McAslan + Partners, progressed onto Stage 2. The work that had been completed during Stage 2 was presented to the MalDent Project team on Wednesday 6th January 2021.

The team assembled for the presentation of the Stage 2 Report

The design consortium had undertaken a massive amount of further work and the illustrative materials that were presented really started to bring the planned building to life, particularly for those of us who are not accustomed to involvement in projects of this type. Many of the diagrams provided a 3D perspective which was immensely helpful to allow visualisation of the emerging design.

One of many 3D diagrams that were presented

We were shown multiple sections …

… and elevations …

… followed by a fascinating description of the work that was underway to design the surrounding landscaping, moving from original concepts …

… to a more detailed master plan:

Significant further work had also been completed around the mechanical, electrical and plumbing components of the design …

… including a system to capture significant amounts of rainwater for use in the building – part of the sustainability theme running through the design:

The structural and civil engineering elements have also been developed considerably since the completion of Stage 1 …

… with a very interesting discussion of the design concepts around the foundations to fit with the underlying rock and soil structure:

These were just a few of the areas that were discussed during the two hour presentation.

At the end of the meeting, Chris Platt, Paul East and I stayed on the call for an update discussion with Olivia Welch, a dental student at Dundee Dental School, who is undertaking an intercalated degree in global health and whose dissertation is focusing on this design project in the context of sustainability. You will be able to read about Olivia’s work in a subsequent post.

Chris, Paul and I chatting with Olivia about her dissertation

The finalised Stage 2 report was delivered on 9th February 2021. Subsequently, we were authorised by Scottish Government to re-profile some underspend in the MalDent Project budget to allow an extension of the Stage 2 design work in preparation for a building warrant application in Malawi. In turn, this will strengthen our case when interacting with potential donors for the construction costs.

This new phase of work kicked off with a Zoom meeting on Wednesday 21st April 2021, and the outputs will form the basis of a future post.

Discussing the next phase of the design work

The new facility is drawing ever closer!

The MalDent Project is presented at the UUKI International Higher Education Forum 2021

A few weeks ago I was privileged to be invited to participate in a breakout session at this year’s Universities UK International Higher Education Forum. I am very grateful to Professor Paul Garside, our Dean of Global Engagement (Middle East & Africa) at the University of Glasgow, who had suggested to the organisers that the MalDent Project would be a suitable example of a capacity building collaboration between a UK HEI and a university in a low-income country.

The conference took place on 13-14 April 2021.

The MalDent Project presentation was part of the following breakout session:

The session was chaired by Professor Richard Follett, Deputy Pro-Vice-Chancellor & Associate Vice President (International), at the University of Sussex. There were three 10 minute presentations, followed by a discussion between Dr Joanna Newman, Chief Executive & Secretary General of the Association of Commonwealth Universities and Professor Follett.

The first presentation was delivered by Professor Ernest Aryeetey, Secretary-General of the African Research Universities Alliance. I had heard Professor Aryeetey speak previously in Glasgow at the ‘Capacity Strengthening in Africa Symposium on 28 February 2020, when an MOU was signed between the University of Glasgow and the African Research Universities Alliance.

Professor Sir Anton Muscatelli, Principal of the University of Glasgow and Professor Aryeetey signing the MOU

Professor Aryeetey laid out very clearly the importance of the higher education sector in African countries and provided clear insights into ways in which UK HEIs could provide support.

At the outset, he delivered three main messages:

He then spoke about the fundamental importance of investment in Africa’s higher education sector, with a particular emphasis on partnerships and collaboration:

The significant value of international research collaborations was illustrated in a slide that demonstrated how research outputs in least developed countries were increased significantly by working together:

Prof Aryeetey developed this theme further, stressing the importance of international partnerships to strengthen HEIs in Africa:

He looked at various options, some of which resonated very strongly with ongoing interactions between the University of Glasgow and the University of Malawi College of Medicine:

Professor Aryeetey’s concluding slide gave a very clear steer on how ARUA viewed the way forward:

Our presentation on the MalDent Project was the second of the 10 minute presentations. Those who follow our blog will be very familiar with the various components of the work stream and the progress we have made to date. Our contribution to the meeting was to provide an illustration of an ongoing partnership between a UK HEI and a university in a low-income country, with a focus on capacity-building.

The question I was asked to address was:

What are the mutual benefits of partnerships such as the MalDent Project and why should UK universities be supported financially to implement projects such as this?

One of the main capacity building successes of the MalDent Project to date has been the establishment of Malawi’s first Bachelor of Dental Surgery degree programme, based at the University of Malawi College of Medicine:

Malawi’s first ever BDS students at the launch of the degree course in August 2019

However, this is only one element of a much broader programme, which includes work to develop a national oral health policy, with an emphasis on disease prevention. The strong collaboration between the University of Glasgow and the University of Malawi College of Medicine is under-pinning developments that are of direct value and interest to the citizens of Malawi.

Simultaneously, the partnership brings significant value to the University of Glasgow, in the context of its vision in the 2025 strategy to be The World Changing University:

The basis of the established interaction between the University of Glasgow and the University of Malawi College of Medicine embraces three key principles, which I was keen to highlight:

In the context of the MalDent Project, it was our Malawian colleagues who sought advice with issues relating to oral and dental health in their country. In turn, we responded by developing in partnership the work programme that forms the basis of the Maldent Project. In doing so, we have established strong bonds of respect and trust, which have been, and continue to be, essential to our ongoing progress.

The partnership working has expanded far beyond the two central HEIs involved, as I demonstrated in a slide towards the end of the talk. Links with government, professional and civic organisations, charities, NGOs and the broader health sector are critical and illustrate the point that Professor Aryeetey was making about the centrality of strengthening Africa’s HEIs for the common good. Universities carry a major civic responsibility, both locally and globally, a duty which activities like the MalDent Project illustrate very clearly.

The network of partners involved in the MalDent Project

Finally, I was very keen to thank the Scottish Government for its tremendous support of the Maldent Project. It is true to say that without the financial backing of the £1.3m grant from the Scottish Government Malawi Development Funding Round 2018, virtually none of what has been achieved would have been possible. It, therefore, seemed very apt to close with a photograph of Ben Macpherson MSP, former Minister for Europe, Migration and International Development, on a visit to the Lilongwe campus of the University of Malawi College of Medicine, when we had the privilege of explaining our work and showing how the Scottish Government investment was being used.

(L to R): Jeremy Bagg, Peter Chimimba (College of Medicine MalDent Project Lead), Ben Macpherson MSP and Mwapatsa Mipando (College of Medicine Principal)

The final 10 minute presentation was delivered by Mostafa Al-Mossallami, who is the lead adviser on higher education and skills at the UK Government Foreign, Commonwealth & Development Office (FCDO). He talked about the Strategic Partnerships for Higher Education Innovation and Reform (SPHEIR) programme , which aims to strengthen higher education in focus countries to better meet the needs of students, employers and societies. His talk spoke to the question:

‘How is SPHEIR supporting universities in low-income countries to contribute to national development and what role does the FCDO see for higher education in the longer term for global development?’

The breakout session closed with a very interesting discussion between Dr Joanna Newman and Professor Follett on some of the issues raised in the three presentations, giving consideration to whether the newly created FCDO should invest in higher education reform and, if so, why.

It was a really enjoyable 60 minutes. For any of you who would like to view the session in its entirety, it can be accessed below:

Many thanks to UUKI team members Richard Grubb (Senior Policy Officer, sub-Saharan Africa & International Development) and Anna Zvagule (Communications Officer) who briefed us all very fully and ensured that the technical aspects ran smoothly.

Ministry of Health Technical Working Group gives ‘green light’ to Oral Health Policy drafting

At the National Oral Health Policy Workshop held in Lilongwe on 13th and 14th February 2020, Brian Chaima from the Ministry of Health Planning Department provided a clear exposition of the stages that are required to develop a new policy in Malawi. This sequence of activities is explained in detail in an earlier post on this blog, but in summary the first steps are to produce a Concept Paper and a Narrative Review of existing relevant literature, together with completion of a detailed Situation Analysis.

The Oral Health Policy Task Force has now met via Zoom on 13 occasions, with scheduled two hour meetings taking place twice per month. Final drafts of the three preparatory documents listed above were completed by March 2021 and the next stage was for the Ministry of Health Essential Health Package Technical Working Group (EHP TWG) to consider the work completed to date and, if satisfied, to provide a mandate to the Task Force to draft the Oral Health Policy Document itself.

With financial support from the MalDent Project grant, a meeting of the EHP TWG was set up in the Viphya Conference Suite at the Sunbird Capital Hotel in Lilongwe on Thursday 8th April 2021. Those members who were local attended the meeting in person, with appropriate social distancing, whilst others of us joined via Zoom.

Annie Mwapasa, the MalDent Project Administrator at the University of Malawi College of Medicine, made an excellent job of organising and running the meeting. I joined from my desk at Glasgow Dental School.

The EHP TWG meeting about to commence – online for those of us who could not get to Lilongwe in person

In the two weeks prior to the meeting, we had prepared a slide deck so that we could give a detailed presentation to the TWG members. Peter Chimimba, the Maldent Project lead at the College of Medicine, had travelled to Lilongwe from Blantyre and he made an excellent job of delivering the presentation to the delegates.

Peter Chimimba shows our opening slide to introduce our work to date

The three images we chose for the title slide included photos taken during the pilot oral health survey conducted by Smileawi in 2019 in six schools, a photograph of Peter with Ben Macpherson MSP when he visited the College of Medicine Lilongwe campus in September 2018 and finally, one of the images from the Stage 1 design work for the new dental teaching facility and student hub planned for the Blantyre campus of the College of Medicine.

Peter took the TWG through key details of the Policy Concept Paper…

the Narrative Review and the Situation Analysis…

The presentation and the three documents themselves stimulated a lively discussion, with many interesting and valuable perspectives aired by those present.

Ultimately, it was agreed by the TWG that our preparations were in order and that we should now proceed to draft the Policy Document itself, informed by all the previous work we have completed. That drafting will now form the basis of the continuing twice monthly meetings of the Task Force. We have set the end of June 2021 as the deadline for completion and approval of the policy, so we have our work cut out. However, there is a real determination and drive from those involved to move forward and to progress to the implementation phase of the work, which will be critically important if we are to convert the words that appear in our policy into actions that improve the oral health of Malawi’s citizens.

Grateful thanks are due to Noel Kasomekera, Technical Assistant – Non Communicable Disease Unit and National Coordinator, Malawi NCDI Poverty Commission, Ministry of Health Headquarters, for facilitating the EHP TWG meeting and for his continuing outstanding support of the Oral Health Policy Task Force.

Turning challenge to success -Smileawi and friends collaborate on a digital learning oral health initiative for Malawi

Those of you who follow our blog will be very familiar with Nigel and Vicky Milne, who established and direct the charity Smileawi. Their charity is a very close partner of the MalDent Project, as is Bridge2Aid, with whom we collaborate on several fronts.

Enjoying a break in the sun during the Smileawi Dental CPD meeting in Mzuzu, June 2019

I can be lazy in writing this blog post, because Nigel and Vicky have already published their own blog which describes in detail the recent project I would like to highlight. It’s a great read and you can access it here.

The comments I would like to make relate more to the way in which collaboration, joint working and mutual trust continue to play a central role in the efforts we are all making to improve oral health in Malawi.

The original grant awarded to Smileawi from Scottish Government had been to fund a collaboration between themselves, Bridge2Aid and the Dental Association of Malawi on a pilot task-shifting programme to teach Medical Assistants the fundamentals of emergency dentistry. When this was postponed in June 2020 as a result of the pandemic, it became necessary for Smileawi to identify a way in which the funding could be utilised by 31st March 2021 on an alternative project, which would retain relevance to the original concept but would be feasible under COVID-19 restrictions.

Bridge2Aid already had strong connections with a digital dental education platform called ProDental CPD. They were working together on oral health related materials that could be loaded onto smartphones and used in their work with Tanzanian health care workers. During a brain-storming session between Smileawi, Bridge2Aid, the Dental Association of Malawi and the MalDent Project, a concept for a project to produce 12 modules of dental educational materials that would be hosted by ProDentalCPD was hatched. These modules would be provided to Malawian dental therapists who could claim CPD following successful completion. Other details of the final package can be found in Nigel and Vicky’s blog. The proposal for re-configuration was accepted by Scottish Government and on 31st March 2021 the modules were launched.

The following aspects of this project are worthy of note:

  1. As a result of pre-existing collaborations and working relationships established between the various parties involved, it was possible to demonstrate a nimble and agile response to the re-profiling of the original proposal.
  2. This was a true collaboration between the Malawian and UK organisations involved, ensuring that the materials produced were relevant in the Malawian context. The Project Coordinator in Malawi, Dr Martha Chipanda and the Secretary of the Dental Association of Malawi, Dr Wiston Mukiwa, worked tirelessly with the equally industrious UK team to develop and test the educational materials.
  3. Sustainability is at the core of this work, which supports high level ambitions of the MalDent Project in relation to support and development of the oral healthcare workforce.

The list of acknowledgements at the end of Smileawi’s blog demonstrates what a truly collaborative effort this has been. There is now the opportunity to assess these materials in the field, before rolling them out more widely. Both Martha Chipanda and Wiston Mukiwa are members of the Ministry of Health Task Force which is developing an oral health policy for Malawi, and tools such as the one developed in this project have great potential in support of oral health policy implementation. This integration of approach bodes well for the future.

Induction week for the latest recruits to the BDS course at the University of Malawi College of Medicine

It was smiles all round recently as the latest group of students who have been selected to join the Bachelor of Dental Surgery programme at the University of Malawi College of Medicine were welcomed onto their Foundation Course, prior to entering BDS 1 in 2022. In due course they will form the third cohort of students to enter the new programme. Their induction was led by Dr James Mchenga, who is the academic head of the course and Dr Peter Chimimba, who is the overall lead in Malawi for the Scottish Government-funded MalDent Project.

Peter and James in full flow at the induction event for the BDS Foundation students

The students wore masks and followed the social distancing rules as they listened attentively to James and Peter.

A rapt audience for Dr Peter Chimimba

It seems to me only a short while ago that my University of Glasgow colleague, Dr Petrina Sweeney, and I were in this same lecture theatre in August 2019, participating in the induction event for the very first cohort of dental students. I am impatient for the easing of travel restrictions when I will once again be able to return to Malawi and interact directly with the students and my College of Medicine colleagues!

At that initial induction event in 2019, James had only just joined the College of Medicine. He is now well established in his role as Head of the BDS course and working hard to provide an excellent experience for the students and to develop the careers of the four junior members of staff who have been appointed as Assistant Lecturers.

Dr James Mchenga encouraging his latest students

It is wonderful to see this photograph of James and Peter with a further group of enthusiastic young people who are destined to join the team of dental professionals on the journey towards ‘Oral Health for All‘ in Malawi.

A lovely group photograph at the start of these students’ journeys to become part of Malawi’s dental workforce, under the guidance and tutelage of James, Peter and their colleagues

The final words should be left to Peter and James as they reflect on the progress to date.

Peter said:

Despite the Covid restrictions, the induction for our BDS ‘Foundation’ students went very well. We pretty much followed the induction we had 2 years ago when you and Petrina were here. I hope that this will be the standard going forward. It was delightful to see 23 students including 9 female,  young and enthusiastic and eager to learn. This augers well for Dentistry in Malawi. We crossed yet another historic milestone on this journey. With this third cohort of Dental Students we now have more dental students than registered dentists in Malawi. I feel very proud to be part of this process. Many thanks to the Maldent Project, to you Jeremy and the Glasgow University Dental School and the Scottish Government  for all the support given to us and COM. I look forward to many more years of collaboration with you.

James said:

It was double joy and excitement through and through when we met the largest group of dental students at the College of Medicine yet! And this happened on the day that the third Assistant Lecturer, Dr Don Chiwaya, landed in Johannesburg to commence his post graduate studies in Dentistry at the University of the Witwatersrand, following Dr. Tasneem Chikwatu and Dr Miriam Chipinga who had left 2 weeks earlier. On the same day Dr Nathan Lungu submitted his study visa application at the South African embassy in Lilongwe and we are hoping that he, too, will join his colleagues in the next week or so. So, the dream is becoming a reality and that is exciting.

Successful on-line Flying Faculty delivery of ‘Introduction to Dentistry’ teaching

In a previous post we described the generous financial support from the Scottish Government for the purchase of a large number of digital devices to enable the commencement of on-line teaching for students at the University of Malawi College of Medicine during the COVID-19 campus closure. In addition to under-spend from the MalDent Project as a result of cancellation of international travel plans, the Scottish Government provided a further major additional contribution.

Following receipt of the funding, the College of Medicine rapidly purchased a large consignment of tablet computers, which were distributed to students who required them by drivers from the College vehicle pool. Support was also provided with provision of inexpensive data bundles.

These devices were in heavy use by BDS students during the week beginning 1st February, when two of my good colleagues and I joined forces with local College of Medicine faculty to deliver a programme entitled ‘Introduction to Dentistry’. Richard Welbury, Al Ross and I had been due to fly out to Malawi in March 2020, to deliver the programme in person, but the trip was cancelled two weeks before we were due to leave, on account of COVID-19. The availability of the digital devices for the students had now facilitated delivery of much of our planned material through Zoom.

Professor Richard Welbury was previously our Professor of Pediatric Dentistry at Glasgow Dental School, a former Dean of the Dental Faculty of the Royal College of Physicians & Surgeons of Glasgow and a past President of the International Association of Paediatric Dentistry. Dr Al Ross is Senior Lecturer in Human Factors in Healthcare at Glasgow Dental School and a leading international figure in the field of human factors. Between the three of us we put together a series of presentations relating to paediatric dentistry, communication skills, patient safety, infection control, oral infections, antimicrobial drug use / abuse and antimicrobial stewardship.

On Day 1 we held an introductory session with both the local and Scottish teaching faculty to familiarise the students with the plans for the week’s events.

Introduction of the local and Scottish teaching faculty

The local faculty, Drs James Mchenga, Peter Chimimba, Wiston Mukiwa and Jessie Mlotha-Namarika, provided additional sessions on periodontology, oral medicine and on issues relating to professional regulation.

For my own part, I thoroughly enjoyed interacting with the students. We covered multiple aspects of oral infection ….

Introduction to dental plaque microbiology and plaque-mediated oral diseases

… principles of infection control…

… practical aspects of infection control in dentistry …

… and appropriate use of antimicrobial agents

The recordings of the lectures and the Powerpoint presentations have all been made available to the students in support of their ongoing learning and revision.

A formal post-course questionnaire has been issued to the students so that we can learn from their feedback how to enhance our delivery of on-line teaching for the future.

The COVID-19 pandemic has caused havoc in many ways with education in schools and universities. However, as teachers we have been forced to learn rapidly the principles and practice of teaching and assessment on-line. For international educational initiatives, such as the MalDent Project, it has emboldened us to embrace digital technologies and harness them to our advantage. In this era of serious climate change concerns and the need to make careful choices about volume of air travel, our learning from courses such as the one described above will actually help us to engage in a more regular and sustainable way with students overseas. To quote a famous French artist:

There are always flowers for those who want to see them

Henri Matisse

Thanks are due to the Scottish Government for financial support towards purchase of the digital devices to allow equitable access of all College of Medicine students to on-line teaching. We would also like to thank Ev Wallace at Glasgow Dental School and Annie Mwapasa, the College of Medicine MalDent Project Administrator, for their support in the organisation of the ‘Introduction to Dentistry’ programme.

The MalDent Project is cited in a recent FDI World Dental Federation report

The MalDent Project has recently been cited as a case study in a new report from the FDI World Dental Federation.

The FDI World Dental Federation is an international, membership-based organization that was founded in 1900. It acts as a representative body for over one million dentists worldwide, and is involved with around 200 national dental associations and specialist groups in close to 130 countries. The organisation is based in Geneva, Switzerland, from where it pursues its mission to lead the world to optimal oral health.

The report in question is entitled Vision 2030: Delivering Optimal Oral Health for All’. The document was published on 18th January 2021, to coincide with the 148th session of the World Health Organisation Executive Board, where an oral health resolution was on the agenda for adoption by governments.

The membership of the Vision 2030 Working Group was as follows: Michael Glick (Co-Chair), David M. Williams (Co-Chair), Ihsane Ben Yahya, William W. M. Cheung, Enzo Bondioni, Pam Clark, Stefan Listl, Manu Raj Mathur, Peter Mossey, Hiroshi Ogawa, Gerhard K. Seeberger, Michael Sereny.

Professor David Williams, one of the co-chairs said: “Vision 2030 outlines the ways in which we can integrate our profession within global development agendas, including the UN Sustainable Development goals and the implementation of universal health coverage, that determine important health priorities.”

Fellow co-chair Professor Michael Glick said: “How can we, as members of the oral health community, anticipate transformational changes and trends in the global healthcare environment? How do we seize opportunities to become productive members of healthcare teams delivering person-centered care? These are some of the broad questions we strive to answer through Vision 2030.”

One of the key issues relates to better integration of oral health within overall health, an ambition that is central to the work currently underway by the MalDent Project team in conjunction with the Ministry of Health & Population and other stakeholders on the Oral Health Policy Taskforce in Malawi. Many of the other principles cited in the FDI Vision 2030 document also resonate with the Maldent Project activities.

We were delighted when we were approached by the Working Group to provide a short Case Study of the MalDent Project for inclusion and here it is:

Both the FDI Vision 2030 report and the oral health resolution adopted by the WHO are very important developments for the enhancement of oral health globally and of very special relevance to the work of the MalDent Project. The web-links in the narrative above to the Vision 2030 report and the WHO resolution provide easy access and are strongly recommended to all who have an interest in this area.

I would like to thank the Vision 2030 Working Group for all their work in producing such an excellent document and for having invited us to provide an illustrative example of some of the principles espoused.

The MalDent Project presents on partnerships in health education at Bridge2Aid Conference: ‘Global Remote and Rural Healthcare’

One of the distinguishing features of the Maldent Project is its close interaction with a number of charity partners. These include Dentaid, Smileawi, the Borrow Foundation and the organisation which is centre-stage in this post – Bridge2Aid.

I was introduced to Shaenna Loughnane, the Chief Executive Officer of Bridge2Aid (B2A), by Andy Evans, Chief Executive Officer of Dentaid, at the Scottish Dental Show in 2018. By then, the MalDent Project was already working closely with Dentaid on collection and refurbishment of dental equipment bound for the Dental Department at Kamuzu Central Hospital (KCH) in Lilongwe.

Shaenna explained the task-shifting model that B2A had developed which delivers training in emergency dentistry for Clinical Officers based in rural Tanzania. It immediately became clear that a model of this type could prove valuable in Malawi, which faces similar dental workforce challenges. Subsequently, Shaenna invited me to visit a B2A training programme in Tanzania, which was a real eye-opener as to the amazing results that could be achieved with their methods of training. Since then, Shaenna and her team have been working with the Malawi Government Ministry of Health & Population and the Dental Association of Malawi around introducing B2A’s task-shifting model to rural Malawi. A pilot programme, planned for June 2020, had to be postponed because of COVID-19 but is being re-scheduled for 2021.

In addition to our partnerships with charities, the MalDent Project has also received great encouragement and support from the company Henry Schein Dental, thanks to the interest shown by Patrick Allen, their Managing Director for the UK and Ireland. For example, the re-equipping activities at KCH were aided significantly by involvement of Jonathan Langley, a UK Henry Schein engineer, whose expert services were provided completely free of charge.

The following video is a very interesting discussion between Patrick and Shaenna, which gives a flavour of the enthusiasm and energy of these two colleagues for the partnership work we are all doing to improve oral health in low- and middle-income countries.

Patrick Allen and Shaenna Loughnane in conversation in 2019

For an organization led by someone with Shaenna’s energy and enthusiasm, it has not been surprising that despite the impact of COVID-19 on the training programmes run by B2A, other avenues for meaningful activity have been identified. One of these was the concept of an international e-conference which would bring together participants from across the globe to discuss a variety of issues relating to remote and rural healthcare. Those of us who have been involved in conference organization know what a huge amount of work is entailed, and for this type of on-line meeting there are additional complications such as consideration of delegates’ time zones. However, the conference was duly announced – a partnership between B2A and a well-known and respected on-line educational platform called ProDentalCPD:

This was an intense conference, delivered as six sessions over two days, as outlined below:

The programme for day 1
The programme for Day 2

Mwapatsa and I were delighted to have been invited to participate in the session ‘Partnerships in Health Education’, chaired by Bridge2Aid volunteer Kiaran Weil. We presented along with Dr Meredith Giuliani, a radiation oncologist and Education Director at the Princess Margaret Cancer Centre in Toronto who described a health education partnership with the King Hussain Cancer Centre in Jordan. The content of that session is available to view in the following video:

It was uncanny that so many of the principles of partnership working that we described from our experiences of the MalDent Project were mirrored in Meredith’s excellent presentation. There is definitely scope here for some joint working in 2021.

This conference was a tremendous success. Many congratulations must go to Shaenna and her team at B2A and also to Rob Dyas at ProDental CPD, whose technical wizardry kept things running smoothly. In due course, much of the conference content will be uploaded to YouTube and relevant links will be added to this post when they become available.

Let’s hope this COVID-19-induced innovation from B2A and ProDental CPD is not a one-off event – the MalDent team is already looking forward to the next one!

Big Smile Big Band and Smileawi’s Christmas Wish

Those who are regular followers of our blog will know of the partnership working between the MalDent Project and the charity Smileawi. Our first joint endeavour was a very successful pilot child oral health survey carried out in Malawi in July 2019, which was a collaboration between Glasgow Dental School’s Community Oral Health Research Group, six senior students from Glasgow and Dundee Dental Schools and Smileawi.

The successful team of Smileawi volunteers and dental students on their return with the survey data!

Since then, a strong working relationship has also developed between Smileawi, Bridge2Aid, the Dental Association of Malawi and the MalDent Project, leading work to establish a task-shifting emergency dentistry training programme in Malawi.

Like all charities, Smileawi is highly reliant on donations from members of the public. As a result of the COVID-19 pandemic, 2020 has been a very difficult year for fund-raising. Nigel and Vicky Milne, the founders and directors of Smileawi, are both University of Glasgow Dental School alumni and by a happy coincidence a festive on-line fund-raising opportunity arose at their alma mater.

Glasgow Dental School is immensely fortunate to have its own musical troupe – the Big Smile Big Band. Its founder and director is Callum Wemyss, a Class of 2016 Glasgow dental alumnus, who established the band whilst still a student and has maintained his role as band leader since qualifying. He is now a Specialty Trainee in Oral Surgery at Glasgow Dental Hospital & School, so he has returned home to his band’s base! Such is Callum’s drive and enthusiasm that many fellow alumni, as well as current staff and students, continue to support and perform with the band.

In full swing at the Big Smile Big Band event at the SEC – making music with local schoolchildren

Clearly the COVID-19 pandemic has brought an end to live events, but earlier in the year the band put together two on-line songs by individually recording their parts and then submitting them to be digitally edited together into final performances. These so-called ‘Dental Lockdown Sessions’ were part of a very successful fund-raising initiative for Glasgow’s Prince & Princess of Wales Hospice, led by another Glasgow dental alumnus, Clive Schmulian.

A few weeks ago I met Callum by chance in the Dental Hospital. He was toying with the idea of pulling the Big Smile Big Band together digitally again, to record two Christmas songs. Callum was keen to incorporate a fund-raising element into the project and we decided to have a discussion with Nigel and Vicky, about a plan to make Smileawi the recipient charity. Since then, the project has come together and the two songs were launched at 8pm on Tuesday 22nd December to an on-line audience.

It was a fantastic event and for those who were unfortunate enough to miss it, you can see it on ‘Big Smile Big Band Catch up TV’ here:

Massive thanks are due to Callum and all the members of the Big Smile Big Band. Special thanks also to Roger Marsh who completed the audio mixing (as well as playing trombone!) . Finally, big thanks to Clive Schmulian for kindly providing access to the digital platform and to Clyde Munro for sponsoring the event.

If you have just listened to the performances and would like to donate to Smileawi, you can still do so at:

Merry Christmas and warmest good wishes to all for 2021!