Paula Houston is a dental student at the University of Glasgow. She undertook her elective project in Malawi between the fourth and fifth years of the BDS course. This is her reflection on that elective experience.

In June 2019 I was fortunate enough to travel to Malawi with fellow BDS students, dentists and volunteers with the charity ‘Smileawi’. We were conducting a survey of the prevalence of dental caries in children aged 5-12 years in rural primary schools across the country. We visited six schools in total and surveyed more than 2600 children’s teeth. I believe it will be the largest study of its type among children conducted in Sub-Saharan Africa and it was an invaluable experience.

As a group we discussed and strategized over the daunting task of charting 3000 children’s dentition within the narrow timeframe that we had. (It would require seeing a patient every 2 minutes on average).

We used basic fold down dental chairs (manufactured by the charity Dentaid), a plastic mirror, some cotton wool and a head torch. We took it in turns to assess the patient and to scribe the results and swapped roughly every 20-minutes when inevitable fatigue set in – in order to minimise human error.

In addition to gaining significant data, we were able to give the children of Malawi a positive impression of dental treatment. Unlike children in the UK, most (if not all) of the children that we looked at had no previous experience of dentistry and this survey stood as an opportunity to acclimatise them to dental treatment. It was so encouraging to see how cooperative the children were and how excited they were about our visit!

We had some local Malawian volunteers who helped the children complete the questionnaires and also taught us some useful local phrases.

‘Yasa Mula’ – Open your mouth

‘Yasa Mula Chomeni’ – Open your mouth very much

‘Tawonga chomeni’ – Thank you very much.

These basic words got us by, although admittedly on occasions we mixed up ‘thank you’ with ‘open your mouth’ and had children climbing off of the table post-exam, then jumping back on with wide open mouths in perfect obedience!

For each school that we visited we also spent some time teaching the children some basic oral hygiene and delivering tooth brushing instruction. With the help of our translators, we conjured up a song which reminded the children to brush their teeth twice a day. It wasn’t a chart topper, but it was certainly trending in Malawi! One of the moments that really stands out to me on this trip was hearing an assembly of children singing our song back to us in both Tumbuka and English.

It was an educational trip and checked a box in completion of our required university project, but in the end, it was so much more than that to all of us. Not only have I fallen in love with the beautifully kind people of Malawi, but I am left in awe of the incredible work that Smileawi conduct annually. This small charity, founded by Nigel and Vicky Milne, has made such a noticeable difference to the rural villages of Northern Malawi. They provide emergency dental treatment, in addition to funding dental therapy students to complete their education and provide materials to DCP’s working throughout the country. Furthermore, Smileawi has funded the construction of a kitchen at one of the schools we visited, in order for the children to be fed at school and encourage attendance.

I left Malawi with some great memories, great friends and a great desire to return and help as a dentist in the future.

This post relates to the second phase of a visit I made to Malawi last June. It has been delayed in publication and forms the first of a series of four posts which cover an exciting collaborative project that took place between the charity Smileawi and dental students from Glasgow and Dundee Dental Schools. Three of the students have written reflections of their experiences, which complete the ‘mini-series.’

My involvement started with a very early morning flight on Tuesday 11th June from Lilongwe to Blantyre, following meetings on the previous day with Paul Tasman from Bridge2Aid, Ministry of Health officials, Wiston Mukiwa from the Dental Association of Malawi, and the Christian Health Association of Malawi (https://www.themaldentproject.com/2019/06/23/with-the-scotsman-bridge2aid-and-malawian-partners-in-lilongwe-two-busy-days/). Chris, a local taxi driver, picked me up from my hotel at 04.30 and I caught the 06.15 flight south. We landed at 06.50 and I was picked up by a College of Medicine driver who delivered me to my hotel.  After some breakfast I headed straight to the College of Medicine and met with the Principal, Dr Mwapatsa Mipando, and his PA, Lucy Msiska. Following a variety of discussions during the day at the College of Medicine I returned to the Sunbird Mount Soche Hotel for some dinner and an early night.

On the Wednesday Peter Chimimba arrived after breakfast to pick me up and deliver me to the College of Medicine. He was accompanied by Martin Laird and Rosie Grimes, two Glasgow BDS 4 students who had arrived in Blantyre the previous Thursday and who, at the generous insistence of Peter and his wife, Frider, were staying at their house. With the impending enrolment of the first group of BDS students at the College of Medicine, I had been keen to engage students at Glasgow Dental School with the MalDent Project. Ultimately, we would aim to establish a  student exchange programme between the two schools. I was, therefore, delighted that Martin and Rosie had chosen to visit the College of Medicine for their elective project this year.

On arrival at the College of Medicine, we went straight to the office of Professor Nyengo Mkandawire, Dean of the Faculty of Medicine, where I was presented with a bound copy of the BDS curriculum and the signed certificate from the University of Malawi Senate confirming its approval. This was symbolic of the completion of the first milestone in the MalDent Project – partnership working to achieve an approved BDS curriculum.

Next, we headed to the other side of the Library Building to see Peter Chimimba’s new office. In addition to his office, Peter now also had an assistant, Annie Mwapasa, who had recently been appointed with support of the Scottish Government funding of the MalDent Project. This was great progress as Annie’s role would be essential when the first BDS students were enrolled, as well as the management of the other strands of the project linked with policy development at the Ministry of Health and the design of the new dental facility, together with its construction, on the Blantyre site.

That morning, Peter went with Martin and Rosie to visit a primary school in Blantyre, which they reported later to have been a great success. I had a significant amount of written work to complete linked to the elective students’ project with Smileawi, so I spent much of the day working in Peter’s new office.

At 12.30pm I decided to have a break and head to the Beit CURE Café for some lunch. By chance I met Martin, Rosie and Annie heading to the same venue and then, whilst there, we met the team from the University of Glasgow Institute of Infection, Immunity & Inflammation who were busy installing laboratory equipment as part of the Scottish Government-funded Blantyre Blantyre Project. Inevitably, we decided to have a group photo – far too good an opportunity to miss!

During the evening, Martin and Rosie treated Peter, Frider and I to dinner at 21 Grill, a very nice restaurant at Ryalls Hotel. It was a lovely evening and one way in which Martin and Rosie were able to show their appreciation for the exceptionally kind and generous hospitality afforded them by Peter and Frider during their stay in Blantyre.

On the Thursday, Martin, Rosie and I headed to Mulanje to visit some friends of Martin’s that he had got to know many years previously as part of a twinning project between his school in Lanarkshire and a primary school in Mulanje. You will be able to read Martin’s story in his own blog post which will be published shortly. For my own part, I would just wish to say that we met some utterly inspirational people on that day, including the most engaged and cheerful children I think I have ever met. My reflection, having met the teachers and children we came across, was that a caries prevention programme based upon the supervised toothbrushing model of Scotland’s  Childsmile programme would likely be adopted with enthusiasm.

On the Friday, Martin, Rosie and I, complete with our luggage, left the College of Medicine to head to Mzuzu. The College kindly provided us with a minibus and driver for the nine hour road trip north.

It was a long journey but by and large the roads were of good quality. We stopped and enjoyed lunch with our driver at Salima before the final push, arriving at Mzuzu just after dark.

Our home for the next two nights was ‘Joy’s Place’, a backpackers’ lodge which boasted a Korean Kitchen. There was a power cut as we arrived, so we checked in by candlelight, but shortly afterwards power was restored.

Just after we reached the lodge, Nigel and Vicky Milne, together with the rest of the Smileawi team, Conor O’Brien and our remaining elective students from Glasgow and Dundee arrived to greet us (see: https://wordpress.com/post/themaldentproject.com/621). They were staying nearby at Umunthu Lodge, and we agreed that we would all eat together there later that evening. An hour later the full team was assembled and we enjoyed a lovely meal together – an excellent introduction to Mzuzu for Rosie, Martin and I.

We were up early on the Saturday morning for breakfast, when we met Nathan Bradley, a Peace Corps volunteer who was a soil scientist from Virginia, USA. He was reaching the end of a two year visit to Malawi, and was working with a local group of beekeepers to put their honey through the various analyses and certifications necessary to allow them to export their product. He told us he frequently visited Joy’s Place, together with other Peace Corps volunteers, for relaxation at weekends.

After eating, we headed to the Saint John of God Conference Centre, where Smileawi had organised a conference for dental therapists. As part of the programme, Conor O’Brien, an oral surgeon from Glasgow Dental Hospital, had agreed to deliver a minor oral surgery update lecture and I was to provide a presentation on the problem of antibiotic resistance and the importance of antimicrobial stewardship. After lunch I had agreed I would provide an update on progress with the MalDent Project. The students from Glasgow and Dundee were also keen to speak about their background and  experiences to date.

One of the highlights of the day for me was meeting Edward Hara, who had worked in the area as a therapist for many years. I had heard a lot about Edward previously from my good friend Lisa Taylor who had worked as a VSO dentist in Mzuzu many years ago, shortly after she completed her masters degree at Cardiff Dental School. It was a great pleasure to meet him in person at the conference.

The Guest of Honour at the meeting was Dr Owen Msopole, from the Ministry of Health Directorate of Quality. We spoke at length during the morning coffee break and it transpired that he was a good friend of Dr Nedson Fosiko, with whom we had met in Lilongwe earlier in the week to discuss the Bridge2Aid initiative (see: https://wordpress.com/post/themaldentproject.com/834).

As with any self-respecting conference, a group photo was in order. It is hard to believe that by Malawian standards this was a winter scene!

Conor delivered an excellent presentation on minor oral surgical techniques, incorporating a significant amount of content on quality and governance issues.

More sun was lapped up during lunch, which was served outdoors.

Towards the close of the event, the four dental students who had been working with the Smileawi team delivered a first class presentation. They talked about their BDS course back in the UK and also described with great enthusiasm and clarity the work in which they had been engaged since arriving in Malawi. You can read more in their reflections that will be published immediately after this post.

The event finished with an excellent networking opportunity enjoyed over tea, coffee and snacks. It was fascinating and very valuable to hear from the therapists themselves about their day-to-day work. They were clearly very stretched because of the workforce challenges (nationally there are only 137 therapists in Malawi against a Ministry of Health establishment of 300). There was also great interest in the BDS programme which was due to commence at the College of Medicine in August 2019 and two of those present had submitted applications for entry.

After the conference, we all returned to Umunthu Lodge and turned to data entry from the hard copies of the clerking forms used for the dental inspections. This was a massive job, which the team had been tackling every evening until the sun set.  The industry and enthusiasm of the team was extremely impressive and by the time they left Malawi all of the data had been uploaded.

Once it became too dark to continue working, dinner was ordered and there was great conversation over a beer (or cider) or two! Adjacent to the eating area was a log-burning fire pit which was where the evenings ended, with a sense of time well spent and a tremendous team spirit.

Massive thanks are due to Nigel and Vicky Milne, the founders of Smileawi, for having invited our students to Malawi for this unforgettable experience. The joint working between Smileawi, the University of Glasgow and the University of Dundee has been an outstanding success and will hopefully continue long into the future.

On the Sunday morning, Martin, Rosie and I headed back south to Lilongwe – a drive of about five hours. There was some beautiful scenery and the following video clip gives an idea of the ‘road home’, which was not unlike some of our Scottish scenery:

That evening, I had invited Martin and Rosie to have dinner with me, as I was flying back to Glasgow the following day. As it turned out, Dr Mipando, the College of Medicine Principal, had arranged for Peter Chimimba and I to accompany him early on the Monday morning to deliver a presentation about the MalDent Project to the Senior Management Meeting at the Ministry of Health. As a result, Peter also had to come up to Lilongwe on the Sunday evening, so we all had dinner together.

It was a complete surprise when Steve Mannion, a well-known orthopaedic surgeon  (http://www.stevemannion.com), appeared in the restaurant. He had arrived that day with his team from the UK to undertake a series of operating sessions in Malawi. I know Steve as a result of sitting on the Royal College of Physicians & Surgeons of Glasgow Global Health Group (GHG). Indeed, it had been Steve who had stressed during my first attendance at the GHG in 2017 the importance of trying to develop dental services in Malawi, long before the MalDent Project had emerged. We had some excellent chat!

The following morning, the Principal, Peter and I had very positive feedback from those attending the Senior Management Meeting at the Ministry of Health. It was a most uplifting way to finish this visit to Malawi and as I headed to the airport I felt very buoyed by the enthusiasm and support that had been displayed.

I had a trouble-free journey back to the UK, arriving in Glasgow on the Tuesday morning. That afternoon we had our Dental School Prize Giving and the following day was BDS Graduation. Both were proud occasions for our students, relatives and staff. With Malawi still ringing in my ears, I reflected on what a great day it will be when the College of Medicine graduates its first cohort of dentists in Blantyre.

This is a guest post by Breffni O’Brien and Ciara Durkin from the Mackintosh School of Architecture, Glasgow School of Art

Earlier this month, two Mackintosh School of Architecture (MSA) stage 5 students, Breffni O’Brien and Ciara Durkin, took part in a stakeholders’ workshop at the University of Malawi College of Medicine, involving 25 senior academics, architecture students and architects.

This was a result of an invitation from Professor Jeremy Bagg, the Head of Glasgow University’s Dental School, to Professor Christopher Platt, MSA’s Chair of Architecture, to lead a workshop to inform the design process for a new building for the recently inaugurated Dentistry Degree Programme at the University of Malawi College of Medicine Blantyre campus.

Breffni and Ciara took a leading role in two of the workshop groups.

Ciara Durkin writes,

“The energy during the workshop was powerful and invigorating, with an holistic and beneficial exchange of ideas.  I enjoyed watching the Scottish and Malawian participants use this workshop to cement a common vision within a unique team of international and local collaborators.”

Breffni O’Brien writes,

“To be involved in such a collaborative and thought provoking design process was an incredibly unique experience. Being given the opportunity to contribute to such an exciting project and work alongside Malawian architecture students and the staff of the College of Medicine was an honour.”

Christopher Platt writes,

“Breffni and Ciara were hugely effective in how they worked closely with a range of academic and student stakeholders to explore the key issues which should inform the new building’s brief. They led some of the discussions, presented their group’s findings to the wider workshop body and used their architectural graphic skills to quickly sketch key ideas which could be easily understood to a lay audience. They were outstanding ambassadors for MSA and GSA and we all enjoyed the experience with Professor Bagg and his colleagues in Malawi enormously, which has established firm foundations for future collaborations.”

Partnership working is key to international development activities and we have been extremely fortunate with the MalDent Project to have established a network of enthusiastic, multi-skilled collaborators. That network developed another arm recently when Mwapatsa Mipando and I met Chris Platt, Professor of Architecture at the Mackintosh School of Architecture, Glasgow School of Art (https://wordpress.com/post/themaldentproject.com/966).

On Tuesday 3rd September I headed to Glasgow Airport to meet with Chris and two of his senior students, Ciara Durkin and Breffni O’Brien. We were heading to Blantyre for a site survey of the College of Medicine campus and a stakeholder workshop – all set up to inform a design brief and costing exercise for the new teaching facility that will house the clinical components of the Bachelor of Dental Surgery course.

We travelled via Dubai and Johannesburg.

Complications to our journey began after we landed in Johannesburg. First, the A380 from Dubai taxied too far towards the terminal building at the gate and we needed to wait for 20 minutes until a tug arrived to push us back to the correct position for the doors to be opened. We were seated at the back of the plane, so it took a long time to disembark and our connection was quite tight. After passport control we ran to the Malawian Airways desk, to be told that the flight on which we were booked was not available! After some extended phone calls by the ground staff, we were finally given boarding passes for a plane to Lilongwe and then an onward connecting flight to Blantyre.

As a result, we arrived at Blantyre Chileka Airport several hours later than planned, but remarkably so did our bags!

We were driven to the Sunbird Mount Soche Hotel by a College of Medicine driver, arriving at about 6.30pm. After a quick shower, I headed downstairs for a meeting with Dr Nedson Fosiko, Deputy Director of Clinical Services at the Malawi Government Ministry of Health, and Dr Peter Chimimba. We had a very positive discussion about the oral health policy development activities that are planned through the MalDent Project, and now have a clear way forward to commence the work.

Chris, Ciara, Breffni and I then had dinner together in the hotel and turned in early for some much-needed rest.

The next morning, after breakfast, we were collected by a College of Medicine driver and then headed to the College Library for a meeting with the Principal and Peter Chimimba.

The Principal laid out the history of the project and the need, now, to create a design and establish a costing for a new facility in which to deliver clinical dental teaching. Later in the morning we were joined by Peter Creaser, an architect from a local, well-established practice called MOD Architects. This company has worked on many projects at the College of Medicine through the years and Peter and his colleagues have extensive knowledge of the campus.

After these initial discussions in the Board Room, we enjoyed some refreshments and general discussion…

… a group photo

… then all headed outside to walk around the campus, armed with a site plan and Peter’s local knowledge. Chris, Ciara and Breffni took notes and many photographs for future reference.

Breffni and Ciara provided excellent support for Chris during the site survey.

Once the walk-round was complete, Chris, Ciara, Breffni and I went back to the hotel for a quick lunch. We were then collected and taken to the Polytechnic, which is part of the University of Malawi, to visit staff and students at the School of Architecture:

We were welcomed by the Head of the School, Ike Phiri, and introduced to a number of his staff colleagues and students. There was great enthusiasm for our visit and for their invitation to the stakeholder meeting the following day.

Chris presented Ike with a copy of the MacMag, which is an annual publication from The Mackintosh School of Architecture.

I was also delighted to meet Grace Phiri Zimba, the Estate and Development Officer for the Kamuzu College of Nursing, which is about to merge with the College of Medicine to establish the Kamuzu University of Health Sciences. Among her qualifications, Grace has a BSc in Architectural Studies from the Polytechnic. Grace is inevitably involved with the  establishment of the new dental teaching facility on the Blantyre College of Medicine campus.

Just before leaving we took a group photo and during the discussions that went on as people organised themselves for the shot, Ike mentioned that he had done his Masters degree in Dublin, Ciara and Breffni’s alma mater!

Just after the photograph was taken, Dave Rodocanachi from The Dental Warehouse in Johannesburg (a Henry Schein company) arrived. He would be providing expertise from a dental equipment perspective at the workshop the following day. Whilst Chris, Ciara and Breffni headed back to the College of Medicine to check out the venue for the workshop the following day, Dave and I headed back to the hotel and had a discussion in the bar based around a PowerPoint presentation on the equipping of a dental outreach teaching facility in South Africa which is currently in the final planning stages. There were a number of relevant learning points for the workshop the following day.

In the evening we were joined by the Principal for dinner at 21 Grill on Hannover. It was a good chance for many of us who would be participating in the workshop to get to know one another better. Peter Creaser from MOD Architects sat next to me and it was fascinating to hear about his career as an architect, starting in Lincoln but culminating in many years spent in Africa, particularly Malawi.

The following morning we set off from the hotel at 8.30am to set up for the workshop, which was held at the Research Centre at the College of Medicine campus.

Once the tables were laid out it was a matter of waiting for the many stakeholders to arrive and for the work to start. 

Whilst waiting for the event to commence …

… and Chris spent time speaking with Peter Creaser and his business partner Patrick from MOD Architects:

It was a very successful event. Chris first described how he had become involved in the MalDent Project and about his own background …

… before explaining the purpose of the workshop and how the day would be based around four tasks undertaken in small groups, with feedback delivered after each task.

The initial task aimed to identify the main themes that delegates believed to be important for consideration during the design of the building. These themes would then form the basis of the following three tasks, examining specific issues in increasing detail. The work undertaken is best described in pictures:

After each piece of group work, a spokesperson fed back for 5 minutes:

Chris made notes as each group fed back to the delegates:

After Task 1 was completed we broke for coffee and a group photograph:

During the coffee break, Chris identified and wrote up the main themes that had emerged from Task 1 on a flip chart. This was slightly refined following discussion with the delegates. The themes were then allocated to individual groups who would work on them during Tasks 2 and 3.

After Task 2 and feedback we enjoyed lunch, when the discussions continued on many fronts:

One of the advantages of the College of Medicine campus is the vista of the mountains and distant scenery, that can be viewed from so many angles. This was mentioned during the workshop as a feature that should not be forgotten when the new building was being designed.

For the final task we were asked to consider which of the three possible sites we would choose to erect the new building and to submit some relevant drawings. I found the latter particularly difficult, but Ciara was well versed in the concept and produced six drawings for Group A with no difficulty whatsoever.

By the end of the day, we had accumulated a very large number of feedback sheets:

When the meeting closed, Breffni and Ciara photographed all of the sheets. The hard copies were left with Ike who will use them for a design exercise with his architecture students at the Polytechnic. Chris, will work from the photographs of the sheets.

At the end of the event the Principal, Patrick from MOD Architects, Chris and I sat down to discuss the next steps. The outputs from the workshop would be used to inform a design brief, which in turn would allow a schedule of accommodation to be created and a cost estimate to be made.

We returned to the hotel, totally exhausted but very happy with the outcome of the day. After a couple of celebratory drinks in the bar, shared with Peter Chimimba, we had dinner and retired early in preparation for the start to our journey home at 5.15am the next morning.

Our driver arrived on the dot at 5.15am and everything went smoothly at Chileka Airport. It had been a whirlwind visit, packed with activity. As we headed out to the plane on the tarmac in the early morning light it was hard to believe how much had been achieved in just two days – an immensely successful outcome. 

On Thursday 15 August 2019, I set off from Glasgow to participate in the Induction Week for the first ever students to enrol on the recently approved Bachelor of Dental Surgery programme at the University of Malawi College of Medicine. It was a thrilling prospect! I was accompanied by my Glasgow Dental School colleague, Dr Petrina Sweeney, who would join me in delivering components of the Induction Week programme.

The journey was trouble-free and we spent the weekend completing the preparation of materials for our induction sessions. We also enjoyed time with Dr Peter Chimimba (Malawi MalDent Project Lead) and Prof Nyengo Mkandawire (Dean of the Faculty of Medicine), all of which helped to prepare us for the week ahead.

On Monday 19th August we met the students for the first of their induction sessions. Here they are, pictured with Dr Mwapatsa Mipando, Principal of the College of Medicine, in the centre of the group photo. The curriculum development and approval process had been arduous, but here was the result – and what a great result! It was the start of what would be a truly memorable week.

Following some initial introductory words from Prof Mkandawire, the Principal welcomed the students to the new BDS programme. In total, 10 students have been enrolled into BDS 1 (the Class of 2024) and 15 are commencing the Foundation Year before entering BDS 1 in 2020 (the Class of 2025).

Subsequently Peter, Wiston, James, Petrina and I introduced ourselves and spoke for a few minutes about our own careers in dentistry, to provide some background for the new students. We had a very broad range of experience between us, including primary care dentistry, hospital dentistry, academic dentistry and health services delivery, the latter of particular note since Peter and Wiston had both held very senior posts in the Malawi Government Ministry of Health at various points in their careers.

After a tea break, I delivered a presentation about the MalDent Project, to provide background context to the programme on which the students had enrolled, but also to stress the parallel work stream on oral health policy development and the need for prevention to form a core component of that policy.

The afternoon closed with a presentation by Petrina on some of the common oral disorders that the students would learn about over the course of their five year degree programme.

The following day, Tuesday, we were not required for Induction Week activities and instead we visited the Malawi University of Science and Technology (MUST) (https://www.must.ac.mw).

In a previous post I had described a recent meeting in Glasgow with Prof Wilson Mandala (https://wordpress.com/post/themaldentproject.com/988). Subsequently, Wilson, who is Executive Dean of the Academy of Medical Sciences at MUST, had arranged a very interesting itinerary for Peter, Petrina and I. Our first stop that morning was at MUST itself, which is about a 40 minute drive out of Blantyre in Limbe.

As described on its web-site, MUST was established by an Act of Parliament in 2012 “… with the aim of promoting the development, adaptation, transfer and application of science, technology and innovation for macro- and micro-economic development of Malawi”

Having passed through the entrance gates, the scale of this complex becomes clear immediately.

The first cohort of students was enrolled in 2014. MUST currently offers seven undergraduate and two postgraduate programmes in Engineering, Computer and Information Technology, Innovation and Entrepreneurship.

The Academy of Medical Sciences started its operations in 2018 with programmes in medical imaging, immunology and medical microbiology. This school also houses a large teaching hospital building, the operation of which is still undergoing development.

We were generously hosted by Professor Jonathan Makuwira, Deputy Vice-Chancellor, and we enjoyed a very productive meeting with him together with several other senior staff members. Two areas have emerged that may develop into collaborations with the MalDent Project:

• MUST runs a Bachelor of Engineering programme that focuses on Biomedical Engineering. There are possibilities for joint working in this area of training in the specialist field of dental equipment installation, maintenance and repair.
• There may be the possibility of developing a dental outreach ‘teach and treat centre’ in the hospital building which forms part of the Academy of Medical Sciences. Senior BDS students could work in this facility under the supervision of qualified dentists. The facility would also improve access to dental care for those living in and around Limbe, an area which is currently poorly covered by dental services.

After this very interesting and positive meeting we were treated to delicious refreshments, before heading back to Blantyre itself.

Following our meeting at MUST, Wilson took us to meet Professor Robin Broadhead who was Principal of the College of Medicine prior to Professor Maleta, who in turn was Dr Mipando’s predecessor. I had heard a great deal about the tremendous work of Professor Broadhead at the College of Medicine and it was a real privilege and honour to meet him over coffee in the lounge of his delightful house. Professsor Broadhead provided some very valuable advice on our plans to design and build a new dental teaching facility on the College of Medicine campus in Blantyre, based upon his extensive experience of other major construction projects for the College, including the associated fund-raising.

In addition to his medical and administrative knowledge and experience, Professor Broadhead is also a very talented artist and it was fascinating to visit his studio and see so many of his canvases, both completed and underway.

After bidding farewell to Professor Broadhead, Wilson drove us back to the Sunbird Mount Soche Hotel for a meeting with Mr William Mpinganjira, who is Deputy Managing Director of FDH Bank Ltd, based in Blantyre. We had a very valuable discussion during which Mr Mpinganjira provided clear advice on how to structure our proposal to potential funders in our bid to identify support for the construction of the new dental teaching facility on the Blantyre campus.

Wilson, Peter, Petrina and I then enjoyed lunch together at the Mount Soche Hotel. It had been a fantastic morning of meetings and I am very grateful to Wilson for setting them up for us.

That evening, the College of Medicine had arranged for all the MalDent team to have dinner at 21 Grill in Ryall’s Hotel, to celebrate the beginning of the BDS course. It was a lovely event and much appreciated by all present.

On the Wednesday morning we had a MalDent Project meeting. The many facets of the project resulted in a wide-ranging set of agenda items, but all linked and interconnected:

The Wednesday afternoon was filled with an induction session run by Peter, Wiston, Petrina and I for the BDS students. This included presentations and extensive discussions on the importance of prevention of oral disease, a description of the various specialties in dentistry, and some aspects of professionalism, with particular emphasis on the pros and cons of using social media channels in a professional context.

On the Thursday morning we were shown the preparations that were ongoing in the lecture theatre to prepare for the programme launch. The carpenters were hard at work and we were left to guess what was being built, because we were next due to participate in a third BDS student induction session.

This session had been billed as an opportunity for general discussion, providing an opportunity for the students to ask questions about dentistry as a profession and about the course ahead. Wiston, Petrina and I were joined for this session by Dr Jessie Mlotha-Namarika, the Head of the Dental Department at Kamuzu Central Hospital who, like Wiston, has been appointed as a part-time Clinical Lecturer for the BDS programme. It was a lively session with tremendous interaction from the students.

Petrina left this session slightly early to meet with Dr Joyce Gwonde, who is Dean for Students at the College of Medicine. This role carries significant responsibilities for the pastoral welfare of the students studying at the College of Medicine. Petrina has many years of experience as a Student Advisor at Glasgow Dental School and the two had arranged to meet to share experiences. It proved a very successful meeting and it was agreed that on return to Glasgow, Petrina would prepare some materials for me to deliver to Joyce during my next visit, scheduled for the near future.

I also left the induction session slightly early to meet Dr Susan Chichlowska, a Senior Lecturer in the Faculty of Public Health & Family Medicine at the College of Medicine. Susan was originally from the UK but has lived in Malawi for many years. Susan is involved in joint research projects with my colleagues Prof Peter Mossey and Mr Remus Chunda at the University of Dundee and I was keen to discuss some related issues with her. We had a very valuable discussion over a coffee at the Beit Cure Café and were subsequently joined by Petrina.

After lunch at the café, Petrina and I headed back to the main Lecture Theatre in the Library for the official BDS degree launch ceremony. It was a hive of activity as final preparations were underway. The carpenters had made a great job of decorating the stage and  the screen announced the launch of the BDS programme: 

A booth had been built which contained a sign announcing the new BDS programme behind a ribbon and bouquet:

A local band, The Melltones, was playing and singing to welcome guests to the event. I had heard this group previously on an earlier visit, when Peter and I were enjoying dinner at 21 Grill, and had commented then how great they sounded, so it was fantastic to hear them again.

We were ushered to seats in the front row and the hall slowly filled up. The BDS students had pride of place and were joined by other staff members from the College of Medicine, Mrs Papeye from the Ministry of Health and members of the national media.

The event was chaired by Dr Diston Chiweza, the College of Medicine Librarian, who welcomed us all and began proceedings with a prayer.

He then invited Dr Peter Chimimba to describe the background to the long-standing ambition to establish a BDS degree at the College of Medicine, which stretched back over many years. Peter described the launch of the programme as having a potential impact on oral health care in Malawi akin to the impact for mankind of Neil Armstrong landing on the moon. It was an emotional speech which illustrated very clearly the excitement that the BDS programme was finally a reality.

Professor Nyengo Mkandawire was the next speaker. He gave a very clear exposition of the mission of the College of Medicine and how the commencement of the BDS programme fitted into the overall structure. He followed with an outline of the course structure and some of the next steps in the development of the programme, including the need to design, fund and build a clinical dental teaching facility on the Blantyre campus.

It is tremendous at last to see Dentistry on the list of undergraduate programmes available in the Faculty of Medicine:

I was then invited to the stage to provide a brief overview of the MalDent Project. It was a pleasure to be able to acknowledge the support of the many individuals and organisations that were involved, both locally in Malawi and internationally, particularly the Scottish Government and UK partners. The importance of developing an oral health policy for Malawi, through close working with the Ministry of Health, was something I stressed as a critical parallel strand of work to ensure that the students who would be trained at the College of Medicine would have a suitable environment in which to work following graduation.

After a musical interlude by The Melltones the Principal, Dr Mwapatsa Mipando, spoke of his excitement that the BDS course had now been launched. He then invited Mrs Papyeye to speak on behalf of the Ministry of Health. In her very positive speech, Mrs Papeye issued an invitation to the Principal to update the Senior Management Group on the progress with the MalDent Project at one their forthcoming regular meetings.

Following the speeches, the official ribbon cutting took place to launch the BDS programme. I was very honoured to be invited to share the ceremony with Mrs Papeye. We were each provided with pair of scissors to cut either side of the central bouquet … 

… which was then held aloft by the Principal and one of the BDS students. 

After all the work that had gone into the development of the curriculum and its approval by the University of Malawi Senate, together with the many years of campaigning by colleagues like the Principal, Peter, Wiston and Jessie, this was an emotional moment of celebration.

Finally, the Principal accepted a donation of dental materials from Central Medical Stores Trust (DFID), which had been donated to mark the occasion.

The launch event closed with a prayer from Dr Chiweza, following which all the guests were then invited to move to the hallway behind the Lecture Theatre for refreshments and networking.

This photo of Dr Peter Chimimba, taken at the launch event, shows the elation and happiness that so many of us felt now that the BDS programme had finally been launched.

Colgate had a trade stand and provided everyone with a bag containing oral hygiene products and a commemorative mug: 

A number of us were interviewed by the journalists present and both Petrina and I spent a long time talking with the dental students. This culminated in the request for a photograph and we were delighted that Dr Joyce Gwonde, the Dean for Students, was able to join us.

The final photo is a tribute to the three men at the College of Medicine who have worked so hard to make this BDS programme a reality – the Principal, Dr Mwapatsa Mipando, the MalDent Project Lead in Malawi, Dr Peter Chimimba and the Dean of the Faculty of Medicine, Professor Nyengo Mkandawire.

Finally, the Principal kindly drove Petrina and I back to our hotel and shortly afterwards both Peter and Nyengo joined us for a celebratory drink together in the hotel bar. It was a lovely way to close off the day, spending a while with these two great friends and colleagues who have been on the MalDent Project journey from the outset.

Petrina and I were booked on an early flight out of Blantyre Airport the next morning and were to be picked up at 5am for the drive to the airport, so after dinner we both retired early to our rooms to finish packing and get some sleep.

Walking across the tarmac to board the waiting plane at Blantyre Airport the following morning, I reflected on what had been one of the most rewarding and exciting weeks of my professional career. We will undoubtedly face significant challenges over the next few years but the course is now up and running with a group of very impressive young students and a very determined team of staff and partners.

My colleague Petrina, having now experienced Malawi and the staff and students of the College of Medicine, is already looking forward to a future visit, as was Niall Rogerson after he accompanied me last November. I have no doubt that the many other colleagues who are offering their support as Flying Faculty, now that the programme is running, will experience the same pull to keep returning to the Warm Heart of Africa and to support this fledgling BDS programme through its early years.

Following the installation of donated dental chairs and pre-clinical skills units (phantom heads) in May, by Dentaid and Henry Schein, (https://wordpress.com/post/themaldentproject.com/688), we are now on a joint mission to identify a further six dental chairs, ideally of the same type (Belmont Pro II) as recently installed, and a further six phantom heads for the Dental Department at Kamuzu Central Hospital. This week has taken us a long way forward.

I am just back from a round trip to Inverurie, a few miles north west of Aberdeen, to collect a Belmont Pro II dental chair that Stuart Bassham at Dentaid had been contacted about. Once again I had visited Leslie Commercials in Hawthorn Street, Glasgow, for a suitable van.

Literally whilst I was waiting at Leslie Commercials to be shown to the van, I received a WhatsApp message from Stuart to say that he had identified, in Chichester, six phantom head units which matched those that had been installed at KCH in May and which were being donated to Dentaid.  This is like finding gold, because it will allow us to complete the refurbishment of the 12 unit pre-clinical skills facility in Lilongwe, which will support the College of Health Sciences dental therapist training and, in due course, the College of Medicine BDS 3 students on the new programme. Many thanks to the Medical Education Centre at St Richard’s Hospital, Western Sussex Hospitals NHS Foundation Trust for this generous donation.

So I was in high spirits when I set out at 7.30am today for Inverurie. Despite a yellow weather warning for heavy rain, the drive up was completely dry. It included a short break at 9am for some breakfast at Glendoick Garden Centre, one of my favourite pit stops. I arrived at Inverurie Dental Care about 11.30am and met Jill and her husband.

Like all of the dentists in the practice, Jill qualified from the University of Glasgow Dental School, graduating in 1999. She had recently installed a new suite of equipment in her surgery, although the dental chair itself was still functioning well. Shortly after graduating, Jill had worked in Orkney for a few years and had been involved with transfer of equipment to Dentaid from there as well, so this donation was continuing a theme!

The dental chair was on a ‘skateboard trolley’, so it was relatively simple to move to the van and load. It is in great condition and a perfect match for those that have already been installed at KCH. The van was huge compared with the size of the load, but small vans aren’t fitted with tail lifts!

The weather stayed fine for the drive back to Glasgow. On Monday morning our friendly and helpful portering staff will help me to unload the chair for temporary storage at Glasgow Dental Hospital.

In due course I will be heading back to Leslie Commercials for another van to complete the chair’s journey to Dentaid in Southampton. For that trip the van will be full – many more donated dental items will be crossing the Border from Scotland en route to Malawi in the not-too-distant future.

Thank you for your support Jill. We’ll send a photo of your chair in its new home in due course!

On Thursday and Friday this week I enjoyed two inspirational meetings linked to the MalDent Project.

The first of these was with Professor Wilson Mandala, Executive Dean of the Academy of Medical Sciences at the Malawi University of Science and Technology. Wilson and I knew each other through Twitter but had never met in person and I am grateful to Alex Mackay and Paul Garside from the University of Glasgow Institute of Infection, Immunity  & Inflammation for identifying  a slot in Wilson’s busy visit schedule to come along to the Dental School.

I mentioned in a previous blog post that four students studying for a BEng degree in Biomedical Engineering had joined us at the Kamuzu Central Hospital Dental Department in Lilongwe in May, when the replacement dental chairs and phantom head units were being fitted (https://wordpress.com/post/themaldentproject.com/688). These students were from the Malawi University of Science & Technology. What I had not realised was that this is a relatively new course and that the first ever cohort will graduate next Summer.

Maintenance and repair of medical equipment is an essential function in any healthcare environment. At present, there is a shortage of skilled engineers to undertake these functions in Malawi, and the new BEng degree in Biomedical Engineering is a crucial development as the country develops its healthcare system further. Wilson explained that he and his colleagues are looking at subsequent training routes for graduates in sub-specialisms such as medical imaging, and that the work we are planning in the MalDent Project with Dentaid and Henry Schein, to provided a training opportunity in dental equipment engineering for two young graduates, fits perfectly into this scheme.

In addition to discussing this particular aspect of joint interest, we enjoyed a true meeting of minds on many related issues. Wilson has very kindly arranged for me to visit the Malawi University of Science & Technology on 20th August when I am in Malawi for the BDS student induction week. I am really looking forward to picking up our conversation again and meeting Wilson’s colleagues.

The second meeting, held at Glasgow Dental School, brought together the two charities Smileawi (Nigel and Vicky Milne) and Bridge2Aid (Shaenna Loughnane and Paul Tasman). At lunchtime we were joined by Professors Lorna Macpherson and David Conway, who are increasingly involved in the dental public health aspects of the MalDent Project, and by Niall Rogerson my co-lead for the project in Scotland.

I had reported in a previous blog post that Bridge2Aid and the Dental Association of Malawi have been awarded a grant from the Tropical Health and Education Trust to establish a partnership that will facilitate a pilot of the model used successfully in Tanzania for the past 15 years to up-skill Clinical Officers in emergency dentistry (https://wordpress.com/post/themaldentproject.com/785). This project is progressing well and initial discussions with the Ministry of Health have been supportive in principle (https://wordpress.com/post/themaldentproject.com/834).

The plan is to work towards a pilot in the North of Malawi, where Smileawi already has an excellent network of contacts and is well known to the local dental therapists, who have independently established a group known as ‘Smile North’. Shaenna, together with Andrew Paterson, will visit Mzuzu in September when they will deliver presentations to the local therapists about the Bridge2Aid model. They will seek input and advice from the delegates who will have opportunity to become involved in the THET project and its continuation should the pilot prove a success.

The fantastic work that Smileawi and Bridge2Aid are doing in Tanzania and Malawi directly supports the aims and ambitions of the MalDent Project. The collaborative alignment of all our activities is allowing very significant progress to be made with our partners in Malawi.  Partnership working and mutual learning – keys to success!

During the week commencing Monday 15th July, the Principal of the University of Malawi College of Medicine, Dr Mwapatsa Mipando, visited Glasgow with a team of his colleagues from the University of Malawi College of Medicine. The visit, funded through Erasmus, had been organised by Paul Garside and Alex Mackay at the University of Glasgow Institute of Infection, Immunity & Inflammation and was linked with the Scottish Government funded Blantyre to Blantyre Project. As always, Alex and Paul generously provided time in the itinerary to allow interaction and a working meeting for Mwapatsa with those of us involved in the MalDent Project.

On the Wednesday afternoon, the schedule included a Scottish cultural trip to the Auchentoshan Distillery (https://www.auchentoshan.com) followed by dinner at the ‘Lodge on the Loch’ at Luss, on the banks of Loch Lomond. I was invited to join the delegation and it was a great opportunity to meet some new friends from the College of Medicine who I hadn’t spent time with previously. In addition to the Principal, the visiting team comprised:

• Mrs Esther Masi, Marketing and Communication Officer
• Mr George Namandwa, Resource Mobilisation and Investment Director
• Mr Dikani Salema, Laboratory Manager for the Blantyre to Blantyre Project
• Mr Youngson Ghambi, Commercial Manager
• Dr Abena Amoah, Science Programmes Officer, Malawi Epidemiology & Intervention Research Unit (MEIRU)

Despite heavy rain (part of the Scottish cultural offering!) it was a very enjoyable event -many thanks to Paul and Alex for having invited me along.

Mwapatsa spent the Friday morning at Glasgow Dental School with Niall Rogerson and I, during which time we covered a large volume of business.

At 11.30am we were joined by Professor Chris Platt, who is Professor of Architecture at the Glasgow School of Art. Chris has been working with Professor Phil Cotton at the University of Rwanda on aspects of design of the University estate and I had met both of them briefly a few weeks previously, during a short visit by Phil to Glasgow. Subsequently, Niall and I had enjoyed a follow-up meeting with Chris to discuss the design of the new building that is planned for the Blantyre campus and which will house the clinical dental teaching facilities. The insight and professional expertise around design methods that Chris brought to the table was fantastic and I was delighted that he was able to meet with Mwapatsa in Glasgow.

In brief, Chris has agreed to facilitate a stakeholder workshop in Blantyre during early September, to generate a detailed brief that will encompass all aspects of the building requirements from a broad spread of College staff who will use it, not just those involved in the BDS programme. The delegates will also include those with local expertise and knowledge of the site from a technical and construction perspective. The aim is to have an outline plan and estimated costing by the end of November 2019. This is a very exciting development, bringing together expertise from both Scotland and Malawi, which will lay a strong foundation for the next phase of the design and construction project.

At the end of the morning we were joined by Dr Petrina Sweeney, who has agreed to participate in the induction week for the first intake of BDS students, which will be held at the Blantyre campus from 19th – 23rd August 2019. This will be an important and exciting milestone event, with a group of prospective young dentists who will be the first to benefit from the new facility that is now in its fledgling design phase.

On Friday 7th June I left Glasgow to travel back to Malawi for a ten day visit with multiple objectives in multiple places. In this first of two posts I will cover the initial couple of days of activities in Lilongwe.

My journey from Glasgow was less than straightforward thanks to a cancellation of the Glasgow – Heathrow flight, a switch to an Edinburgh – Heathrow flight which was itself delayed, a rush across Terminal 5 to the Johannesburg departure, which in turn was delayed by a technical fault during engine start-up. Subsequently things ran smoothly and I arrived in Lilongwe early on the Saturday afternoon.

On the Sunday morning I had arranged to meet with Susan Dalgety. Susan is a columnist for The Scotsman newspaper who has moved to Malawi for six months and is writing a book about the country. In her weekly column, Susan shares stories about life in Malawi and about the strong relationship between Scotland and Malawi.

Susan arrived at the Sunbird Capital Hotel as planned at 11am with her husband, Nigel, and we spent a fascinating hour sharing our stories. I chatted at length about our ambitions for improving oral health in Malawi, supported by the significant funding from Scottish Government for the MalDent Project. I also mentioned that a team of colleagues from the University of Glasgow Institute of Infection, Immunity & Inflammation would be visiting Blantyre the following week to install laboratory equipment as part of the Scottish Government-funded Blantyre-Blantyre Project. As events turned out, Susan was able to visit Alex Mackay and the Blantyre-Blantyre team at work later that week and to meet Dr Mwapatsa Mipando, the Principal of the College of Medicine. She left them having gained a clear understanding of their aims and ambitions.

Susan’s column in The Scotsman on Saturday 15th June focused on both projects, which were knitted beautifully into the context of healthcare needs for native Malawians. You can read the article at https://www.scotsman.com/news/susan-dalgety-a-country-of-18-million-and-just-39-dentists-totreat-them-1-4947489

We were delighted to have had this opportunity to share our work and to benefit from Susan’s insight and skilled story-telling in The Scotsman. We will all be keeping in touch as the work develops and look forward very much to reading Susan’s book in due course.

Later on the Sunday I was joined by Paul Tasman, Operations Manager for Bridge2Aid (B2A), who had arrived in Lilongwe for meetings we had set up to discuss the plans for extending the work of B2A from Tanzania to Malawi. At 7pm we met with Wiston Mukiwa, Secretary of the Dental Association of Malawi, for a working dinner. As mentioned in a previous post, the Dental Association of Malawi and B2A have recently been awarded a grant from the Tropical Health & Education Trust to establish a formal partnership. Over dinner we enjoyed a wide-ranging discussion which served as excellent preparation for the meeting scheduled the next morning at the Ministry of Health

The following morning, Wiston collected Paul and I before driving us all to the Ministry of Health building on Capitol Hill. Dr Nedson Fosiko, Deputy Director of Clinical Services, had arranged for Mr Burton Uatantha Chrmo, Deputy Director of Human Resources, to join the meeting and it was also a pleasure to see Mr Richard Ndovi again, who attended in his role as Acting Registrar of the Medical Council of Malawi. Dr Martha Chipanga from the KCH Dental Department attended on behalf of Dr Jessie Mlotha-Namarika.

The main purpose of this meeting was to provide an opportunity for B2A and the Dental Association of Malawi to discuss with senior figures at the Ministry of Health and Medical Council of Malawi the potential for adoption of a task-shifting model that would support delivery of emergency dentistry in rural areas of Malawi. The model would be based upon that developed and used by B2A very successfully in Tanzania for the past 15 years, but adapted to suit the specific requirements of Malawi.

In summary, there was a full and frank discussion with a very positive outcome. It has been agreed that Paul and Wiston will write a concept paper for consideration by the Ministry of Health so that appropriate oversight and approvals can be initiated.

For those wishing to watch the development of this exciting partnership and story, please go to https://www.bridge2aid.org or follow B2A on Facebook or Twitter (@Bridge2Aid).

Following the meeting at the Ministry of Health, Wiston drove us to the Dental Department at Kamuzu Central Hospital. Stuart Bassham from Dentaid had provided me with some items for both the pre-clinical skills facility that had been recently up-graded and for the dental chairs, which I was able to hand over.

It also provided an opportunity for Paul to enjoy a short tour of the facility and to see the work undertaken recently by Dentaid and Henry Schein to upgrade many of the dental chairs, phantom head units and related services.

Our next and final stop on today’s round of meetings was at the offices of the Christian Health Association of Malawi (http://www.cham.org.mw).

CHAM is a key partner to the Government of Malawi and works with the Ministry of Health to implement the Health Sector Strategic Plan. At present, CHAM covers 29% of the health service delivery in Malawi. This includes a significant role in healthcare worker training to enhance the availability of skilled workforce. Furthermore, 85% of CHAM’s work is in the rural areas of Malawi, making it a very important player in the discussions linked to the emergency dentistry task-shifting plans of B2A and the Dental Association of Malawi.

Wiston had arranged for us to meet with Dr Titha Dzowela, the Head of Health Programmes for CHAM. This was a great opportunity for sharing of ideas and, as in the morning at our meeting with the Ministry of Health, there was strong support for working together on the preparations and field work ahead of a pilot study of a B2A training programme in Malawi.

Following this final meeting of the day, Wiston kindly dropped Paul and I at the Sunbird Capital Hotel, before he headed back to work. Paul and I enjoyed some further discussion over lunch after what had been a very inspiring day of preparatory meetings. An excellent foundation had been laid for the next steps to progress the THET – funded partnership project.

Six students from Sun Yat Sen University School of Stomatology are visiting Glasgow Dental School for a month as part of a long-standing exchange programme this Summer.

On Saturday 1st June they joined myself, my staff colleague Petrina Sweeney and one of our BDS 3 students, Pei Rong Chua, for a visit to Dunoon. The purpose of our trip was to participate in the inaugural Smileawi Spanners bogey run, to raise funds for the work of this offshoot of the dental charity Smileawi. I had agreed to act as a marshal whilst the others would spectate.

Smileawi Spanners has been established by a small group of local motor mechanics who travel to Malawi with the Smileawi volunteers, and whilst the dental teams are treating patients, the engineers set to work repairing ambulances. Recently their activities have been given a boost by the acquisition  of a mobile workshop, sponsored by Arnold Clark, which has now been sent across to Malawi in a container with other Smileawi items.

Nevertheless, there is a constant call on components, and the team aims to leave tool sets with local motor mechanics to add sustainability to the work, so fund-raising is an important part of their activities.

The trip to Dunoon in a University minibus included a 20 minute crossing with Western Ferries from McInroy’s Point, Gourock to Hunter’s Quay, Dunoon.

From Hunter’s Quay it was a short drive to Dunoon Stadium, which hosts the famous Cowal Highland Gathering each year. We were welcomed by Nigel Milne, one of the founders of Smileawi, and then made our way to the café for a coffee and (for some of us!) bacon rolls. I was called away for a marshal’s briefing, leaving the Glasgow team in the capable hands of Lester Cheung, a Glasgow BDS graduate from 2013, who now works at The Hollies Dental Surgery with Nigel and Vicky in Dunoon.

I took up a marshalling spot near the start ramp.

There were ten teams, each with their individual bogeys, ranging from a very professional looking ‘Ferrari’ to a converted shopping trolley.

Each team had three runs down the hill, with the first set of heats starting just after midday. Each bogey was manhandled onto the ramp and then given a ‘team push’ to set it off on its journey down the hill towards the stadium. The following video gives a flavour of the event.

The students watched the first set of heats and were then taken by Lester to see around The Hollies Dental Practice. Since most dentistry is delivered via hospital facilities in China, this visit was of great interest to them.

In addition to the bogey run itself, there were a number of craft stalls, food outlets and a live local band called ‘The Evil Geniuses’, so there was plenty to do and the day was a great success.

Craft stalls

The Evil Geniuses

Next year’s event is already being planned, with at least one of the marshals suggesting that a ‘hoop of fire’ would provide some additional entertainment for the spectators!

Before we left the stadium, Nigel handed over a very large bag containing hundreds of eco-friendly Bamboo toothbrushes, which had been generously donated by the manufacturer (http://www.bamwoo-bamboo.com). I had agreed to take these to Malawi with me the following week and to hand them over for distribution to schoolchildren by Smileawi and the team of students from Glasgow and Dundee dental schools who would be conducting an oral health survey in several primary schools. There will be more about this activity in a future post.

After the bogey runs were completed, we drove down to the waterfront with Lester, parked up and then enjoyed a tasty meal in one of the restaurants in the Argyll Hotel. It was a very pleasant way to end our stay in Dunoon.

When we arrived back at Hunter’s Quay, a ferry was already docked and waiting. The weather had turned sunny and the sail back to McInroy’s Point was very enjoyable.

Many thanks to Nigel, Vicky and Lester for making us all feel so welcome. It’s interesting to reflect that all three are Glasgow Dental School graduates, as is Petrina, so it was a great meeting of alumni and students in an unusual setting. All in all it was a fantastic day out in aid of a very good cause!