For the middle part of my visit to Malawi the weather was uncharacteristically cool, wet and windy – not at all the hot, dry season that would be anticipated for this time of year. Comments were made that I had brought Scottish weather to the Warm Heart of Africa! This change in the weather was compounded by multiple power cuts, one of which lasted for more than 24 hours. The solar powered lanterns that Ruthie normally used on the khonde in the evenings came in very handy for interior lighting.

On Tuesday 1st October Ruthie drove me to The Beehive Social Enterprise at Chilomoni. Many of my colleagues in the Scotland Malawi Partnership had praised this organisation on multiple occasions in discussion and I was grateful to Ruthie for making the introduction. There are many strands to the work of Beehive, but I was particularly keen to hear about their work in Early Child Development Centres (ECDCs) and schools.

Our visit was hosted by Limbani Njewa, the Community Services Manager, who introduced us to Hannah Kagona, the Outreach Manager. Limbani explained that the focus of their work is to support vulnerable people in the community, with an emphasis on family support. They have an extended schools team and provide education and support from ECDC (nursery) level through to tertiary education. Limbani’s teams collect data on the ECDCs and associated food programme. The food is provided by Seibo and prepared by local villagers through parent forums.

Following Limbani’s description of their activities, I spoke about our ambitions for child oral health improvement in Malawi, including our search for potential sites in ECDCs and schools to undertake feasibility studies. Limbani was very enthusiastic and encouraging in relation to a possible role for Beehive as we develop our plans, so there is tremendous scope here for collaboration.

On Wednesday 2nd October I spent the morning with the Blantyre District Health Management Team. Although he was away on other business, this meeting had been set up by Dr Gift Kawalazira, the District Health Officer.

The morning started with three summary presentations by postgraduate students. The first related to distribution of essential medicines in Limbe, an area in the Blantyre district …

… the second on ergonomic hazards in healthcare in Malawi …

… and the third on a PhD project on retinopathy in children with cerebral malaria …

There followed reports from the coordinators of six of the healthcare programmes operating in Blantyre District. The School Health & Nutrition Programme is led by Ennis Kaunda, who gave a very interesting presentation that is of direct relevance to the work we are planning around child oral health improvement interventions in schools:

We also heard from Chrissy Banda who heads up the Health Promotion Programme:

One of Chrissy’s slides was especially relevant to our ambitions to improve child oral health, citing that health education messaging, whilst important, is insufficient on its own to change behaviour:

My good friend Wisdom gave a brief presentation on oral health care for children:

Following the presentations from the leaders of the individual programmes already underway, I gave a short talk about the MalDent Project and our plans for the future. Once again, there were clear opportunities for collaboration moving forwards and I left the meeting feeling very encouraged.

One of the challenges facing any form of dentistry in public institutions in Malawi relates to ensuring a reliable pipeline of the required consumables such as local anaesthetic solution and filling materials. On Thursday 3rd October my friend and colleague Nelson Nyoloka, a Lecturer in Pharmacy at KUHeS, kindly arranged a meeting for Peter Chimimba and I at the Central Medical Stores Trust (CMST) offices and warehouse in Blantyre so that these supply issues could be discussed.

Mr Geoffrey Ngwira, the CMST Director of Pharmaceutical Operations and Mr Vincent Chilinda, the CMST Finance Manager, had both travelled from Lilongwe to join the meeting, for which we were extremely grateful. Later, we were also joined by Mr Godfrey Kadewere, Director of Health Technical Support Services at the Ministry of Health.

It was a very valuable morning. First, Mr Stewart Lichapa, the local CMST Manager, delivered a Powerpoint presentation that provided an overview of the CMST and its operations. The former Central Medical Stores, operating under the Ministry of Health, converted to its current structure through a Trust Deed in 2010 and the CMST became operational in 2012. Its function is to procure, warehouse and sell pharmaceuticals and equipment to public facilities and CHAM hospitals.

CMST has to estimate the volume of materials it procures based on projected Ministry of Health requirements, but is then reliant on public health facilities having sufficient funds to purchase those drugs and equipment. Unfortunately, public health facilities have limited funding, leading to significant financial challenges for CMST, including cash flow problems resulting from delayed payments by customers, potentially compounded by currency devaluations.

It was explained that availability of specific drugs responds to the Essential Health Package, which has resulted in creation of a Must Have List (MHL) of 405 items, from a catalogue of 5842 items. There are currently 10 dental items on the MHL, which we have been invited to review and amend as required. We have agreed to create a document that will define in more detail the list of commodities and volumes required to support both dental education and delivery of dental clinical services.

One of the final activities to satisfy requirements of the Scottish Government MalDent Project grant is to undertake an end of project evaluation. The advert to recruit a suitable consultant has now been lodged in the local press with expressions of interest due by 17th October. We look forward to this external evaluation of work to date, which may also provide some guidance for our future plans.

Blantyre Farmers’ Market is a local tradition that takes place on the first Saturday of every month, so one was scheduled for Saturday 5th October. Ruthie normally attends and she kindly invited me along too. At the end of a busy week it was good to take some time out and enjoy this new experience.

The event is a hub for promoting locally made products, including food, crafts and textiles. It aims to support the growth of local businesses and artisans.

Once parked, we entered the market. It was a vibrant event full of colour and the aroma of good food cooking.

I wandered around the market and purchased some locally made items from two of the stalls:

After perusing the stalls, I settled down to chat with some of the new friends I have made during my recent stay, thanks to introductions from Ruthie.

This short video gives a feel for the atmosphere at the event, enlivened by the music being played by the live band:

On the Sunday, I enjoyed lunch with my friend Nelson, who was about to leave for Lilongwe, where he would be teaching pharmacology to nursing students for the next week. We visited Sky Lounge Restaurant, an eatery that was new to me and which served up a very tasty lunch.

This had been an excellent week for making new contacts with whom we can collaborate as the MalDent Project moves into its next phase. Over the following week we would be joined by Leon Grobbelaar from John McAslan + Partners, a longstanding collaborator, when our attention would turn back to finalising the designs and gaining permissions for the new dental teaching facility / student hub on the Blantyre campus of KUHeS.

In a previous blog post, I described the Oral Health Forum that was organised by the Scotland Malawi Partnership whilst Esther Khomba and Chifundo Banda, two dental students from Kamuzu University of Health Sciences, were visiting Scotland. If you would like to watch the forum, a time-stamped video is available here.

Tracy Morse, Professor of Environmental Health and Head of the Centre for Sustainable Development at Strathclyde University, Maria Soko, a Behaviour Change Specialist from Water Aid Malawi, and I delivered a short presentation during the forum which examined the possibilities for collaboration between colleagues working on projects addressing the WASH agenda in schools, particularly hand hygiene, and our plans for developing oral health interventions aimed at improving oral health in children.

One of the very positive outcomes of the meeting was that Tracy subsequently arranged a Zoom call that allowed Lorna and I to meet her friend and colleague Dr Kondwani Chidziwisano who is an academic at Malawi University of Business and Applied Sciences. Kondwani did both his Masters degree and PhD at Strathclyde University and has been working with Tracy for many years.

During that on-line conversation we learned about a project of Kondwani’s that was about to begin, which would examine aspects of sanitation and hygiene in Early Childhood Development Centres (ECDCs) – facilities that provide care for children under the age of six years who are not yet attending a formal school or equivalent. Lorna is keen that we include such centres, as well as primary schools, in our plans to develop oral health improvement interventions. Kondwani explained that his team was developing a data collection tool to gather relevant information from ECDCs and invited us to submit a small number of oral health questions that could be included. Lorna sent the appropriate material and it was agreed that I would meet in person with Kondwani during my current visit to Malawi.

On arrival in Malawi I contacted Kondwani who explained that he and his teams would be going out into the field on Friday 27th September to pre-test the data collection tool, which included the small number of oral health related questions submitted by Lorna. He invited me to join them, which provided an excellent opportunity for me to visit an ECDC and to meet the members of the team.

Kondwani collected me from The Leslie at 9am and we set off for the selected ECDC. We were soon driving along very rutted, unmetalled roads through busy villages:

Eventually we arrived at a junction and Kondwani called a colleague for directions – we were to take the left fork.

Finally we arrived at a very steep incline which put the 4×4 Ford Explorer pickup through its paces …

… before arriving at our destination, Kachumbe Community Based Childcare Centre (CBCC):

CBCCs are buildings that are used as pre-school facilities and as feeding stations for children between 3 and 5 years old. This particular building that we were visiting is also used in the afternoons to deliver classes to older children.

As soon as we arrived, and out of courtesy, Kondwani introduced me to the headteacher. Whilst I was there, he enquired about delivery of oral health education messages to the children, but we were told that none are provided.

Whilst the team worked hard with pre-testing of the data collection tool, I was allowed to wander and observe activities. This was a wonderful opportunity for me to gain a feel for what may be possible in terms of oral health interventions in such environments. Around the site, Kondwani’s team members were busy collecting information from those who work at the CBCC …

… and making observations on the facilities available relevant to sanitation and hygiene:

Each element of data collection was repeated independently by two team members to check for inter-observer consistency of responses and observations, which would be assessed in the afternoon when the team reviewed the data.

I was standing in the shade of the verandah when suddenly there was an outpouring of childrens’ voices – meal time was close and the children were running out through the back door to a handwashing station.

I ran around to the rear of the classroom and saw the children clustered together under supervision of two of the staff members – this was the handwashing station:

As the children finished their handwashing, they skipped and ran back into the classroom to wait for their porridge;

Once the last two children had completed the handwashing …

… the children all sat on the floor of the classroom and tucked into the food they were served:

The feeding component of the work of CBCCs is a critically important part of their activities. There is significant hunger in many parts of Malawi and receiving at least one good meal per day makes a tremendous difference to both the children and their parents.

The food is prepared in a small kitchen behind the classroom:

There was a team of ladies who prepared and served the food and who cleaned all the utensils and dishes after the food had been served.

There was no soap available for either the handwashing or the cleaning of the cooking utensils, dishes and spoons. Kondwani explained that the village community was dependent on NGO supplies and that when soap was available it was often prioritised for washing clothes.

As our visit came towards a close, I went inside the classroom …

… specifically to check whether there would be a secure space in which we could store toothbrushes and toothpaste if we were to consider the feasibility of a supervised toothbrushing programme in facilities like this CBCC. I was very pleased to be shown two lockable cupboards:

This visit left a very deep impression on me. The outward happiness of the children at play and receiving food in very basic surroundings was heartwarming. The dedication of the teachers and staff involved was also inspiring.

I left with the feeling that there was definitely a potential opportunity to include an oral hygiene element into the daily routine, which would complement the handwashing and nutrition programmes already in place. With the support of colleagues like Kondwani, Tracy and Maria we look forward to the next steps in our mission to integrate oral health interventions with the WASH and nutrition sectors as part of the proposed National Child Oral Health Improvement Programme for Malawi.

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

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

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

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

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

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

We left the Dental Department…

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

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

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

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

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

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

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

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

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

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

The surgery was very well equipped …

… and the practice tastefully decorated:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

… and prepared a picnic table for sundowners:

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

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

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

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

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

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

We enjoyed a drink together on arrival …

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

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

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

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

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

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

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

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

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

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

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

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

This is the space as it looks currently:

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

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

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

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

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

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

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

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

Acknowledgement

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

Day 16 – Monday 9th September

For those who missed our previous blog posts about Esther and Chifundo’s visit to Glasgow you can find them at Week 1 and Week 2.

Week 3 began with a second tutorial on maxillofacial radiology, this one delivered by Dr Kirstyn Donaldson, Consultant and Honorary Senior Lecturer in Dental & Maxillofacial Radiology.

After the tutorial, Esther, Chifundo and I walked through Kelvingrove Park to the University of Glasgow James McCune Smith Learning & Teaching Hub to meet Professor William Cushley for lunch. Professor Cushley is Assistant Vice-Principal International and is a close colleague of Dr Mwapatsa Mipando, who was the original instigator of the MalDent Project when he was Principal of the University of Malawi College of Medicine. We had an interesting discussion, including the identification of potential opportunities for young Malawian dentists to undertake postgraduate degrees in Scotland.

After lunch, we crossed University Avenue to The Wolfson Medical School Building for a very enjoyable meeting with Professor Matthew Walters, Head of the School of Medicine, Dentistry & Nursing. Matthew has been very supportive of the MalDent Project since its inception and it was great that he was able to meet Esther and Chifundo whilst they were in Glasgow.

We completed the afternoon with a repeat visit to the African supermarket on Great Western Road where we purchased a top-up of nsima flour, to maintain supplies for Esther and Chifundo over their final week.

Day 17 – Tuesday 10th September

Day 17 was spent in Edinburgh. We walked to Glasgow Queen Street Station where we met Professor Lorna Macpherson who was joining us to participate in a Scotland Malawi Partnership (SMP) Health Forum, focused on Oral Health.

This was the first time Esther and Chifundo had experienced train travel, so there was a degree of excitement about the journey as we set out on the 08.45 Scotrail shuttle service from Glasgow to Edinburgh Waverley:

The weather was bright but there was a cold wind when we arrived in Edinburgh. We made our way to Edinburgh City Chambers, where the SMP has its offices. The Oral Health Forum was to be held in the Business Centre of Edinburgh City Chambers.

The Oral Health Forum was a hybrid meeting, with some delegates attending in-person and others, including colleagues in Malawi, participating on-line. Tea and coffee were available for those attending in person prior to the event commencing at 11.00am.

The programme comprised a series of brief presentations to provide an overview of the MalDent Project and associated activities aimed at improving the oral health of people in Malawi:

Chad Morse, Deputy CEO of the SMP, had set up all the equipment required to run the hybrid meeting, and at 11.00am the attendees were welcomed to the event by Natasha Adodo, the Communications and Engagement Officer for the SMP.

Natasha then handed over to Professor Heather Cubie, Chair of the SMP, who would lead the Health Forum. Heather gave a brief introduction, alluding to her own role over many years working in healthcare in Malawi, specifically in the areas of Human Papilloma Virus immunisation and cervical cancer screening.

Heather then invited Drs. Mwapatsa Mipando and Peter Chimimba to deliver the first presentation, which was an overview of the MalDent Project, funded by Scottish Government International Development. Mwapatsa and Peter covered the development and launch of the BDS degree programme, the creation and launch of Malawi’s National Oral Health Policy in collaboration with the Ministry of Health, and the design of the new dental teaching facility to be constructed on the Blantyre Campus of KUHeS. They also touched on future plans, including the development of an exemplar dental clinic at Chilomoni Health Centre in collaboration with the charity AMECA.

The next presentation focused in more detail on the BDS degree programme. Dr James Mchenga, Acting Head of the BDS course, spoke first from Malawi, while Esther and Chifundo listened from the lectern:

It was then the turn of Chifundo and Esther to provide their own reflections on the course as members of the pioneer cohort of Final Year BDS students who hope to graduate early in 2025. It was uplifting to hear them speaking about their experiences, their aspirations to become specialists and their wish to become involved as academic staff in the Department of Oral Health Sciences at KUHeS. It was their visit to Scotland that had prompted Chad to suggest an Oral Health Forum and their contributions on the day were very well received.

Next on the agenda was a presentation by Dr Wiston Mukiwa, the Secretary of the Dental Association of Malawi, describing in more detail the National Oral Health Policy. Wiston had been a key member of the Task Force that created the policy.

One of the core threads of the policy is a focus on prevention of oral diseases. The recently completed National Child Oral Health Survey, which entailed examination of just under 3000 children, had identified that 47% of 6-year-olds and 23% of 12-year-olds had untreated dental caries. These data were presented at a child oral health workshop in Mponela in May this year, following which it was agreed that a multi-sectoral Task Force should be set up to develop a National Child Oral Health Improvement Plan. The Task Force would include representation from the Ministries of Health and Education.

The next presentation was delivered by Professor Lorna Macpherson in Edinburgh and Dr Don Chiwaya in Pretoria, South Africa. Don is an Assistant Lecturer at KUHeS who is currently undergoing specialist training in Dental Public Health at the University of Pretoria, and Lorna acts as an informal external mentor for him. Between them they covered the principles of the Scottish Childsmile Programme, the plans to develop a Child Oral Health Improvement Plan for Malawi, and the value to Don’s ongoing specialty training of his involvement in this work at a national level, which satisfies some of his academic course requirements. Furthermore, Don will be well versed in the details of the new Child Oral Health Improvement Plan when he returns to Malawi after his training in Pretoria, and will be able to play a key role in implementation.

Finally, there was a section which examined potential collaboration between the oral health and WASH agendas. There are similarities in the challenges of delivering hand hygiene and oral hygiene education and practice in Malawi. I opened this subject area, with subsequent contributions from Ms Maria Soko of Water Aid Malawi, who had participated in our workshop in Mponela, and Professor Tracy Morse, Professor of Environmental Health & Head of the Centre for Sustainable Development at Strathclyde University. Both Tracy and Maria have extensive experience of operating in Malawi’s schools and those of us working in oral health have much to learn from them. The concept of joining forces makes a great deal of sense and will undoubtedly figure in discussions on the Child Oral Health Improvement Task Force over the next few months.

Following the presentations there was an opportunity for attendees to ask questions, and among those joining in was Ruthie Markus, the CEO of the charity AMECA which is partnering with us to establish an exemplar dental clinic at Chilomoni Health Centre.

Finally, Heather brought the forum to a close, after what had seemed a very quick 90 minutes. We are very grateful to the SMP for devoting this entire Health Forum to Oral Health, providing us with an opportunity to update attendees on the current status of the MalDent Project.

For readers who were unable to attend but would like to view a recording of the event, a time-stamped video is available on the SMP web-site here.

For those of us who were attending in person, tea and coffee were available after the event to allow further discussion and networking to take place. We were delighted that Niall McCumesty and Cameron Rogers from Scottish Government International Development had attended the forum and were able to stay behind afterwards for an in-depth discussion with Esther and Chifundo.

After all the excitement of the Health Forum, Esther, Chifundo, Lorna and I found a nearby Italian restaurant for a tasty lunch. Lorna then caught a train back to Glasgow whilst Esther, Chifundo and I took a trip around Edinburgh on an open top tour bus. The city looked beautiful in the sun – a welcome sightseeing opportunity which allowed us to relax after a busy but very successful morning.

After the bus trip, Esther and Chifundo spent some time wandering around the St James Quarter Shopping Centre before we took an evening train back to Glasgow.

Day 18 – Wednesday 11th September

Purely by chance, the World Endodontic Congress (WEC) was taking place at the Scottish Event Campus from 11th – 14th September. Professor William Maclean, Professor of Endodontology at the University of Glasgow, was the Chair of the Congress and through generous sponsorship by Wiley Publishing had been able to arrange complimentary delegate passes for Esther and Chifundo.

Following registration, Esther and Chifundo met Professor Maclean himself, who welcomed them to the Congress:

Shortly afterwards we also met Dr Asuni, who Esther and Chifundo know well, and we had lunch together.

Esther and Chifundo joined a pre-congress session on orofacial pain which lasted the whole afternoon.

They walked home from the congress with Dr Asuni.

Day 19 – Thursday 12th September

Day 19 was spent entirely at the World Endodontic Congress. It was a tremendous opportunity for them to attend lectures by world leaders and they both reported enthusiastically on how much they had learnt.

I collected them from the SEC just after 5.00pm and we drove across the Clyde to pick up Dr Petrina Sweeney from her home. Petrina was a Senior Lecturer / Honorary Consultant in Special Care Dentistry at Glasgow Dental School until her recent retirement. In 2019 Petrina had accompanied me to Malawi for the launch of the BDS degree programme and to be part of the academic team that delivered an induction programme for the first cohort of BDS students. She had, therefore, met Esther and Chifundo previously and was keen to see them again as they neared the end of their undergraduate studies.

We drove to Giffnock for dinner at a restaurant called ‘Catch’, which has a reputation for first class fish and chips.

It was a very enjoyable reunion meal during which Petrina presented Esther and Chifundo with copies of a book entitled ‘Above Scotland’, which contains aerial photographs from across the country. These will be lovely reminders of their visit to Scotland.

Day 20 – Friday 13th September

The last working day of the week was spent in scrubs. In the morning, Esther and Chifundo joined two Restorative Dentistry Consultant Clinics, Chifundo pairing up with Dr Andrew Paterson and Esther with Dr Andrew Forgie. At the end of his clinic, Andrew (Forgie) brought Esther down to the Dental School Administration Centre, where Professor Christine Goodall was waiting to meet our two visitors from KUHeS.

A short while later, Chifundo appeared, following the end of Dr Paterson’s clinic, and we joined Christine for lunch in the Hi Café at the Dental School. It was Christine who, in her role as Dean of the Dental Faculty at the Royal College of Physicians & Surgeons of Glasgow, had introduced me to Mrs Alison Lannigan, Chair of the RCPSG HOPE Foundation, stimulating a discussion that resulted in the funding of Esther and Chifundo’s visit. Without that introduction there would have been no elective visit, so this was a very important ‘thank you’ lunch!

After lunch it was back to the clinics, this time to spend an afternoon with BDS 5 students undertaking endodontic treatments for their patients.

It was close to 5.00pm when Esther and Chifundo were ready to leave the Dental School and walk home. That evening was the formal dinner for the World Endodontic Congress, which was to be held in the grand surroundings of the Kelvingrove Museum and Art Gallery. I dropped Esther and Chifundo at the venue at about 7.15pm, where they joined the other guests who were arriving for the event:

It was smiles all round after the dinner:

What an excellent way to round off the third working week!

Day 21 – Saturday 14th September

One of the Executive Assistants at the Royal College of Physicians & Surgeons of Glasgow, Liz Breslin, had been exceptionally helpful with the organisation of the flights and accommodation for Esther and Chifundo. In addition, Liz had very kindly arranged complimentary tickets for us to visit the Glasgow Science Centre through her husband, who is the Chief Executive of the Centre. We arrived shortly after the Centre opened at 10.00am to begin our tour.

Level 3 of the Centre is called Body Works and covers aspects of human anatomy, physiology, pathology and treatment.

Chifundo immediately recognised the sensory homunculus model from diagrams he had seen in textbooks.

It was exciting that an exhibit on tooth structure, dental diseases and their prevention, together with treatment options, including endodontics, had been unveiled only two days previously as part of the World Endodontic Congress which Esther and Chifundo had attended. ‘At the Root of It’ has been created jointly by the British Endodontic Society and the University of Glasgow Dental School. It is a permanent exhibit and provides a legacy of Glasgow having hosted the 14th World Endodontic Congress.

Chifundo and Esther were soon busy with the interactive exhibits:

The pod incudes a detailed explanation of dental anatomy …

… information on the oral microflora and dental plaque …

… and some explanation of restorative dentistry options …

After viewing Level 3, we had some lunch in the Café at the Centre, before Esther and Chifundo continued to view the remaining areas of the building. Whilst doing so, they won a prize of a free cup cake, so returned to the café to claim it!

The visit to Glasgow Science Centre was a great success and we are very grateful to Liz Breslin and her husband for the opportunity. Before we left the Centre, we captured this quote by Confucius, which is so relevant for all those engaged in education:

Next, we headed to the Riverside Museum, formerly the Glasgow Museum of Transport. The striking building, designed by Zaha Hadid Architects and opened in 2011, has a frontage onto the River Clyde. It houses a tremendous collection of trains, road vehicles, and ship models, the latter recalling the heyday of ship building on the River Clyde.

After the visit to the Riverside Museum I dropped Esther and Chifundo in Sauchiehall Street so they could spend some time in the city centre.

Day 22 – Sunday 15th September

We decided to leave Sunday clear of organised activities, to allow us to begin preparations for our forthcoming journey to Malawi. Esther and Chifundo spent some of their time back in the shops, making some final purchases before their journey back to Malawi.

Day 23 – Monday 16th September

This was the last day of activities in the Dental School for Esther and Chifundo. They started in a Prosthodontics tutorial with BDS 4 students following which they joined the students on a Restorative Dentistry Clinic.

At 11.15am, Esther and Chifundo were due to meet with Professor Shauna Culshaw to discuss some aspects of research in dentistry. Over the weekend, Shauna had developed respiratory symptoms and contacted me on Sunday to explain that she had tested positive for COVID. As an alternative to a face-to-face meeting, Shauna set up a Zoom link and the meeting was held on-line.

At lunchtime, Andrew Paterson and I took Esther and Chifundo for lunch at our old favourite, Café Anti Pasti. We encouraged Esther to order a calzone, which turned out to be a real hit!

Following discussion over lunch about the prosthodontics teaching earlier in the day, and how much they had learned, Andrew agreed to download a number of his lectures onto a memory stick so that Esther and Chifundo could take them to share with their colleagues back in Malawi.

We finished for the day at about 3pm and returned to our respective homes to tidy up and finalise packing

Day 24 – Tuesday 17th September

Several weeks ago I had booked flights for myself to travel to Malawi on 17th September for a three week visit. Unfortunately, by the time their various passport and visa issues had been resolved, providing confirmation that Esther and Chifundo could visit Glasgow, it was not possible to book them onto the same flights that I was using. Instead, they would fly home via Dubai and Addis Ababa, whilst I would take the London Heathrow and Addis Ababa route.

I left my own house at 10.15am to go across to the Airbnb apartment that had been Esther’s and Chifundo’s home for the duration of their stay in Glasgow. A taxi was booked for 11.00am to take us all to Glasgow Airport.

The taxi was punctual and following arrival at the airport Esther and Chifundo were soon checked in for their Emirates flight. I was less fortunate, as there was a massive queue for the British Airways check in and bag drop – it took me almost an hour. Esther and Chifundo had gone ahead through security and by the time I reached the departure lounge it was time for me to board immediately. Our final farewell at Glasgow was, therefore. a quick phone call rather than the relaxed chat over coffee I had hoped for.

Just as I was preparing to board my BA flight, I saw the Emirates flight from Dubai arriving at Glasgow Airport – the plane that would take Esther and Chifundo on the first leg of their journey home.

I am writing this section of the blog post whilst waiting at Heathrow Airport. On checking our schedules, I have just realised that all three of us will be catching the same final flight from Addis Ababa to Blantyre tomorrow morning. We will maybe still enjoy that final cup of coffee after all – in Ethiopia where coffee originated!

In June this year I had visited Ruthie Markus, CEO of AMECA, when she was back in the UK for several weeks. Ruthie had also invited Paul Thomas, the Medical Director of AMECA, and Chig Amin, who has been Ruthie’s dentist for many years, to lunch that day. Chig was very interested to hear about the MalDent Project and was keen to visit Malawi for a few days to see at first hand the wonderful work that AMECA is doing, and to learn more of the oral health developments in the country. It was subsequently agreed that he would leave on 17th September for a five day visit.

As a result, Chig and I met at Heathrow Terminal 2 on 17th September to catch the 9.00pm overnight Ethiopian Airways flight to Addis Ababa. The flight was smooth and punctual.

Day 25 – Wednesday 18th September

After landing at Addis, Chig and I passed through security and headed to Gate B4 to wait for Esther and Chifundo who would also be boarding the Ethiopian Airways flight to Blantyre. Their connection from Dubai was tighter than ours had been, but they joined us in time to be introduced to Chig and to enjoy that cup of coffee we had missed at Glasgow Airport.

The flight to Blantyre was very busy as we lined up to board for the final time.

On arrival at Chileka Airport in Blantyre we were greeted by a fantastic welcoming party of Ruthie Markus, Peter Chimimba and Nelson Nyoloka. It was the final stage of Esther’s and Chifundo’s elective visit to Glasgow, and very fitting that in true partnership style we had all arrived together in Malawi to be met by friends of the MalDent Project!

Acknowlegements

This elective visit to Glasgow by Esther and Chifundo would not have been possible without the generous funding from the HOPE Foundation of the Royal College of Physicians of Glasgow (RCPSG). Massive thanks are due to the College President, Mr Mike McKirdy, and to the Chair of the HOPE Foundation, Mrs Alison Lannigan together with the Foundation Trustees.

The Acting CEO of the RCPSG, Mrs Linda Irvine, together with her team of staff including Mrs Liz Breslin, Ms Liz Mitchell and Ms Claire McDade provided outstanding assistance with booking of flights and accommodation, and visits to key attractions such as the David Livingstone Birthplace and the Glasgow Science Centre.

Attendance at the 14th World Endodontic Congress was kindly facilitated by the Congress Chair, Professor Will Maclean, with generous sponsorship from Wiley Publishing.

Massive thanks are due to the many members of academic staff in the University of Glasgow and colleagues in NHS Greater Glasgow & Clyde, who welcomed Esther and Chifundo into their teaching sessions and provided an exceptional learning opportunity.

Frank Bonner, the Dental School Manager and his team of Professional Services colleagues all played key roles in delivering a successful visit for Esther and Chifundo.

Thanks are due to Professor Peter Mossey and his colleagues at the University of Dundee for an exciting meeting with Malawian PhD students studying there – an inspiration for Esther and Chifundo.

We are very grateful to the CEO, Stuart Brown and his Deputy, Chad Morse along with their team at the Scotland Malawi Partnership for the oral health-themed Health Forum, and to Professor Heather Cubie for chairing the event.

The brainchild of Nigel and Vicky Milne, to incorporate the Cowal Highland Gathering into the itinerary, made for a memorable day of Scottish hospitality and culture.

Finally, but by no means least, many thanks to Esther and Chifundo for engaging so positively with all the experiences and opportunities offered, which made hosting their visit an absolute privilege and pleasure.

For those readers who missed the blog post about Week 1, you can see it here.

Day 9 – Monday 2nd September

To describe the first day of Week 2 as ‘rainy’ would be a massive understatment. We were scheduled to arrive at Dundee Dental School by 10.45am and the drive from Glasgow was more like a boat trip than a car journey. Nevertheless, we arrived on time and were met by Frances Zaccarini, the Dean’s PA, who showed us up to the Campus View meeting room on the seventh floor.

I had been keen to include this visit to Dundee for a number of reasons. My friend and colleague Professor Peter Mossey, Professor of Craniofacial Development & Associate Dean for Internationalisation at the University of Dundee Dental School, is heavily engaged in global health activities and is very supportive of the MalDent Project. He was instrumental in our project being used as an exemplar in the FDI document ‘Vision 2023: Delivering Optimal Oral Health For All’, and he also attended the recent workshop in Nottingham. Another reason for a visit was the focus on Malawi by the Principal & Vice Chancellor of the University of Dundee, Professor Iain Gillespie. As part of his strategic intent, Professor Gillespie has established, in collaboration with the Vice Chancellors of all six of Malawi’s public universities, The Blantyre Declaration. Through this initiative, there are several Malawian PhD students studying at Dundee University, four of whom I had met previously, either on visits to Dundee or at the recent SMP event with the First Minister. The four students are Remus Chunda, a Malawian trained dental therapist, who has just submitted his PhD thesis on health coaching, Esther Mabedi and Colleen Mbughi who are pursuing PhD studies in the Department of Geography & Environmental Science, School of Humanities, Social Sciences & Law, and Gervasio Nyaka from Kamuzu University of Health Sciences, who is studying aspects of inter-professional training for his PhD in medical education. We were also joined by Dr Alistair Geddes, Senior Lecturer in Human Geography, who has major research interests in Malawi, and works in partnership on some of these with Peter and with Dr Neil Merrylees, a Senior Lecturer in General Medical Practice.

We spent the morning session discussing a wide range of subjects linked to the variety of research projects underway, as well as aspects of oral health in Malawi. It provided an excellent opportunity for Esther and Chifundo to meet some of their fellow citizens and to recognise the possibilities for postgraduate study in the UK.

Peter had arranged a very tasty lunch for us and conversation continued as we ate:

After lunch, Colleen, Remus and Gervasio took Esther and Chifundo for a walk around the university campus and down to the V&A Dundee Museum. Despite the intermittent rain, they had a good time together:

We had arranged to meet Dr Doug Stirling who leads the central guidance development team of the Scottish Dental Clinical Effectiveness Programme (SDCEP), part of NHS Education for Scotland and based in Dundee. Doug joined SDCEP when we first established it 20 years ago as an initiative of the Scottish Government National Dental Advisory Committee, and I have known him since then, working closely with him, Professor Jan Clarkson (Director of SDCEP) and their outstanding team on multiple projects, including during the COVID pandemic. We recommend the SDCEP materials to the staff and students at KUHeS, for whom they provide an excellent, free online resource of up to date, evidence-based clinical guidance. Doug explained SDCEP’s working methods:

The full portfolio of published guidance documents is now extensive and impressive:

It had been a very successful and enjoyable visit to Dundee thanks to the interest and hospitality of our hosts. Unfortunately, the weather had only slightly improved for the drive back to Glasgow, so the beautiful scenery was still largely obscured, but our journey home was otherwise uneventful.

Day 10 – Tuesday 3rd September

As I indicated at the beginning of the previous blog post, the visit by Esther and Chifundo was made possible by generous funding from the HOPE Foundation of the Royal College of Physicians & Surgeons of Glasgow. Much of Day 10 was spent at the RCPSG, visiting the beautiful College building and meeting key officers from the College.

Our first meeting, at 10.00am, was in The Glasgow Room with Mrs Alison Lannigan, the Chair of the HOPE Foundation. Alison is a consultant surgeon and we enjoyed a fascinating discussion covering different aspects of the healthcare environments in Malawi and the UK. Following our discussion, Alison had to leave to attend a surgical examination meeting in Newcastle, but we were able to take a photograph before she set out on the drive south.

The RCPSG is housed in a very historic and beautiful building. Esther and Chifundo were treated to a detailed tour by Claire McDade who is the Heritage Lead for the College. They returned to the Glasgow Room following the tour, for a photo with their expert guide:

Claire then led us to The President’s Office, where we were met and greeted by Mr Mike McKirdy, President of the RCPSG. When the MalDent Project first started in 2017, Professor David Galloway was President of the RCPSG and Mike was Chair of the College’s Global Health Group. Both David and Mike were very supportive of our fledgling work on oral health improvement in Malawi and we have been very grateful for Mike’s strong, continuing support during his presidency.

Esther and Chifundo had a very enjoyable discussion with the President, who was eager to learn about their course and their aspirations for the future.

Before we left for lunch, Mike took Esther and Chifundo across to his desk to show them the portraits on the wall of Sir William Macewen and Lord Lister, where he recounted a brief summary of the contributions made by both men to medicine and surgery:

As we walked to The Lister Room for lunch, we passed through some of the exhibits for a new exhibition at the RCPSG called ‘William Macewen: At the Cutting Edge’. The exhibition, which opens officially on 11th September, is taking place as the College celebrates its 425th anniversary:

It was interesting that during discussions the day before in Dundee, as well as with Alison Lannigan earlier in the day, we had been talking about the importance of team working amongst different cadres of healthcare professionals. This quote, included in the Sir William Macewen exhibition, seemed especially apt:

For anyone interested in learning more about Sir William Macewen, you may like to look at a RCPSG Heritage blog post available here.

We enjoyed a beautiful lunch, hosted by the President and attended by Linda Irvine, the Deputy CEO of the College who, with her team, had done so much to help us with the arrangements for the visit to Scotland by Esther and Chifundo. After lunch, Linda presented Esther and Chifundo with gifts from the College and then we headed outside for some photos.

The day finished with some discussion and further photos with the College Communications Team. This included a visit to the College Library where Esther and Chifundo were amused to see my name in the GDC Dental Register for 1980:

Finally, we met Kat Hannah, Director of Communications & Marketing, and were able to take a photo with the HOPE Foundation sign as a very appropriate backdrop.

Many thanks are due to the President, Mr Mike McKirdy, and all of the team at the RCPSG for making this such a day to remember.

Day 11 – Wednesday 4th September

On arrival at the Dental School on the morning of Day 11, Esther and Chifundo met Professor Will Mclean, Professor of Endodontology, who is the current President of the International Federation of Endodontic Associations (IFEA) and Chair of the 14th IFEA World Endodontic Congress in Glasgow from 11th-14th September. You will hear more of this in our future post from Week 3, as Esther and Chifundo will attend two days of that congress.

Esther and Chifundo spent the morning session on a new patient endodontics consultant clinic with Dr Abisola Asuni. This was their second session with Dr Asuni, who they knew well from the Flying Faculty teaching in February this year.

In the afternoon, Esther and Chifundo enjoyed a dental public health and Childsmile seminar with Professor Lorna Macpherson, who they had met previously in Malawi, and Mr Peter King, the Childsmile Programme Manager. The principles of the highly successful Scottish Childsmile programme will be followed by the Task Force being set up in Malawi to develop a National Child Oral Health Improvement Programme, so it is very important that the dentists who will be qualifying in Malawi are familiar with those principles.

In the evening, Esther and Chifundo met another great friend of the MalDent Project, Dr Lewis Olsson. Lewis, a Glasgow dental graduate, visited Malawi for one of the elective projects he undertook during his subsequent medical training. He worked with the Head of the BDS programme at KUHeS, Dr James Mchenga, both assisting during operations but also delivering some teaching, including to Esther and Chifundo. Lewis generously treated us all to dinner at Nando’s:

Day 12 – Thursday 5th September

One of the highlights of the BDS degree course at the University of Glasgow is the adult outreach programme for Final Year students. In this model, the students spend 50% of their last year in community dental facilities, delivering dental care under supervision. It represents a very valuable stepping stone between undergraduate teaching in the Dental School and Vocational Training after graduation. During this outreach training, students rapidly increase their clinical experience and confidence. The largest of these outreach centres for the Glasgow BDS programme is in Dumfries, which now houses 12 dental students at any one time. The centre was highlighted in a recent BBC News item which you can read here.

We arrived at 10.45am and were greeted by Susan Morrison who is the Senior Dental Nurse at the Centre. Esther and Chifundo signed confidentiality agreements, changed into their scrubs and each then departed to separate wings of the building. Drs Alun Scott, Hans Brown and Stavros Karampatos were the tutors on duty and between them they looked after Esther and Chifundo as they observed the students undertaking treatment in the clinical areas.

At lunchtime we visited the café in a nearby hospital building where Esther and Chifundo had a chance to relax and chat with some of the Glasgow students who had been allocated to Dumfries Dental Centre that week.

The visit to Dumfries allowed Esther and Chifundo to see another aspect of the BDS degree programme in Glasgow. The concept of outreach teaching is one that in due course would be very applicable in Malawi as the BDS programme there matures. Many thanks are due to all involved in organising and delivering the visit, including Dr James Donn who is the Course Lead for BDS 5 at Glasgow.

As we neared Glasgow on our drive back, I diverted to Clarkston on the south side of the city where we enjoyed dinner in ‘The White Cart’ before heading home.

Day 13 – Friday 6th September

On the Friday morning I had to attend a Scotland Malawi Partnership meeting in Edinburgh. Esther and Chifundo made their own way into the Dental School where they were looked after for the morning by Mr Stephen Dunn, one of the Dental Technology Lecturers.

Esther and Chifundo joined a small group of students from Malaysia and Brunei who would be joining BDS3 as part of the partnership arrangements Glasgow Dental School has with the IMU University in Kuala Lumpur and the Universiti Brunei Darussalam. The first part of the morning was spent revising the principles of partial denture design:

Later, Esther and Chifundo were introduced to the growing trend for computer aided design of partial dentures:

This photo of Stephen with Esther and Chifundo includes reference to traditional dental technology – shelves full of dental articulators – and the move to digital design and workflow, visible on the computer screen behind Chifundo:

Esther and Chifundo were also able to test out scanners on dental models …

… and experience the new Zirkonzahn digital workflow equipment received recently by the department:

On my return from Edinburgh I met Esther and Chifundo at their apartment and we walked through Kelvingrove Park to the University of Glasgow campus at Gilmorehill. The sun was out so we took the opportunity for some photos at the South Front …

… in the quadrangles …

… and in the cloisters:

At 3.00pm we had arranged to meet Professor Heather Cubie, who is the Chair of the Scotland Malawi Partnership. Heather will be chairing a Scotland Malawi Partnership Oral Health Forum on Tuesday 10th September, in which Esther and Chifundo will both participate, so it was an excellent opportunity for everyone to meet. Heather treated us to drinks and cake while we enjoyed a wide-ranging discussion.

After our meeting with Heather we walked back across Kelvingrove Park and dropped in to ‘The Maverick’, as we had done on the previous Friday, for an end of working week drink.

Another week gone – time was flying!

Day 14 – Saturday 7th September

The first day of the weekend was bright and sunny as we headed to Blantyre (Scotland!) to visit the David Livingstone Birthplace Museum (DLBM). Claire McDade, Heritage Lead at the RCPSG, had kindly put me in touch with Sandra Lowson at the DLMB and luckily Sandra was on duty that weekend.

One of the first things that visitors see on arrival is a large bronze statue depicting the attack on David Livingstone by a lion:

For those interested to learn more about the incident, you can read it here:

The DLMB is a large white building with an adjacent shop and café:

After an initial chat with Sandra at the Reception, we headed up to the top floor to begin the tour. The exhibits included artefacts relating to David Livingstone’s medical training. Esther and Chifundo were already aware of the links between David Livingstone and the Royal College of Physicians & Surgeons of Glasgow following their meeting earlier in the week with Mr Mike McKirdy, President of the College.

After completing our visit to Floor 3 we broke for lunch in the café and then returned to finish our tour. The beautiful Pilkington Jackson Tableaux on Level 2 illustrated various stages in David Livingstone’s life:

Here are two examples, one entitled ‘Truth” …

… and the other entitled ‘Endurance’:

Towards the end of the exhibition there is a very ornate metal sculpture depicting a tree …

… close to this wooden sculpture:

Just before leaving the exhibition, Esther and Chifundo left hand-written notes from Malawi:

Finally we caught up again with Sandra for a photo before leaving the Museum.

The afternoon was spent at Braehead Shopping Centre, which went down especially well with Esther:

In the evening, it had been arranged previously that Esther and Chifundo would have dinner with Rachel and Maria, the daughters of my good friends Frank and Christine Bonner. Rachel and Maria are both students at the University of Glasgow. Frank is the Dental School Manager who has been very helpful in facilitating the elective visit by Esther and Chifundo. In addition, Rosie Cullen, a niece of Frank and Christine, was able to attend. Rosie is a Glasgow dental graduate who recently completed her Vocational Training and is now an Associate in a general dental practice in Glasgow. Whilst they had dinner together, Frank, Christine and I enjoyed a curry elsewhere, joining the team for coffee to round off the evening:

It had been a varied and very enjoyable day – history, culture, shopping, good food and time spent with friends.

Day 15 – Sunday 8th September

It had been a hectic two weeks and on Day 15 we all took a rest, preparing for the excitement of Week 3!

The Royal College of Physicians & Surgeons of Glasgow (RCPSG) has been a very strong supporter of the MalDent Project since its inception. In September 2017, the RCPSG funded my airfare to Malawi when I made my first ever visit there for the initial BDS curriculum conference. Subsequently, in 2018, it hosted a dinner for colleagues from the University of Malawi College of Medicine (now Kamuzu University of Health Sciences [KUHeS]) and in 2020, the HOPE Foundation of the RCPSG supported the transport of a container of dental equipment to Lilongwe.

Towards the end of last year, following an introduction by Professor Christine Goodall, Dean of the Dental Faculty at the RCPSG, I met with Mrs Alison Lannigan, a Consultant Surgeon who is Chair of the RCPSG HOPE Foundation, to discuss possible initiatives linked to the MalDent Project. As a result of this discussion, we agreed to explore the possibility of bringing two of the senior dental students from KUHeS to Glasgow for an elective visit. Whilst I was visiting Malawi in February this year, I met with senior colleagues at KUHeS to discuss the possibility and there was overwhelming support. We wrote a paper which detailed the logistics and cost of such a visit, for review by the Trustees of the HOPE Foundation Board. The Board was supportive, and the plan was finally approved by the College Council in April 2024.

In due course, Dr James Mchenga, Head of the BDS programme at KUHeS, established a competitive entry process for the 10 students in the BDS 5 class, and the successful applicants were Esther Khomba and Chifundo Banda. It is the visit by Esther and Chifundo that will form the basis of the next few blog posts.

Day 1 – Sunday 25th August: Arrival

Chifundo and Esther departed from Kamuzu International Airport, Lilongwe, on Saturday 24th August to begin their journey to Glasgow:

Their routing took them via Nairobi Kenyatta Airport and Dubai, where they would board an Airbus A380 for the final leg of the journey.

I arrived at Glasgow Airport in good time to meet the Emirates flight which was scheduled to arrive from Dubai at 12.45pm. The plane arrived on time and after about an hour, Esther arrived through the security gates …

… followed a while later by Chifundo …

We took the obligatory photo beneath the ‘International arrivals’ sign, marking the start of their three week long elective visit to Scotland.

We called in at the Marks & Spencer food store at the airport to buy a few items for later in the evening and then headed to the taxi rank. The weather was dreadful with pouring rain and a brisk wind – in stark contrast with The Warm Heart of Africa! Thankfully we didn’t have to wait too long for a taxi and were soon on our way to the Airbnb address in St Vincent Street that had been booked a few days earlier by colleagues at the RCPSG.

Once we had gained entry to the apartment we took a brief look round and then had a chat before I left for home, allowing Esther and Chifundo to settle in and have a much needed sleep. We agreed that I would call to pick them up at 9.00am the next morning for the 10 minute walk to the Dental School in Sauchiehall Street.

Day 2 – Monday 26th August

The first morning at the Dental School was spent dealing with various elements of induction and talking through the timetable that had been prepared for their visit. We organised scrubs for Esther and Chifundo to wear in the clinics (many thanks to Lezley-Ann Walker) and door entry cards. We took time to call in to see Paul and Robert, two members of the team of hospital porters who had been so helpful with managing the storage and loading of the dental chairs donated by Glasgow Dental Hospital, that had been sent to Dentaid for servicing and subsequent shipping to the Dental Department at Kamuzu Central Hospital in Lilongwe. These chairs have made a significant difference to the clinical learning experience of Esther, Chifundo and their fellow students.

Towards the end of the morning, Andrew Paterson and Niall Rogerson treated Esther and Chifundo to lunch as part of an extended tour of the Dental Hospital & School building. Both Andrew and Niall had met Esther and Chifundo twice previously in Malawi, including during the recent Flying Faculty visit in February.

Earlier in the year, on the Smileawi stand at the Scottish Dental Show, I had met Hannah Macdonald, a BDS 3 student at Glasgow Dental School, who had shown great interest in the MalDent Project. I had mentioned that we would be hosting two students from KUHeS, and Hannah was keen to be involved.

Hannah pulled together a small group of ‘buddies’ from her year group who will help to host the visit by Esther and Chifundo. They all met together at the end of the first day, established a WhatsApp group, and agreed that their first joint trip would be to the Kelvingrove Art Gallery & Museum and to the Botanical Gardens on Sunday 1st September.

Once the timetabled activities were complete, Esther, Chifundo and I enjoyed dinner, before heading to a Tesco supermarket for a ‘weekly shop’ and then home. It had been an excellent first day.

Day 3 – Tuesday 27th August

The dreadful weather that had greeted Esther and Chifundo on arrival in Glasgow made a comeback on the Tuesday morning, so I had extra umbrellas with me when I met them at their accommodation to walk to the Dental School.

Once at the Dental School they changed into the scrubs that Lezley-Ann Walker had provided for them. They were then ready for their first session on maxillofacial radiology.

The whole morning was spent with Dr Neil Henderson, Clinical Senior Lecturer / Honorary Consultant in Dental and Maxillofacial Radiology. Neil showed Esther and Chifundo the various items of imaging equipment in the department and discussed aspects of radiographic diagnosis with them.

At the lunch break, I took Esther and Chifundo to the EE Store in Buchanan Street to purchase pay as you go SIM cards for their phones. This was dealt with very quickly and efficiently, then we headed back to the Dental School for lunch.

Whilst in the Hi Cafe at the Dental School we were joined by Robbie and Patricia Thomson, long-time friends and colleagues of mine. Having sold their dental practice, Robbie and Patricia now deliver clinical teaching in the Dental School, using their many years of experience to the benefit of the students on the BDS course. We had a very enjoyable chat and no doubt Esther and Chifundo will be meeting them again during some of their timetabled sessions.

On the first day of their visit, I had asked Esther and Chifundo whether there were any activities missing from the timetable we had prepared that they would like us to insert. The answer was ‘wire bending’ and thanks to Mr Neil Nairn, Lecturer in Orthodontic Technology, a session was included early in the afternoon of Day 2.

Both Esther and Chifundo really enjoyed getting to grips with the exercises that were set by Neil – the same exercises that the Glasgow dental students grapple with.

The final stop of the day was on Level 9 of the Dental School in the Decontamination Training Laboratory. This is a unique facility where students are taught in detail the practical aspects of running quality-controlled dental instrument decontamination and sterilisation processes. The laboratory is run by Mr Stuart Smith, a qualified equipment engineer, and ensures that graduates have all the necessary theoretical and practical knowledge to run a dental instrument decontamination facility.

In this session, Esther and Chifundo were joined by three visiting elective students from Hong Kong – an international symposium on dental instrument decontamination!

It had been a busy day, which we rounded off with dinner followed by a walk home from the city centre. Our route took us past the Royal College of Physicians & Surgeons in St. Vincent Street, the ‘home’ of the HOPE Foundation which is generously funding the visit by Esther and Chifundo. The sun was out and we took the opportunity to capture some photos at the public entrance …

… and the formal entrance …

It was a fitting end to a very successful day.

Day 4 – Wednesday 28th August

We had agreed between us that Esther and Chifundo would find their own way to the Dental School from their accommodation, having now practised the route several times with me. It was no problem and we met at the Sauchiehall Street entrance as planned at 8.30am.

After donning their scrubs, it was straight off to a 9.00am periodontology tutorial, followed by attendance at a BDS 5 student periodontology clinic.

Once the morning clinic was over, we were treated to a very enjoyable lunch at Café Anti Pasti with Professor Aileen Bell, the Head of Glasgow Dental School, who is part of the team that has been responsible for the visit by Esther and Chifundo.

After lunch, Esther and Chifundo enjoyed a hands-on endodontics session in the Pre-clinical Skills Facility under the direction of Dr Mohammad Tiba, a Clinical Lecturer in Endodontology.

Following the theoretical instruction …

… it was time to cut access cavities in the central incisor replica teeth. Following Mohammad’s teaching, both Esther …

… and Chifundo …

… began the practical exercise, supervised carefully by Mohammad.

At each stage of the process, Mohammad took Esther and Chifundo across to the double-headed operating microscope to review their work critically:

Once the access cavities were prepared to Mohammad’s satisfaction, Esther and Chifundo instrumented the canals and obturated them. The moment of truth was when the teeth were radiographed:

The results were impressive and followed up by some discussion with Mohammad and with Dr David Brunton, another very experienced member of academic staff working in the Pre-clinical Skills Facility that afternoon.

The session finished with a cheerful group photo:

It had been a very full day and we rounded it off with a visit to an ice cream parlour close to the Dental School …

… before heading home to rest and prepare for Day 5.

Day 5 – Thursday 29th August

Day 5 was spent in scrubs, observing in clinics, so there was no scope for photographs. In the morning, Esther and Chifundo attended a BDS 5 student clinical session in Restorative Dentistry. In the afternoon they joined Dr Abisola Asuni , who they knew very well from the Flying Faculty visit in February this year, for an endodontic treatment session

After work activities included a visit to Primark!

Day 6 – Friday 30th August

The morning of Day 6 was spent in the Oral Surgery Department, observing a sinus lift and implant placement procedure. Esther and Chifundo were met by Dr Craig Mather, the Oral Surgeon in the team, who would be operating with Dr Gareth Calvert, Consultant in Restorative Dentistry.

Whilst Esther and Chifundo had read about this type of procedure, it was a great opportunity for them to observe the operation in real life. Once the session was completed, they changed out of their scrubs and we headed to a nearby Nando’s restaurant for lunch. Chifundo was very pleased to see corn on the cob, one of his favourite foods, on the menu!

After lunch, it was back into scrubs to attend a sedation symposium with Dr Kurt Naudi and Dr Conor O’Brien.

Esther and Chifundo joined a group of BDS 4 students and had opportunity to engage in simulations of some of the practical skills required for administration of sedation:

It was hard to believe that it was already the end of the first working week in Glasgow for Esther and Chifundo. Now it was time to turn our thoughts to the weekend. Chifundo had been missing his regular intake of nsima, which is a staple food in Malawi. It is a thick porridge that is made from maize flour and water, which is normally eaten with vegetables and a source of protein such as meat, fish or beans. In order to remedy this situation we went to the African food shop in Great Western Road where Chifundo was delighted to find the maize flour he needed to make some nsima over the weekend.

We walked back through Kelvingrove Park and came across ‘The Maverick’, just five minutes walk from their apartment, and decided that a Friday night drink would be in order.

We enjoyed a good chat about the week’s activities and a preview of what was to come in the following week.

Finally, we made arrangements for the early morning pick up the next day when we would be visiting Nigel and Vicky Milne, our Smileawi colleagues, in Dunoon and attending the Cowal Highland Gathering – some Scottish culture to temper the dental learning!

Day 7 – Saturday 31st August

Since Esther and Chifundo had arrived in Glasgow, the weather had been disappointing, with heavy rain a frequent feature. Today would demonstrate to our visitors that Scotland can also experience days of blue sky and sun. I picked up Esther and Chifundo from their apartment at 8.00am and we set out on the two hour drive to Dunoon via the A82, A83 ‘Rest and Be Thankful’ through Glen Croe and, finally, the A815. At 10.00am we reached the lodge that is temporarily home for Nigel and Vicky Milne, whilst their own house undergoes renovation. Nigel and Vicky greeted us in their Smileawi branded merchandise:

After a brief chat we headed into Dunoon and parked up outside The Hollies Dental Practice, which Nigel and Vicky had owned and run for many years before their retirement in 2023. The new owner kindly allowed us to visit so that Esther and Chifundo could see inside a UK general practice.

After the tour, and a photo outside the practice …

… we walked through Dunoon town centre en route to Dunoon Stadium. On the way we passed by Dunoon Burgh Hall, which turns out to have a very direct link to the MalDent Project.

As regular readers will know, the architectural practice that is designing the new dental teaching facility / student hub on the Blantyre Campus of KUHeS is John McAslan + Partners (JMP). John McAslan was born in Dunoon, and in 2008 the John McAslan Family Trust acquired the Burgh Hall before undertaking a major programme of refurbishment, resulting in its current use as a vibrant arts and culture hub.

A plaque on one of the interior walls recognises this tremendous contribution by John and his family to the local community. It was a perfect opportunity for a photograph with Esther and Chifundo, two budding young dental professionals who, like many other other dental students, qualified dentists and patients in Malawi, will benefit greatly from the new JMP-designed dental facility on the Blantyre Campus of KUHeS once it is complete.

Our walk through Dunoon ended at the Dunoon Stadium, where the Cowal Highland Gathering was underway …

The beautiful weather had attracted large crowds to the event …

… but we soon found a pitch and settled down to a lovely picnic kindly prepared by Vicky:

After lunch, Chifundo, Nigel and I went for a walk around the grounds and found suitable hoardings for some photos:

All afternoon, a succession of pipe bands marched out into the arena and played under the watchful eyes of the judges and onlookers. Here’s a short sample:

It was very warm, so ice creams and cool drinks were the order of the day:

Nigel and Vicky had been practising dentistry in Dunoon for many years and met a large number of their friends among the crowds. One of these was Andy Lancaster, who has visited Malawi as a member of Smileawi Spanners, along with Alan Stewart who has figured frequently in this blog.

In addition to the pipe bands there were the Finals of the World Highland Dancing Championship and athletes competing in a large variety of Scottish sports including tossing the caber, backhold wrestling and hammer throwing.

The gathering was a great opportunity for Esther and Chifundo to experience some traditional Scottish culture and we are very grateful to Nigel and Vicky for suggesting and organising our visit.

On the way home we had hoped to stop for dinner at the The Coylet Inn, a 17th century coaching inn close to Dunoon, but it was a busy Saturday night and we would have had to wait a long time to be served. We decided to carry on with the journey, but took the opportunity to capture a photo of Esther and Chifundo at the beautiful Loch Eck, opposite the inn, before we set off again.

Our eventual stop for dinner was at The Tarbet Hotel, where we ordered a ‘haggis, neeps and tatties’ starter for Esther and Chifundo to try, ahead of our main dishes. Both agreed it was very tasty and a suitable end to a day of Scottish culture.

By the time we reached Glasgow we had been out for 14 hours and were weary, but very pleasantly so after a great trip.

Day 8 – Sunday 1st September

On Sunday, Esther and Chifundo spent time with Hannah MacDonald and Jack Houston, two of their Glasgow BDS 3 buddies. They spent time at the Kelvingrove Art Gallery and Museum, then walked along Kelvin Way …

… to Glasgow Botanic Gardens:

Esther and Chifundo had reached the end of their first full week in Glasgow! Keep an eye open for the next blog post which will cover Week 2.

I was recently given the opportunity to speak briefly about The MalDent Project during a meeting at Edinburgh City Chambers on 12th August between John Swinney, First Minister of Scotland, and the Scotland Malawi Partnership.

The meeting also involved Angus Robertson MSP, the Scottish Government’s Cabinet Secretary for International Development, and Sarah Boyack MSP, Vice Convenor of Holyrood’s Malawi Cross-Party Group.

A full account of the event, including video recordings of the adresses by John Swinney and Angus Robertson, has been published by the Scotland Malawi Partnership and can be viewed here.

The evening demonstrated the vibrancy of the many civic society links between Scotland and Malawi across multiple sectors. It was a privilege to participate and, in the case of The MalDent Project, to acknowledge the significant financial support we have received from the Scottish Government International Development programme.

The event closed with comments from Stuart Brown, the Chief Executive Officer of the Scotland Malawi Partnership:

Many congratulations are due to Stuart and his team for organising such an impactful and engaging event.

Acknowledgement

Photos: Kirsty Stroma Photography, courtesy of the Scotland Malawi Partnership (SMP)

This is a guest post written by George Kafera, a Final Year student on the Bachelor of Dental Surgery degree course at Kamuzu University of Health Sciences.

My Profile 

I am George Kafera, a final year dental student at Kamuzu University of Health Sciences, aiming to graduate this coming December. I am passionate about dental public health, data analytics and academics. I am constantly reading and writing more on dental public health to sharpen my skills and shape my career path. My ambition is to become a senior figure in dental public health in Malawi not many years from now, helping to enhance oral and dental health for all Malawians. I would be glad to receive any mentorship or help from anyone which could help me to achieve this goal. 

How I found the OpenWHO course 

Following the multi-sectoral child oral health workshop in Mponela, where the results of the first Malawi National Child Oral Health Survey were being disseminated on 15th and 16th May, 2024, the MalDent Project blog published a post on 25 May which summarised the workshop content and outcomes. This blog mentioned a recorded lecture by Dr. Yuka Makino, the WHO Technical Officer for Africa, who highlighted the scale of dental problems in the WHO African region. It was pointed out that prevention should be the ultimate goal in addressing oral diseases in Africa. Dr Makino, Prof Bagg and his team recommended a free course that provided helpful teaching materials on oral disease prevention: OpenWHO course ‘Oral Health Training Course for Community Health Workers in Africa’. I enrolled on the course and obtained my certificate on May 31, 2024:

Why I took the course 

I took the course to improve my knowledge on how I can give simple and well understood information during dental awareness campaigns. I saw that the course would help me teach leaders of the community and schools on maintaining good oral health, as not everyone can have a chance of taking this course. Since I am deeply interested in public health, I saw this course as an opportunity to learn and sharpen my skills towards my career path of dental public health. 

What I learned 

The course had five modules encompassing basic, yet important, information on oral health with its focus on public health. Module one was on general oral health, covering pregnancy, infancy, childhood, adolescence, adulthood and older people. This was followed by module two on common oral diseases, risk factors and oral screenings. Module three covered oral health promotion and oral disease prevention and management. Module four was very important as it aligned with public health, dealing with school and community based oral health promotion. The last module discussed oral health data monitoring and management. 

How it will be useful in my life 

The course simplified oral health and will be my teaching aid to the community whenever a need arises. It has also inspired me to increase my interest in public health following the statistics and general facts about oral health I learnt through doing this course. It also reminded me of the basics of oral health and what one needs to focus on to play a role in the community. I would encourage my fellow students to take the course – it is a very important teaching aid when giving oral health instruction and when community dentistry is needed.

A recent post described the very successful child oral health improvement workshop at Mponela in May. One of the main outcomes, suggested by the representatives from the Ministries of Health and Education, was to establish a Task Force that would develop a National Child Oral Health Improvement Plan. Work is now underway between Malawian and Scottish stakeholders to draft a Concept Paper and Terms of Reference for the Task Force, which will be submitted to the Ministry of Health for comment and approval.

In an earlier post, we had introduced some of the Assistant Lecturers who had been appointed through World Bank funding as teaching staff for the new Bachelor of Dental Surgery degree programme at Kamuzu University of Health Sciences (KUHeS). One of these staff members is Don Chiwaya, who is currently in South Africa pursuing specialist training in Dental Public Health, prior to returning to his academic post at KUHeS. When Don read our blog post about the Mponela meeting, he contacted Lorna Macpherson, who provides him with informal mentoring. Don is at a stage in his postgraduate training when he needs to undertake some project work for his dissertation, ideally operating at a national level in Malawi. Lorna and I, therefore, set up a Zoom call with Don to discuss possibilities.

As a result of this call, and following discussions with Malawian colleagues, it has been agreed that Don will join the Task Force being established to develop a National Child Oral Health Improvement Plan. This will provide him with great experience of working at a national level and ensure that when he returns to Malawi at the end of his specialist training in dental public health he will be perfectly placed to participate in the implementation of the programme developed by the Task Force.

Prior to the meeting at Mponela, Yuka had alerted us to a WHO and UNICEF collaboration entitled “Well-Child and Adolescent Care Visits: Programmatic Direction”. The package provides guidance on scheduled child and adolescent well-care visits – seventeen interactions from birth through the teenage years. Oral health assessments are already incorporated into some of the visits. The programme is being overseen by Dr Anne Rerimoi, a paediatrician and epidemiologist who is currently employed as a WHO consultant based in Liverpool, U.K.. Lorna, Yuka and I had a very useful Zoom call with Anne in April, following which she kindly provided a pre-recorded presentation that we were able to share with the workshop delegates in Mponela:

There is a special relevance to our ongoing work on child oral health because Malawi is one of the countries that has been chosen to pilot the WHO/UNICEF package. This provides a potential opportunity for us to link the work of the Task Force developing a Child Oral Health Improvement Plan with introduction of the new WHO/UNICEF package, potentially benefitting both programmes.

In order to pursue discussions further, Lorna and I invited Anne to visit us in Glasgow. Anne travelled from Liverpool on Sunday 14th July and we met her on the Monday morning at the hotel in which she had stayed overnight.

We walked to the Dental School and then spent a very valuable morning identifying the ways in which we could integrate our efforts. Anne explained that she would be visiting Malawi at the end of July to meet with key stakeholders, some of whom are Ministry of Health officials already familiar with the MalDent Project. It was a great opportunity for Lorna and I to provide Anne with a detailed summary of the various facets of the MalDent Project and of our ambitions around child oral health improvement. Similarly, Anne was able to provide us with additional information on her own programme of work.

Following our deliberations during the morning we headed across to our favourite local Italian restaurant, Café Anti Pasti, to continue the discussions.

It was a fantastic day which identified many exciting opportunities for collaboration. We are very grateful to Dr Yuka Makino for alerting us to the planned pilot in Malawi of the WHO/UNICEF programme of child welfare visits. Joining forces at this early stage will allow us to plan activities and collaborate in a logical, structured fashion. Watch out for future posts as we take this work stream forward.

In recent weeks, a number of the MalDent Project work streams have been making significant progress. This post provides some brief updates.

Collaboration with AMECA at Chilomoni Health Centre

Previous blog posts have introduced the collaboration we have established with the charity AMECA to enhance the physical healthcare infrastructure at Chilomoni Health Centre, just outside Blantyre. Ruthie Markus, the dynamic CEO of AMECA, was back in the UK for several weeks over the Summer and on 25th June I visited her for lunch at her home. We were joined by Paul Thomas, the Medical Director of AMECA …

… and by Chig Amin, who has been Ruthie’s dentist in the UK for many years …

Chig has a longstanding interest in AMECA’a work in Malawi and is now very keen to identify any ways in which he can engage with the work of the MalDent Project. To that end, I am extremely excited that Chig is going to travel out to Blantyre with me on 17th September this year and will stay for a week, which will provide a great opportunity for him to meet key players and to learn about our vision for the future.

In relation to the planned developments at Chilomoni, joint working between Jan Sonke, our architect in Malawi, and Chris Cox at Henry Schein Dental has resulted in a fully worked up plan for the new dental clinic:

The tremendous step forward is that Ruthie and the Trustees of AMECA have very generously agreed to provide £15k to cover the costs of the building work required to convert the identified space into the footprint shown in the diagram above. The work is due to commence in early September this year. My job, together with friends and colleagues, is to raise the funds for the equipment that is required and this exercise is now underway. We will provide regular updates on progress over the next few months.

Transportation of phantom head units and related dental equipment from Dentaid HQ in Southampton to Blantyre, Malawi

Last year, a large number of A-Dec phantom head units were removed from the University of Sheffield Dental School as part of a refurbishment programme. These very high quality units were generously donated by the University of Sheffield to our partner Dentaid for servicing and subsequent installation in the new building that is currently in the final planning stages for the Blantyre Campus of Kamuzu University of Health Sciences (see below).

Dentaid arranged for the transfer of the phantom heads to Southampton and over a period of several months checked and serviced every unit meticulously. The phantom heads were stored in a shipping container, which also contained some additional items for the planned new building.

During a recent refurbishment of one of the clinics at the University of Glasgow Dental School, four functional A-Dec dental chairs were removed and placed in storage. Thanks to the good offices of Andrew Paterson, Senior Lecturer / Honorary Consultant in Restorative Dentistry, and Lauren Hughes, NHS Liaison Manager at the Dental School, these chairs were generously donated to the MalDent Project by NHS Greater Glasgow & Clyde.

On Tuesday 2nd July I hired a van to take these four chairs, together with a number of operating stools, down to Southampton. I hired from Little’s Vehicle Hire, a company I had not used previously, and they provided excellent customer service.

When I arrived at the Glasgow Dental Hospital & School building at about 08.20, Paul Deans and Robert Ryan, two members of the Dental Hospitals’s superb portering team, had already begun the process of moving the chairs up from the basement. As a result, we had loaded the van by 09.15 and I was able to make an early start on the road heading south. I broke my journey overnight at Membury Services on the M4 and arrived at Dentaid’s HQ in Southampton at 08.45 on the Wednesday morning. I was greeted by my good friend Stuart Bassham, Workshop Manager at Dentaid, and we enjoyed a coffee before starting the hard work. After coffee we were joined by Richard Hill, Dentaid’s Transport Manager, who accompanied us to the storage yard where the shipping container was located. We set about unloading the van …

… at the end of which the container was full:

As a link to the previous section of this post, the three brown boxes contain equipment that Ruthie Markus had acquired in the UK for use in AMECA’s work in Malawi and which I had collected when I visited her in June. Transportation of small consignments of bulky items to Malawi is a very expensive business and collaboration among partners when a container is being dispatched makes good use of a valuable resource.

It was very heavy work and massive thanks are due to Stuart and Richard for their efficiency and good humour.

We returned to Dentaid HQ for another coffee before I hit the road for the drive back to Glasgow. There were several pockets of congestion and road works en route but I was back in Glasgow by 11pm. Stuart has now prepared all the documentation for shipping the container, so the next time I see it will be later this year in Malawi!

Final stages of design for the new student hub and dental teaching facility at Kamuzu University of Health Sciences.

The phantom head units alluded to in the section above are destined for the new building that is to be built on the Blantyre Campus of Kamuzu University of Health Sciences. Previous blog posts have covered earlier work on the design together with the visit by Peter Lee, Studio Lead for John McAslan + Partners Edinburgh Studio.

Since Peter’s visit to Malawi in February, extensive work has been underway to finalise the plans within the $5.2m budget available from the World Bank. This has resulted in some modifications to the original concept but retaining all the functionality. The working plan now is for a cubical structure with a central atrium. The atrium acts as a solar chimney to draw out heat and pull fresh air through the building.

A model has been produced by the design team that showcases the planned structure:

The model can be dis-assembled floor-by-floor to show each level. Here is the model with the roof removed:

Here, the top floor has been removed to reveal the level that will include the dental clinical teaching facility:

Finally, this view shows the basement of the building:

Images of the external aspect of the building show the overhanging slats which provide some solar shading …

… together with the landscaping that will set the building in a pleasing green environment:

The plans are being reviewed by Blantyre City Council in July. Subsequently the steps required to procure a contractor can be initiated as the project moves towards commencement of construction.

Visit to Kamuzu University of Health Sciences by the CEO and Deputy CEO of the Scotland Malawi Partnership

As part of a two week visit to Malawi, Mr Stuart Brown, CEO of the Scotland Malawi Partnership (SMP) and Mr Chad Morse (Deputy CEO of the SMP) were able to visit the Blantyre Campus of Kamuzu University of Health Sciences. They met Dr Mwapatsa Mipando, Dr Peter Chimimba and Mr George Chirambo, for discussions about the Scottish Government-funded Blantyre-Blantyre and MalDent Projects.

As part of their visit, Peter and Mwapatsa were able to show Stuart and Chad the planned site for the new student hub and dental teaching facility, as discussed in the section above.

Whilst the four sections of this post are separate items, they are linked by a common thread of activities to enhance the training environment for dentists and upgrade the physical infrastructure in which oral health professionals can use their skills to improve the oral health of Malawi’s people. It’s a long journey but as Vincent Van Gogh said:

Great things are not done by impulse but by a series of small things brought together