In November 2024, I was honoured to be invited as one of two keynote speakers to the Third Global Citizenship event organised by the University of Dundee and NHS Tayside, with sponsorship from Global Citizens Tayside and Kids Operating Room (KidsOR):

This annual event is a great opportunity for both undergraduate and postgraduate students at the University of Dundee to showcase their global citizenship activities and to compete for prizes. The evening was a joyous celebration of the engagement of so many students in transformative projects.

My fellow keynote speaker was Dr David Cunningham, CEO of the Scottish charity KidsOR. David delivered an inspirational talk which demonstrated the massive impact of the state of the art surgical infrastructure delivered by KidsOR, which allows paediatric surgeons to deliver high quality care for children in low resource environments. Now operating in over 40 countries, the global impact of the charity is massive.

David and I had opportunity for some informal discussion during the evening about our respective activities. We touched on the fact that in many low resource settings, including Malawi, there is a desperate shortage of high quality, well-equipped, functional dental surgeries. As a result, dental therapists and dentists struggle to deliver care for children and adults alike, because they are unable to use the full range of skills within their scope of practice. This results in many unnecessary referrals to central hospitals for relatively minor procedures, causing additional costs and inconvenience to patients. Furthermore, the already busy central hospital departments become overwhelmed.

David’s wife Claudia graduated as a dentist from the University of Dundee and is now Head of Dentistry at the University of Central Lancashire. David and I engaged in some further discussions after the global citizenship event and early this year he informed me that he would be in Malawi on 10th and 11th February to participate in a regional meeting of Ministers of Health in Lilongwe. He planned to bring Claudia with him to allow her to assess the dental situation on the ground and asked whether The MalDent Project team would be able to organise a suitable itinerary for her. Peter Chimimba and I began planning and arranged a programme that included both Lilongwe and Blantyre.

Day 1: Lilongwe

On Monday 10th February, Peter and I collected Claudia from her hotel in Lilongwe and headed to Kamuzu Central Hospital (KCH) Dental Department. We met initially in the office of Dr Jessie Mlotha-Namarika, the Senior Dental Surgeon at KCH, who is also the Course Coordinator for BDS 3. Dr Wiston Mukiwa also attended who, like Jessie, is a part-time lecturer on the BDS programme. Following introductions, Claudia was taken on a tour of the clinical facilities and then we headed to the conference room, where five of the Final Year BDS students who live in Lilongwe had kindly agreed to join us and were waiting. These students had all sat their final examinations and were awaiting the results. We enjoyed some further discussion before leaving Claudia alone with the students so that she could glean their views without any staff members present!

At the end of the morning session we had a group photograph …

… before Peter and I took Claudia to the Sunbird Capital Hotel for lunch.

We returned to KCH at about 3pm to meet David, who was keen to view the paediatric operating theatre at KCH – one of the first that KidsOR had installed. Following his flying visit we had time for a group photo before heading to our respective hotels.

Day 2: Blantyre and Chilomoni

Early on the morning of Tuesday 11th February, Peter and I collected Claudia from her hotel and headed to Kamuzu International Airport, where we caught the 08.10 flight to Chileka Airport, Blantyre.

On arrival, we headed directly to the Blantyre Campus of Kamuzu University of Health Sciences, where we met Dr James Mchenga, Acting Head of the BDS degree programme, Dr Nathan Lungu, Lecturer and Dr Tasneem Chikwatu, Assistant Lecturer. After initial discussions we went across to the Dental Department at the Queen Elizabeth Hospital, where the BDS 5 students had undertaken their Integrated Dental Care programme over the past year. Here we met Wellington Chikuni, who will be overseeing the internship programme for the successful BDS 5 students who are allocated to the QEH Dental Department over the next year.

Our final stop was at Chilomoni Health Centre, where the charity AMECA is undertaking a major renovation of the infrastructure, including the establishment of a two chair dental surgery. Claudia was introduced to Ruthie Markus, the CEO of AMECA, who gave her a guided tour of the work underway.

The visit to Chilomoni concluded with a visit to the ongoing work on the dental clinic which, once completed, will be the first facility of its type at health centre level.

After bidding farewell to Ruthie and her team, Peter, Claudia and I had a light lunch in the city centre before returning to Chileka Airport for Claudia to catch her flight back to Lilongwe.

It had been a whirlwind visit by Claudia which has hopefully provided a real-life sense of the achievements to date but also the significant challenges that lie ahead. It has been partnerships that have helped us to this point and it would be wonderful if there were an opportunity for KidsOR and The MalDent Project to establish an element of collaboration moving forward.

I arrived back in Blantyre on 2nd February for the first of four blocks of six weeks each that I will be spending at Kamuzu University of Health Sciences (KUHeS) during 2025 as a Visiting Professor in the Department of Oral Health Sciences. One of the joys of the journey to Malawi is watching the African sunrise and this time I had a window seat on the Emirates Airbus A380 from Dubai to Johannesburg. It is impossible to capture the real beauty of the colours in a photograph, but this was the best of several attempts:

The story to be related in this blog began back in December 2024, when I received an e-mail from someone I had never previously met, called Jo Frencken:

The substance of Jo’s e-mail is self-explanatory. Jo had found my e-mail address through reading our MalDent Project blog and was keen to re-connect with Peter Chimimba, my long-term friend and colleague, and The Maldent Project lead in Malawi. I forwarded Jo’s e-mail to Peter and contact was restored!

Jo graduated DDS from the University of Nijmegen, the Netherlands, in 1975. He had worked as a Dental Officer at St Luke’s Hospital in Milosa, Malawi, between January 1977 and January 1980, which was where he had met Peter. In 1981 he completed an MSc in Dental Public Health at the University of London then moved to the University of Dar es Salaam, Tanzania, as a Lecturer in Preventive and Community Dentistry from January 1982-1986. He returned to the University of Nijmegen between 1986 and 1988 to complete his PhD, then from November 1988 – January 1992 was a Senior Researcher in the Department of Community Dental Health & Epidemiology, Netherlands Institute for Preventive Health Care in Leiden. In a further return to Africa, Jo spent January 1992 – July 1997 as Consultant in Dental Public Health at the Ministry of Health & Child Welfare, Zimbabwe, where he was also Acting Chief Dental Officer. Jo spent the remainder of his career in a variety of senior academic posts in the Netherlands until his retirement from academic dentistry in 2015.

Subsequently, Jo informed Peter that he would be visiting Malawi in late January / early February. By coincidence, his time in Blantyre coincided with the start of my own visit – and that was how I came to meet the inventor of Atraumatic Restorative Treatment (ART).

On Thursday 6th February, Jo spent the morning at the Blantyre Campus of KUHeS with Peter and I. We were joined by our junior teaching staff colleagues, Nathan Lungu and Tasneem Chikwatu. We provided Jo with a summary of the various components of The MalDent Project, our progress to date and aspirations for the future. Subsequently, Jo spoke about some of his own work and academic interests, especially in the field of minimal intervention dentistry and atraumatic restorative treatment. It was during his time delivering dental care in low-resource settings in Africa that he had developed the concept of ART, and it was such a privilege for us to hear from the originator himself about this technique which has become so well known in dentistry and is of such direct relevance to Malawi.

Jo had kindly brought a number of books with him which he donated to the Department:

Following a fascinating morning, Jo, Nathan and I enjoyed lunch together before dropping Jo back at his hotel

Later in the day, Peter and I were able to meet with Jo at his hotel to discuss how he might become involved in The MalDent Project. With his wealth of experience delivering clinical service and dental education in Africa, together with an extensive research record (214 peer reviewed journal articles, co-author of seven scientific books and 16 book chapters), we could not have wished for a more experienced adviser and collaborator. During his career he had also held senior positions in both the FDI (World Dental Federation) and WHO, adding further to his credentials for collaborating with us. We agreed that we would develop a proposal, incorporating training opportunities for the teaching staff as well as support for undergraduate training, that Jo could utilise in discussions with his many contacts and attempt to seek additional support for our work moving forwards. Before Peter and I left, Jo kindly presented us with copies of one of his books entitled ‘The art and science of Minimal Intervention Dentistry and Atraumatic Restorative Treatment’.

Jo left Blantyre on 7th February for a few days visiting his old haunts in Malawi, but we had opportunity to meet him once again on 11th February, before he travelled back to the Netherlands. On this occasion we were able to introduce him to Dr Mwapatsa Mipando who, in his former role as Principal of the University of Malawi College of Medicine, had been the initiator of The MalDent Project.

Our work with Jo is just beginning – another exciting chapter opens in The MalDent Project story!

This is a guest post written by Professor Lorna Macpherson, a core member of the MalDent Project team and a Trustee of The Borrow Foundation. Lorna attended the WHO Global Oral Health Meeting in Bangkok from 26th – 29th November and has provided this report of her experiences at the event.

The WHO Global Oral Health meeting was held in Bangkok, Thailand, from 26th – 29th November 2024. This large-scale meeting was hosted by the Government of Thailand.

The specific objectives of the meeting were:

• To promote the implementation of the Global Oral Health Action Plan 2023-2030 and negotiate a joint Bangkok Declaration on oral health.
• To develop national roadmaps that will accelerate the implementation of the Global Oral Health Action Plan 2023-2030.
• To integrate oral health into primary health care and universal health coverage packages.
• To discuss six strategic objectives, 100 actions, 11 global targets, and monitoring of the framework of Global Oral Health Action 2023-2030.

Approximately 300 individuals attended the meeting. Member states were invited to send up to two delegates, and ultimately representatives from 98 member states were present in person. 

The Borrow Foundation provided a grant to the WHO to enable the 45 countries classed as ‘least developed’ to travel to the meeting and 36 countries, including Malawi, were able to attend. It was, therefore, tremendous news for The MalDent Project that Dr Innocent Lanjesi, National Oral Health Coordinator and Dr Jessie Mlotha-Namarika, Chief Dental Surgeon at Kamuzu Central Hospital, were able to travel to Bangkok to represent Malawi:

The Borrow Foundation was represented by Professor Andrew Rugg-Gunn, Nigel Borrow and Lorna Macpherson: 

The meeting also attracted delegates from UN agencies, international organizations, philanthropic foundations, civil society organizations, and other stakeholders dedicated to advancing oral health, non-communicable diseases, and universal health coverage programmes.

The first three days of the meeting considered driving change in relation to the six strategic objectives of the Global Oral Health Action Plan:

• Oral health governance, leadership, and finance
• Oral health promotion and oral disease prevention
• Health workforce
• Oral health care – ensuring universal health care for oral health  
• Oral health information systems
• Oral health research agendas

Two topics were covered each day. In the morning, keynote presentations and case studies were presented from across the world, followed by panel discussions from Member State representatives outlining their experiences, including challenges and opportunities for advancing the strategic objectives under discussion.  

Dr Jessie Mlotha-Namarika participated in a panel discussion on workforce, outlining the issues and recent developments in Malawi:

Planetary health was also discussed and the role for oral health care in building climate resilient health systems and in phasing down the use of dental amalgam was covered.

In the afternoon sessions, Member State representatives were divided into groups, reflecting the six WHO Regions, to discuss the morning session and to work on developing national roadmaps to take forward the strategic objectives: 

This was followed by a series of side events from 5pm to 6pm. Topics included noma, sugar control, school oral health programmes, oral health interventions for the ageing population and shaping a contemporary oral health workforce.

Jessie contributed to a side-event that covered oral health workforce:

There were good opportunities for social events and informal discussions. The Borrow Foundation hosted an evening meal with Drs Kofi Nyarko and Yuka Makino (WHO/AFRO) and Member State representatives from the African countries associated with the Foundation.

On the final morning of the meeting, three key activities were delivered:

1. A high-level session with presentations from regional directors and ministers of health from several countries, declaring their commitment to advancing the Global Oral Health Action Plan and integrating oral health into their national NCD and UHC strategies.  
2. The potential to form a Global Coalition on Oral Health, to assist member states take their oral health strategies forward, was proposed by the WHO and representatives from ‘non state actors’ described ways in which their organisations could collaborate and help promote the implementation of the Global Oral Health Action Plan. Groups participating in the panel discussion included the IADR, FDI, International Dental Manufacturers, UNICEF, the NCD alliance and charities such as The Borrow Foundation.
3. The Bangkok Declaration was adopted. This Declaration outlines collective commitments from member states to accelerate the implementation of the Global Oral Health Action Plan. It seeks to guarantee oral health as a fundamental human right and recognizes that improving access to affordable oral health care cannot be achieved without integrating it into primary health care and universal health coverage packages.

The Bangkok Declaration will inform the Director General’s report for the 4th UN high-level meeting on NCDs due to take place in New York in 2025, to ensure better recognition and integration of oral diseases in the future global NCD agenda.  

Following the conclusion of this successful global meeting, delegates have returned to their home countries armed with new knowledge and a range of activities to pursue in ways that are locally relevant and applicable to their individual nations. Taken in concert, these actions at country level will contribute to taking forward the global oral health agenda.

Acknowledgement

Photographs 1, 3, 4-6, and 9 in this post are credited to WHO / Ministry of Public Health, Thailand, to whom the author gives grateful thanks.

Regular followers of the blog will be aware of the partnership between the charity AMECA and The MalDent Project to establish an exemplar dental clinic at Chilomoni Health Centre, just outside Blantyre. The development of the dental clinic is one component of a much larger programme of work by AMECA at Chilomoni Health Centre which also includes:

• A new physiotherapy clinic
• A complete refurbishment of the maternity unit
• Replacement of the roof and a refurbishment of the outpatient department

The physiotherapy clinic, beautifully decorated with hand-painted colourful murals by a local artist, is already completed and in use:

The following two photos show early stages of the construction work on the maternity unit, which has been making excellent progress:

The replacement of the roof of the outpatient department is also underway, ahead of the refurbishment work required inside:

The origin of the work to provide a functional dental clinic is described in an earlier post. What began as an initial request from Wisdom, the dental therapist, to assist with installation of an existing dental chair into a sub-optimal space has transformed into a much larger project to establish a two chair dental clinic that can act as an exemplar for other healthcare facilities in Malawi.

As a reminder, this was the original dental surgery with its un-installed dental chair and leaking ceiling:

A much larger structure was subsequently identified with sufficient floor space to develop a two-surgery dental clinic. Dr Gift Kawalazira, District Health Officer for Blantyre, gave his approval for the space to be re-utilised for this new purpose.

The establishment of this exemplar dental clinic at Chilomoni Health Centre will:

1. Deliver the first fully equipped dental clinic in a Malawian Health Centre, integrated with other co-located primary care facilities.
2. Provide a model for demonstration to the Ministry of Health and other key stakeholders, who could replicate the core components in other District Hospitals and Health Centres across Malawi.
3. Improve the working conditions for Wisdom Maize and his colleagues delivering dental care within Blantyre District.
4. Increase access to high quality dental treatment for the 63,000 Malawians living in the catchment area of Chilomoni Health Centre.
5. Deliver the potential for outreach teaching of BDS Year 5 students from Kamuzu University of Health Sciences, since it is located very close to Blantyre. This model is widely used in the UK to provide a ‘stepping stone’ for students from clinical practice in the Dental School to a more realistic primary care setting.
6. Provide a facility for collecting accurate oral health data.

Construction work

AMECA has generously agreed to fund the construction work required to convert the space, at a cost of £15,000. That work is currently in progress as shown in the following video and photos:

The outlines of some of the new spaces that are being formed are illustrated by this initial course of bricks:

This photograph shows the very significant changes to the existing structure to convert it into a functional, two surgery dental clinic:

The contractor, Mr Mbewe, produces items such as door frames, window frames and security doors at his own premises then transports them to the site:

Once the construction work is completed, the facility will be decorated and will then be ready for installation of equipment. A later blog post will provide an illustrated description of the facility at that stage.

The Chilomoni AMECA / MalDent Project Dental Clinic Campaign

The dental chair that lay un-used in the previous surgery is brand new and a second dental chair is also available for installation. In addition, Henry Schein Dental has donated a new autoclave for the decontamination room in the facility.

However, funding is required for additional equipment including a compressor, suction motor, ultrasonic cleaner, X-ray units, handpieces, scalers and hand instruments. We have, therefore, launched a fund-raising campaign for the purchase of these items, which are required to allow the clinic to become fully operational.

If you would like to contribute to the campaign and make a donation that will help us to equip the new Dental Clinic at Chilomoni Health Centre you can do so here

Many thanks in advance to those who decide to contribute to our fund-raising. Your donations will help us to make a further significant step towards our goal of ‘Oral Health for All‘ in Malawi.

Regular readers of the blog will recall that Peter Lee, Head of the Edinburgh Studio of John McAslan + Partners (JMP), visited Malawi in February this year. We had a busy week of meetings and visits, including the signing of the contract between JMP and Kamuzu University of Health Sciences (KUHeS) for the next phase of design work on the planned dental teaching facility and student hub to be built on the Blantyre Campus.

Since then, a massive amount of work has been undertaken by JMP, together with local Malawian partners, to produce the dossier of materials required for submission to the Project Implementation Unit (PIU), which acts as the intermediary between the Ministry of Education and the World Bank. The PIU has the main responsibility for project implementation, coordination and monitoring of projects – like this KUHeS building – that are funded through the Skills for a Vibrant Economy (SAVE) programme of the World Bank. The plans have also been submitted to Blantyre City Council for approval.

On Sunday 6th October, another of the JMP architects who is closely involved with our project, Leon Grobbelaar, arrived in Blantyre for a week of on-site work. The main ambition was to review the design with the local teams and contractors to validate it and confirm that it is all fully deliverable to the required standard.

Leon’s work commenced on the Monday morning by meeting with key members of KUHeS staff engaged in the project. It was confirmed that the dossier of documents and drawings produced by JMP and recently forwarded to KUHeS had now been submitted to the PIU. Leon intimated that he could speak directly with members of the PIU if this would be helpful and Chisomo Msefula, who is now the KUHeS academic link with the PIU, passed on that offer.

Leon then presented the various elements of the tender documentation to the team, and explained the key aspects of the final design. This was extremely helpful as the paperwork ran to hundreds of pages, much of which was highly technical. The amount of detail was extraordinary and very impressive.

The visuals of the exterior of the building were especially exciting for the lay audience present:

The exterior of the building is exposed brickwork and Leon enquired whether a small sample wall could be constructed for him to view before he left Blantyre on the Friday. You can read about the outcome of that request later in this post.

Following our meeting in the Board Room we moved to the proposed site for the building:

We were subsequently joined by Soobhas Sobnack, the engineer on the team, who has been involved in the construction of about 80% of the existing buildings on the campus, so he brings with him a wealth of local knowledge.

Soobhas was concerned that the site of the building identified on the plans would incur significant drainage problems on its southern perimeter and that by moving the building slightly north-east, these could be largely eliminated, also reducing the overall cost of construction.

As part of our walk around the site we identified the location for the proposed demonstration wall that Leon had requested at the initial meeting. This was marked out by producing a shallow trench – the first time any soil has been moved during our many discussions over the building design!

After the site meeting, Soobhas took Leon and I to see the new CREATOR Building, constructed for the Malawi Liverpool Wellcome Trust. It is a fantastic building which is now nearing completion:

Leon commented on the regularity of the bricklaying which was first class and a valuable benchmark for our planned new building on the KUHeS campus:

On the Monday evening, Leon, Peter Chimimba, Chisomo Msefula and I met for dinner in Vincent’s Restaurant at the Sunbird Mountain Soche Hotel. It was a very convivial evening which gave Peter and I an excellent opportunity to provide Leon and Chisomo with the back-story of the MalDent Project from its inception.

On Tuesday 8th October, Leon and I visited the recently opened St John Paul II Catholic College, which is part of the Beehive Social Enterprise. Our visit was organised and hosted by Jess Baily, who was the architect for the project. Since completion of this building Jess has recently been engaged by John McAslan + Partners on a part-time freelance basis.

Leon was keen to learn from Jess about any of the challenges that had been encountered during the design and construction of the St John Paul II Catholic College and to discuss in detail the materials employed, design features and sources of the various components of the building. As a lay person I was fascinated by the detailed technical discussions between Jess and Leon. Our visit lasted about an hour during which time we gained a significant amount of information relevant to our planned new building at KUHeS.

We enjoyed a guided tour around all of the facilities, during which Leon took multiple photos. It was a very vibrant building with large numbers of students in attendance. Both Jess and Leon described the thrill for an architect of seeing a completed building which they have designed being put to good use.

Following our tour of the College, Jess took us to visit some building suppliers in Blantyre. Our first stop was at the Universal Trading Company. This was a very large premises with multiple entrances:

Entrance 3 housed a massive array of pipes of different dimensions, angle iron, mesh and related metal items. Leon’s camera was red-hot!

In another part of the warehouse, Leon was able to view sanitary ware, taps, door handles and related fittings:

After ironmongery we moved to another store to view tiles:

By now it was lunchtime so we headed to Caffe Grazia for a snack. Jess then dropped me back at KUHeS before she and Leon visited one last supplier.

As described above, during our first meeting with Leon on the Monday, he had requested that a 1m x 1m demonstration wall be constructed near the planned site for the new building. Following the visits we had made to brick and SSB production facilities in February with Peter Lee, the design team had agreed that they would specify bricks made by the Malawian company Terrastone. Leon contacted Patrick Calisse at MOD Architects who spoke with Terrastone. We were delighted to hear later on the Monday that Terrastone had agreed to donate bricks and construct the wall according to the technical specification provided by Leon.

On the Tuesday, the bricks were delivered together with a wooden former that was placed into the recess dug for the foundation. Cement would be poured to allow the brick building to commence on the Wednesday.

On the Wednesday morning the bricklaying got underway on the cement foundation which had set overnight:

By lunchtime the wall was built and ready for pointing …

… thanks to these three bricklayers and their foreman from Terrastone:

At 12 noon that Wednesday I was picked up at the KUHeS campus by my friend Mwapatsa Mipando and we drove to Malawi University of Science & Technology (MUST). Mwapatsa has recently retired from KUHeS and is now a member of academic staff at MUST. I had visited this university in 2019 and on arrival I was as impressed with the campus and its buildings as I had been previously.

The main reason for our visit was to discuss the feasibility of setting up a small plant to produce affordable fluoridated toothpaste. The high cost of fluoridated toothpaste in Malawi was identified during the recent workshop in Mponela as a major barrier to our ambition to improve child dental health via supervised toothbrushing programmes in Early Childhood Development Centres and primary schools. MUST’s vision and mission have a major focus on entrepreneurship, including provision of links between academia and industry. We have already been in discussion with colleagues in the Institute of Pharmacy & Biomedical Sciences at Strathclyde University, who are also keen to collaborate.

We met in the University Technology and Innovation Garage…

… where we enjoyed a very positive discussion with Professor Dalison Mkwambisi, who is Professor of Environment & Development, and Director of MUST Institute of Industrial Research & Innovation, along with some of his team. Prof Mkwambisi showed great interest in our proposal and agreed that it could fit well with MUST objectives. We will now proceed with producing a concept paper to take the idea forward.

We drove back from MUST to Blantyre and enjoyed lunch at La Caverna. At Mwapatsa’s suggestion, we then returned to the KUHeS campus where he introduced me to a friend and colleague of his, Dr Luckson Dullie. Dr Dullie trained in medicine at the University of Malawi College of Medicine (now KUHeS) and is currently the Chief Leadership Development & Engagement Officer for the organisation Partners in Health. He has been a pioneer in the development of Family Medicine in Malawi, and those interested in reading more of his ground-breaking work, including his role in developing HIV and NCD (non communicable disease) management protocols in Neno, can do so here.

Whilst we had been drafting Malawi’s National Oral Health Policy we had heard about the NCD demonstration project at Neno, a district in the Southern Region of Malawi. One of those involved, an American physician called Dr Todd Ruderman, had joined the seventeenth on-line meeting we held during the policy writing process and described his work on NCDs and PEN Plus in Malawi. We remain keen to identify whether the ongoing work in Neno would provide an existing platform in which could we pilot integration of oral disease prevention, building on the principle of common risk factors. Dr Dullie has agreed to link me with the key players so that we can instigate some initial discussion.

After our meeting with Dr Dullie, and as we were driving out of the campus, we passed the trial brick wall, which was now being pointed by two of Terrastone’s staff members. As instructed by Leon, the horizontal jointing was recessed and the vertical jointing flush, using a mortar that was stained to provide a red colour that matched the bricks. Mwapatsa and I stopped to view progress and to speak to the two bricklayers. It may seem a fairly trivial development to many readers, but for those of us who have been involved in the design work since 2019 that small demonstration wall represents a very significant milestone.

Since my recent return to Scotland, Leon has kindly sent me this image of the finished product – in Leon’s words, “a totem to the future”!

Mwapatsa gave me a lift home from KUHeS. On arrival, we visited Ruthie in her house and had a drink together on the khonde. Ruthie had been putting the finishing touches to the next newsletter for her charity AMECA and she shared many of the photographs from the ongoing work at Chilomoni Health Centre, including the new dental clinic, with Mwapatsa.

This was my final evening in Blantyre before leaving for Scotland the next day. It had been a varied and exciting three weeks of activity during which I had also made a number of new friends. The MalDent Project has a long way to go but with small steps, like the demonstration wall, we’re making progress.

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!