Wednesday 28 November 2007

Good services in Malawi can be a model for neighbouring countries







Considering all these bad things that you hear about Malawi
Have you ever wondered whether there is anything good that comes from Malawi and spreads to the neighbouring countries?

When I received an email in June 2007 from an International Eye Organisation that my name had been suggested as one of the team members that would be useful in setting up a new Eye care programme in the rural part of Mozambique; a few thoughts came into my mind. Firstly I wondered whether the current eye service delivery in Malawi would be a model for Mozambique (in the context of so many things still not being efficient in the Malawi programme) and why my name was given and who gave it. If they wanted a neighbouring country ,Why did they not look for a consultant in South Africa where there is so much expertise, I wondered ? The only plausible explanation I had at that time for being chosen for the job was that this was not a very interesting and well paying assignment (imagine spending two weeks in rural Mozambique where the main language is Portuguese and not English).Anyway somebody had to do this job so I wrote back that I would be interested to go.
Arrangements were made to meet Mozambican counterparts in Nampura Province at the Provincial hospital. I did not know what to expect when I arrived in Nampura .A language translator had been organised to be part of the team. I had my digital camera to record all the adventures

Interestingly there was so much fun when I got there and there were not many obstacles as I had anticipated. I observed that Eye diseases do not respect the political boundaries and do not need a VISA to cross borders so every other eye condition that I have seen in Malawi was there in Nampura. Unfortunately Nampura did not have an effective eye programme in place so the problems were much worse there (lots and lots of blind people) . However their villages,districts ,and health services were so similar to Malawi that more than often I forgot I was miles away from Malawi. Getting to the famous Nacala City (where the port is and the Nacala corridor -which the Malawi defence forces had been defending for years ) I expected to see a lot of unusual things. But all I met were nice friendly people and some of their food was the same as we have in Malawi (Nsima). It was during the meeting that we had at the District administrators offices that it transpired to me that these people had heard of so much good eye work that was being done in Malawi and were wondering why the same thing couldn’t happen to them and were hoping I was the solution.
A report about how a programme could be started in the Nampura province was submitted to the NGO a few weeks later and fortunately most of our recommendations were taken seriously such that the programme has actually started.
Looking back ,it would have been a difficulty assignment if a consultant from a well developed country who is not used to working in the community could have been chosen.And somebody,somwhere knew that this assignment could better be tackled by eye workers in Malawi.
The little good things that are happening in the eye sector in Malawi are being watched by many; and in this competitive world it is a rare opportunity for Malawi to spray its wings to the neighbouring countries and become a role model.

Tuesday 27 November 2007

Makandi Tea and Coffee Estates - Thyolo Malawi







The advantages of working as an Eye doctor in the community in Malawi is that you get to see a lot of places within Malawi.
One such place that caught my eye during a recent visit was the Makandi Coffee and Tea Estate situated along the Blantyre -Thyolo Road (about 30 Km from Blantyre).
The view that you see when you get here is just magnificent and you wonder whether you are in Malawi.Everything is green expect the yellow contrast that comes from the rain coats of the workers of the estate who are busy picking up the tea leaves and not minding about your interfering with them. The well tarred road runs right in the middle of the estate so you can easily see all the scenery without stopping your car. You have to be careful when you want to stop as many cyclists are riding along the road. Villages are a bit further inside the estate so you don’t see many people, occasionally a woman carrying a bucket on their head.
After a long day working at the Thyolo District hospital helping the eye patients, you are assured of getting back home with plenty of bananas.

The Joys of working in a community in Malawi






How you ever thought of how hard and impossible it is for a professional person to work in a rural area in Malawi where there is no internet?The truth is that it is not that difficulty .
We are all faced with a series of great opportunities brilliantly disguised as impossible situations.
Charles R. Swindoll

A recent NGO International advert looking for health workers to work in developing countries caught my eye. It started like this :”Heroes not wanted. If the main motivation for applying for this job is money ,then we are probably not looking for you. “ I should have applied for this job, but didn’t because my currently job has almost the same conditions.
Working in a community in Malawi can be very challenging but also very rewarding (not financially).The job satisfaction comes from the fact that you are able to help in situations where communities feel helpless; and by the end of the day you have much more satisfaction(even though your pockets are still empty) .Initially we all crave for money, but eventuality we realise that money is not the only thing that we need to think about. Afterall all this evil, robbery, corruption, political wrangles that we have in Malawi have very little to do with people wanting to serve our country; but rather to enrich themselves.
If you really want to serve or do something for Malawians think of doing something peacefully in the community where people appreciate your role and you appreciate theirs.
One interesting thing about the rural Malawi is that despite the many problems available(HIV/Aids,Hunger,e.t.c),people are usually smiling and happy .This is in great contrast to the west where people have all this money and credit cards, but everyone looks so gloomy when you are with them in the trains and buses. You can be sure that when you spend a whole day in the community in Malawi, your face is full of smiles.
Of most interesting to me is the children I found everywhere I go in the rural communities of Malawi ,actively running after my car and willingly asking to have their pictures taken (not this business of asking for consent to take a picture in the west and being embarrassingly refused).As a result I end up with lots and lots of Photos of children from all the districts in Malawi.
Lunch is also served with a lot of respect from the following resthouses ( Nsanje discovery lodge in Nsanje, Matechanga in Chikwawa, Mulanje view motel and Chididi in Mulanje, Jali in Zomba, Chinese restaurant in Mangochi, Kanthunkhako in Mzuzu) and many other places all over Malawi.After all having a full meal with a drink and a lot of respect for only USD 2,who can complain !!!!
I love working in the community in Malawi.

Blind Children have no one to speak for them in Malawi but they also need treatment







You often read or hear about certain people in Malawi who have a particular disease that needs treatment outside the country and that they need finances to seek medical treatment otherwise they will die.

Do you know that there are at least blind children 1000 blind children in Malawi who also need financial assistance to get to effective treatment within Malawi?

I have decided to post these pictures of blind children from Malawi to highlight the need that is there.

Unfortunately these children have no one to speak or write for them and are doomed to remain blind for life. I have failed them, you have failed them and our society has failed them by not speaking or doing something about them.

The commonest treatable cause of blindness in children in Malawi is cataract (ng’ala); which can occur as a result of many things such as a mother having an infection during pregnancy; or being inherited (genes) from parents.

Children are either born blind or develop the cataract earlier in their lives.

If these children are not operated within the first few years of life (before 10 years of age), their brain switches off the light stimulus and these children will never regain sight even if they are operated later in life.

Most parents who have children blind from cataract do not know that this condition can be treated; as a result they stay within their communities or present at the hospital when it is very late.
Operations can be done in Malawi; but the surgical supplies and other requirements needed are a bit expensive so there is limitation as to how many can be helped. On top of operation itself, children need glasses which are usually expensive. They also need to stay in hospital for a few weeks.

A child who is blind will most likely not end up in school; remain uneducated, poor and continue the circle of poverty.
Unfortunately there is no Voice to speak for these children; so they get neglected and life goes own in Malawi and elsewhere.

My conscious tells me I should write more about blind children and try to engage people to do more.
I have already started researching ways of how to get blind children with cataract early from their villages to hospital in Blantyre but I have not sorted out all the logistics yet.

You can help. Email me!
I will tell you how

Monday 26 November 2007

Greed among Professional and Business Malawians


Partnership and collaboration are two of the most common words I have been hearing recently since I have been attending several meetings here in London and everywhere else.
But are these two words applicable to professional and business Malawians at the moment?
To me partnership involves two or more organisations/bodies/firms/businesses/institutions (you name it) who have a memorandum of understanding to work together (lawyers may know how to really define this) under one umbrella.
Collaboration on the other hand as described by my colleagues involves two or more separate entities willing to work together but each one still operating other their mother entity. For example a University in UK may collaborate with a University in Malawi to do joint research but each institution continues to have its own values and virtues.

Malawians do not want to go into partnership because of greed and luck of trust .Do you know how many lawyers are practising in Malawi? To have a rough idea ;just count the number of lawyers you know in Malawi and that will roughly give you the number of legal firms available for them. Each one has their own legal firm named by their difficulty surname( Kalua and associates , chekacheka legal firm ;e.t.c) and situated in an old debilitated building somewhere in Blantyre. Why cant these lawyers come together and form one good posh legal firm and share the profits. Its all not possible because of greed( according to a lawyer friend of mine operating his own legal practice in Zomba).

What about in Health (my field)?
Each Doctor practising n Malawi has their own clinic; and claim to be specialists in everything .Why cant they come together and form one good clinic ?Greed again.

I was in a vibrant private clinic a few years ago but left after we could not agree on the percentage of share holding by each stakeholder within the clinic. Its really sad that even at a higher professional level we still can not agree to be partners.

This is evident in all other areas in Malawi ( accounting firms, construction companies, estate agents, car dealers and many more).

A few people I have spoken to say they can not trust a fellow Malawian to be a partner as Malawians are usually greed and steal from our own business.As a result each one wants to do business on their own but this becomes very hard when you experience some emergency situation. Recently I saw a vibrant legal firm closed down after the owner died as there was no one to take care of business. This could not have happened if there was a business partner involved earlier own.

Partnership is mainly a problem among the indigenous Malawians; However Malawians of Indian origin usually have a partner (or at least family members fully involved in business);and no wonder they excel in all business in Malawi.

The world is changing and business in the future will mainly thrive because of partnership and collaborations. Evidence is already available in Malawi where the new Game and Shoprite stores have taken over all the business from the common Malawian.

In Health ;its worse .If you are refusing to collaborate no one will give you any money for research or service delivery.

Collaborating and partnership promotes accountability (which most Malawians do not want).

Next time you think of starting business, seriously think of partnership or collaboration.
What do you think?
Email me!.

Being a productive youth in Malawi - Lions Club of Limbe





What is the first thing you think about when you hear about Lions Clubs International existing in Limbe, Blantyre ? a group of foreign investors ???

The Lions club of Limbe in Blantyre is a vibrant group of young Malawians who want to make a difference by serving the less privileged communities in Malawi .These people are all professional and business gentlemen and ladies who voluntarily give their time to sit down and discuss where they can help in Malawi.
Activities based on member donations have included the cleaning of Limbe Health Centre, Rehabilitation of Salima School for the blind; providing dust bins in Limbe ; sweeping Limbe market; donating food and clothes to various districts in Malawi just to mention a few. Fund raising through Braii , Dinners and donations is an ongoing process. I have been an active member of this club for the last 6 years and the Lions club have had many other successful stories apart from the ones mentioned above.? One such story is the construction of the Lions Eye Hospital in Blantyre Malawi in 2004 (the hospital was handed over to Government –Ministry of Health) ; Lions Club International raised and donated 1.6 million USD dollars for the project (see hospital picture).
You can be a member of Lions club of Limbe even if you don’t stay in Malawi

Malawians leaving outside of Malawi or in Malawi who want to help in any needy area in Malawi can channel their funds/activities through the Club and there will be sure their help will be put to good use.

The Lions club of Limbe meets monthly at Shire highlands Hotel in Limbe .All members are required to wear a Lions club uniform while attending the meeting. The club is a member of Lions Clubs International
Membership to the Lions club is only by invitation ( you can not decide to join- existing club members have to see your potential and invite you to attend 3 meetings before they can veto to induct you).

Lions Club international.
We Serve.
Email me for comments!

Lions Eye Hospital Blantyre Malawi





This is where I work in Blantyre.The hospital is part of Queen Elizabeth Central Hospital and is also a teaching hospital for College of Medicine and other Health teaching institutions in Malawi

Sunday 25 November 2007

More than 10,000 Blind people in Malawi






Fellow malawians -those who are outside the country and the ones in Malawi who can still access email,Do you Know that there are over 10,000 blind people in Malawi and that the majority of these can be cured by a simple 15 minute operation done by an eye Dr like me.
Cataract (Ng'ala,Nkhungu) is the commonest cause of blindness in Malawi (and is everywhere and not in Chikwawa and Nsanje only).The majority of the blind are old people (over 50 years old).These people are completely blind;and the unfortunate part is a child quits school to take care of them.Cataract is not painful and develops so gradual such that the sufferers do not come for help at the hospital.Also the children of these parents/grandparents (like you and me) are usually outside the country or in town and we do not care about these people.Infact most people in Malawi believe it is a time for these people to die.
This need not be so.
Cataract is a white opacity on the eye (lens)-see picture 1 and occurs as part of the normal ageing process (like grey hair,imvi,chituvu,mbuha).Fortunately with technology this can be removed within 15 minutes at the hospital and the sight restored.
I believe all of you reading this article should have in Malawi a relative who is blind from Cataract.
I illustrate to you a case of an old man that I operated on who ended regaining his sight after being blind for nearly 5 years.
1.The first picture is of the patient.You can see the white in both of his eyes and that he is completely blind.He was blind like this for 5 years and a young grand child was taking care of him.
2.The second picture is of my team and I operating on him.
3.The third picture is of him immediately after the operation eating his food (nsima)(you can see that both his eyes are covered with bandage).
4.The 4th picture is of him after i opened the bandages the next day (day 2) after surgery .You can see that the white thing is not there.He is mute because he is initially shocked that he can see.
5.The 5th picture is a nice one.You see now he is finally smilling and happy to see again after 5 years.He even looks younger.

You can help in making sure that the 10,000 blind people in malawi do not stay blind.Ask me how.
Change a life of somebody.You will see how satisfying it can be.

We treat;but God Heals.

Did you know that Children can also go blind from Cataract(Ng'ala?).Read my next article.
Email me for comments!

More Research More Money

The last week was a busy week for all of us at the International Centre for Eye Health (ICEH) , London School of Hygine and Tropical Medicine
as we were busy preparing for a two days Research Retreat in Oxford (about 80 Km out of London).Even though I had been invited for this two days meeting I did not know what a retreat was so i didnt know what to expect .The retreat took place from 19-20th November both days inclusive.
At 8.00 am in the morning am sitting in the room with all these distinguished/ high level eye Researchers discussing what we need to do in terms of Research for developing countries and especially Africa where there little is being done. The whole morning we are brain storming ideas/research topics and planning how to do the Research.By afternnon the message is clear to me;if we want to do more Research in Africa we need to train much more local people to collaborate in these research areas.Even though most researchers are willing to do research in many african and other developing countries,they prefer to have a local person conduct research in their own country . Iam thinking,wow!! I will be collaborating so much research in Malawi.
Coming the next day;the obstacles are more obvious to me;Lack of money is definetely not one of the major ones;but lack of human capacity and space (Infrastucture )where to do the research.I am a bit more dissapointed as every little thing I am asked whether malawi has- the answer is no.As such most research ideas are shifted to Tanzania and Kenya where they have better infrastucture.
What have I gained/Learnt at this meeting?
If you have good Research ideas and ready to do the research(or collaborate it in Africa) ;most NGO's are willing to fund Eye Research.

Outcome of research meeting/Retreat
8 to 10 research topic areas identified and coordinators appointed. 2-3 year Proposals in the range of USD 300,000 -USD 2 million to be written and submitted soon to major granting bosies as dates for deadlines are nearing .Most of the reserach to be done in India and Bangladesh where there is both Human Resource and Infrastucture.
A few proposals for Kenya and Tanzania where there are people who can collaborate.

As for Malawi;I am already commited on another already funded project( Check my Research ) for the next four years ;The priority should be on identifying Malawian people to go for training in Health Research who can collaborate Research in future.Is there any candidate out there ready for training?

One thing I now know-finding money can but is not the major obstacle in Research; the major obstacle is lack of Skills/People to do the research.
For more information about what Research in Eye care is needed check Eye Research

Cape Maclear /Monkey bay -Lake Malawi





Lake Malawi
is one of the tourist attractions in Malawi.Unfortunately most malawians have not even been here to see how nature unfolds itself.
During a recent field Visit I hard an opportunity of visiting the Lake in Mangochi and explored h the two wonderful places along the Lake, Monkey Bay and Cape Mclear .Monkey is about 98 Km away from Mangochi Boma and Cape Maclear is about 60 Km.I happened to have beeen at Monkey-Bay when one of the ships sailing on lake Malawi (Mtendere ) was just docking.The scene of seeing the passengers off the ship was fantastic.And plenty of monkiees were indeed there.
Of most unexplored areas along the Lake is the Cape Maclear;where nature is still intact.All you see is a few local people with a Boat (named sunset)who wants to take you on the water.While there you actually wonder how the lake can be so attractive and yet people around so poor.
Next time you have a chance to visit malawi, Make an effort to see the Lake .And fellow malawians,no excuse for not going there if you are already in the country.Even buses go there.You will be amazed which what is in store.

Tuesday 13 November 2007

Port Harbour






My weekend was spent at Port Harbour;a distance of about 3 hours by coach from London.
This is a small vibrant interesting city by the Sea and I was happy to have ended up here.as usual i took all the pictures myself.Look at how bad the first one is.I was hungry this time and bought myself a cheese burgar while exploring the port. I then called Malawi on my phone.Sooner I discovered there was a ferry to Gosport (the other side of the sea) and i needed to get there(ferry cost was only £3 for return trip).Before i know I am on the ferry;doo! doo! doo! it sounds as it rolls over the water.Within a short time am getting out on the other side.Surprisingly this side is very quet with lots of old people with scooters.Is this a retirement home for some rich fellows?I ask myself.Ok lets go for a walk and shoping;Oops !not many shops here .Back to the water for a ride to the main Port Harbour.and then to the main town;looked for some souvernier to buy;didnt get anything.In the evening back in the Coach to London.Not a bad experience.

Friday 9 November 2007

Tapiwa My Miracle Daughter






This is Tapiwa Kalua,My lovely daughter.
Tapiwa is a Tumbuka name(her tribe) meaning God Given.
She is a miracle in many ways;
Born before the mother reached 7 months of her pregnancy ;Tapiwa only weighed 1 Kg at Birth.
She had to stay in hospital (special intensive care unit)alone for 3 months but still only managed to gain an additional 1.5 kg.
She was discharged home (Manchester UK)at 3 months just weighing 2.5 Kg

Despite all she has now picked up weighing a whoooping 11 Kg and has become a very chearful girl;forgetting what she went through.

Medical miracles are a reality;my family have experienced one.

My family would like to thank all the medical staff in Manchester UK that worked hard to save my daughter;she visited 3 hospitals within one week of her birth.
But now she can eat porridge(Nsima).

And who is the mum?
Ofcourse she is my lovely wife.
I will write about her later.
Check about her on my other blog site:
Ng'anga

We were in Chirazulu






These two with me are student doctors from canada;they spent 7 weeks with me in Blantyre in august.I took them to Chirazulu and Mulanje where we had so many eye patients.
Thank god everything went well.We treat;God Heals

Finaly we went back to Blantyre and had a drink with Richard at peoples shopping centre.
But the many we left there in the districts have never been to Blantyre to see the Ng'anga who can be found at
dokotala.blog.co.uk