Sunday 14 December 2008

Only a few Malawians in London for Lucius Bandas show








London is an expensive city; and if I had a choice I also wouldn’t be staying there. Unfortunately the institution that I ma based at is in London, and I have to spend a substantial amount of my time (and money) there.
One doesn’t meet many Malawians in London (compared to Manchester) and indeed when you are there to save money (and maybe send some home) you wouldn’t want to be staying in London where you pay for a one bedroom apartment for £1000 per month.
Recently (9 November 2008) I attended a concert by the famous Malawian musician Lucius Banda near Kings cross tube station in London , and only about 50 Malawians were there( overall turn up was very poor).Well the charge per head was expensive (£30) and considering that not many Malawians stay there, its not surprising that less than 50 people would attend. To my opinion on the gig was a flop!!!! .Well am posting some pictures of Lucius Banda and the audience for you to see.

Do you know Malawians in London that would want to be in touch with me?
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Merry christmas and happy new year from BICO







Greetings from Kigali,Rwanda! A few pictures (kigali motorcycle taxis) for you to view

On behalf of all of staff of Blantyre Institute for community Ophthalmology (BICO) in Malawi, I would like to wish you a merry Christmas and a happy new year 2009.
Since the launch of BICO in mid 2008 with the mission of contributing to the prevention and control of blindness in Malawi through conducting practical research, teaching, training, consultancy and advocacy in eye care delivery, I have been on the run up and down to make things moving. A lot of thanks should go to BICO’s project coordinator, Ruby who also worked hard to put all logistics in place.
As a blog from Kigali ,Rwanda where I am conducting the last BICOs assignemnet for 2008 and where I will spend my Christmas and New year, I would like to thank all of you who have supported us in either reading this blog and sending comments ,or giving us some work to do .
This year our major research achievements included the childhood blindness pilot project in Mulanje, and the Trachoma prevalence survey in Malawi.
The idea to start BICO was conceptualised after realising that despite nearly 10 years after the launch of the VISION2020: THE RIGHT TO SIGHT the global initiative to eliminate avoidable blindness and the various successes/ achievements in other areas of the world; Malawi has still not made much progress especially in the area of research on practical preventative community eye care blindness programmes.
Within a year BICO has spreads its wings across the border and helped in capacity building in Malawi and other countries

The centre aims to conduct and disseminate findings of research being done eye care professionals and other stake holders in the region and transfer the best of its expertise and experience to an ever-increasing number of eye care institutes across Southern Africa. The centre will strategically be located within the University of Malawi College of Medicine teaching eye hospital, the Lions Sight first eye hospital in Blantyre.
The planned activities of the institute contributing to eye care in Malawi and other neighbouring developing countries can be broadly classified under the following areas:
• Capacity building of community eye care health workers
• Training Programmes – focussing on community eye care delivery
• Research capacity building through conducting practical local research (operational and health services research )
• Publications
• Consultative support to countries with no expertise in community eye health
• Advocacy and contribution to Eye Care Programmes at National and International level through the Government and International NGOs.
• Fund raising for eye care service delivery
BICO as a centre within the Lions Sight Eye hospital, College of medicine, University of Malawi, Blantyre will work closely with the collaborating Community Ophthalmology centres within the region (Kilimanjaro Centre for community Ophthalmology-KCCO in Tanzania) and also with International Centre for Eye Health (ICEH, London); which continues to take a leading role in developing Community eye health workers for Africa and elsewhere.

Wednesday 26 November 2008

Participatory Rural appraisal (PRA)



When I attended a full day workshop on Participatory Rural Appraisal (PRA) two years ago at the Senate Lecture theatre, University of London; little did I know that the facilitator himself Robert Chambers is the most distinguished figure that has published extensively on this topic and is referred to as the guru of “PRA”. Had I known, I would have paid more attention to his teachings and this would have made my life easier today. I am struggling to read about this PRA now and had to attend other workshop to increase my skills on PRA. Well, what is this PRA? Unless you are someone who is interested in the community and research, this word is probably of no meaning to you and will not affect your life anyway. But for me, unfortunately this is what I have to deal with every day that I will spend in the community; fortunately Prof Chambers has provided guidelines on what is all about and how to conduct PRA. Robert Chambers describes PRA as "a family of approaches, behaviours and methods for enabling people to do their own appraisal, analysis and planning, take their own action and do their own monitoring and evaluation." (Chambers, Participatory Workshops, 2002) The methods are open ended, participatory, and often visual as well as verbal. PRA processes have facilitated the process of development in many contexts, rural as well as urban. According to my reseach project (finding blind children in rural Malawi )and possibly helping them; PRA offers a method of engaging the community to identify where those children are; shed more understanding as to why the don’t come and finally for the community themselves to find ways of identifying (finding) the blind children and making them come to me so that I offer eye services. It seems Robert chambers has given solutions on what I need to do next in Malawi; and fore sure I am about to embark on PRA methods to find blind children in the Southern Part of Malawi. Are you surprised? Well Robert chambers is one of the most quoted authors that you will find on the internet .And if you dont hear his name when you read any paper on PRA methods,I can bet a few dollars with you .If you find a scientific paper on PRA that has not mentioned Chambers or referred to his work in the literature , I promise to bring to your attention at least 300 articles that have referred to him. And I will be writing more and more about PRA methods and blind children; as that is my next area of research. Write now I am looking for someone with PRA expertise who can help with conducting a PRA workshop with my staff in Malawi .But one day you will hear that Dr Khumbo Kalua, the local doc from Ezondweni, Mtwalo, Mzimba,Mzuzu, Nothern Malawi is one of the few medical doctors with expertise in PRA. . As for now are you available to help , or do you want to comment? Email me!

Saturday 8 November 2008

Malawians in London: I got You .Lucius Banda playing at Islington Acameny in North London on Sunday 9th November:





Finally I have found means of tracking where the Malawians hang in London and I will try to find them .My purpose is to associate with them and see what they are up to and maybe engage some of them to fund for the community work I am doing in Malawi or ask them to do the same.
You remember, for the last 3 years that I have been moving up between London and Malawi (after I left Manchester in early 2006),I have been asking where are all these Malawians who are supposed to be in London ? While on the tube (train) or buses if you look front or backwards, left or right all you see are the Nigerians and proudly enough our African counterparts have the courage to speak loud in their language ,so you can not mistake them for Malawians .But I have not heard Malawians speaking Chichewa on buses. I was once told there were many Malawians in East of London (Stratford ,Leyton and Hackney );I stayed there for 6 months and I didn’t see any. Now I am in North London (Seven sisters ,Finsbury park) and I have held this is where the home of a famous and rich Malawian called Mr Chair is ;but I haven’t met any of his family or bodyguards. And if you do see a face that looks like a Malawian and you try to talk to them; they tell you sorry, I am from Zimbabwe and we are neighbours. I miss the early 90’s when I was in the earlier part of my studentship in Adelaide South Australia as we used to know everyone from Malawi and visit each other and gossip about the then life president Dr Kamuzu Banda (we couldn’t speak loud because we had spy’s amongst us and if reported one could be deported back home, in Ezondweni, Mtwalo, Malawi) ;those were the good days !!! I also remember the late 90’s where I was in Nairobi, Kenya as a mature postgraduate student (now I have over matured) and when I was the vibrant treasurer of AMAKE(associations of Malawians living in Kenya)and we could organise parties and raise funds for Malawi whenever there were floods in lower Shire .Having come to the UK (on an over matured student VISA) and having heard that there were many students, nurses, Drs ,watchmen, carer takers and cleaners ,I expected to find a strong vibrant Malawian community but I was wrong.
After many unsuccessfull attempts I decided to goggle search on some common Malawian names like David Banda, Mkandawire and Phiri in london ;and guess what I found ; that the famous Malawian musician and honourable Lucius Banda with his Zembani Band is playing tonight in Nottingham the 8th of November and on Sunday the 9 in North London at Islington Academy ( a few miles from where I stay).Alas, atleast I know where you Malawians hide and I am going to check on you tomorrow ;I am not going to miss this show ;even though its costing £30 per head ( that’s my monthly budget for food in Malawi).But if you thought that by raising the prize you would put me off you are wrong; I will be there .

And I am going to report about that stuff you didn’t want people in Malawi to know about ;and I am going to dance too .

Are you disappointed ? Surprised ?

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We celebrated World Sight day in Blantyre, Malawi on 11th October 2008








World Sight Day was set aside by International Agency for Prevention of blindness(IAPB) and VISION2020 to celebrate the VISION2020 “Right to Sight” initiative .The day is commemorated on the second Thursday of October .

This year BICO organised a series of events to celebrate this day in Blantyre ,Malawi .Firstly we did put radio adverts informing people about what this day was for ; and then we announced that for two consecutive weeks we would be picking and operating for free on all blind patients (adults & children) whose sight could be restored .We scheduled operations in Blantyre from 6th-10october at the Lions sight fisrt Eye Hospital and in Thyolo from 13-17th October at Thyolo District hospital. We printed t-shirts and distribute t-shirts, and made banners which were displayed in front of the hospital .The period was so busy that in total we had over 100 patients operated and have their Sight restored.Thanks to all staff who participated in this exercise .You can see from the pictures - the banners and the faces of happy patients who had come to the hospital blind and were able to see.You can also see me in front row wearing a white lab coat and displaying the banner; a rare glimpse and lucky you!
The national celebrations took place on 18th October at Thyolo community ground and the guest of honour was the minister.

Blantyre institute for community Ophthalmology (BICO) is proud to have been associated with this event and would like to thank our partner and sponsor Sight Savers International Malawi office .

We would like to do more of these operations in future to help the poor Malawians; That’s what community Ophthalmology is all about and that is my role as a Community Ophthalmologist .

Do you want to help or be involved? Tell us how

Or do you want me to quit and join politics?
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Teaching Key informants (local volunteers) in identifying Blind Children in Mulanje

I am back with more field news from Mulanje, Malawi .That is the problem of being a community eye health specialist; you always want to put your community first and expose them. You are probably aware that my interest is in identifying and helping blind children from the rural areas of Malawi. How we are doing this is through Research that is being conducted in Blantyre under the umbrella of Blantyre Institute for Community Ophthalmology(BICO) ; and I am one of the founding members of this organisation. Basically what we do is that the Project coordinator communicates with the Clinical officer in a particular district (for now Mulanje);the officer together with the District environmental/Public officer go to the village chiefs and asks them to identify what we have called key informants (but the are volunteers) who may be willing to give time and be available to identify blind children. Once the list is combined ,a days training of how to find blind children is organised within the community ;after the session the key informants go and find the children ;and myself and the team go and examine those children within their villages 6 weeks after the training .





Recently in September I was privileged to have 2 of my Optometry externship students from Canada (I will tell you later how this is possible) come along to observe the training which was being conducted at Mbiza Health Centre in Mulanje .We trained 23 volunteers and the training was conducted in the vernacular language (Chichewa).
As you can see this was an exciting moment. In the picture you see the clinical officer teaching the volunteers.
What was the result of this training session? And where does the Research come in? Find out later.
Do you want to know about eye services, blind children or any interesting thing about people in the community in Malawi?
Or do you just want to comment?
What do you think?

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Wednesday 29 October 2008

The Fight for trachoma must go on in Malawi






Just about 3 months ago we were busy conducting the research to see if trachoma eye disease was still a disease of public health importance in Malawi .Trachoma ocular infections are transmitted by flies ;and recurrent eye infections leads to frequent eye disease ,lid scarring ,eye lashes turning inwards and rubbing on the cornea and finally causing blindness.
We have verified that Trachoma is still a problem in the two districts that we did the survey (Chikwawa and Mchinji) ;and now we need to plan on how we are going to fight this disease. Trachoma is primarily a community disease and a disease of poverty ;and our emphasis should focus on strategies that overall improve the health and social statuts on people involved .As a community Ophthalmologist ,I am taking this matter further up with the ministry of health and the supporting partners that we should have a national Trachoma control Programme (we never had one);which should lobby for national trachoma eliminations activities .

Are you interested in Trachoma? Do you want to find out how you can help fight this disease?
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World AIDS day 2008: Shopping day in London





Remember 1st December is Worlds AIDS day dedicated to all those who have lost their lives to HIV/AIDS. And this year the day falls on Monday .As for London Oxford Street this is one of the busiest day for people shoppingas this is the first day when the new cheaper VAT tax rates will be put in place.Well ,due to the global recession and crdit card crisis the British prime minister has lowered VAT from 17% to 15% so things will be much cheaper starting today.
As a result I do not expect to see the red ribbons symbolising the AIDS day; and no one cares about what the day means.After all AIDS is still mainly an African problem,as is hunger and poverty.
I normally take time to reflect on this day, and remember the many relatives I have lost to HIV/AIDS among them my only uncle, my brother, and many cousins. I also remember a colleague doctor and classmate we lost a few years ago while I was still a junior Dr . Recently in Malawi we are seeing more and more of eye diseases that are HIV related and I can for see that in the next few years the focus of eye doctors like me will be on HIV related eye diseases. I am not looking forward to abandoning my community work especially working with children.
Last year I went to the centre of London town to take some pictures; but this year due to the bad weather I am not sure what I will do ,maybe call family in Malawi and cheer them up .I am home seek and the weather depresses me more; and not only me but everyone in London suffers some form of depression due to the weather.

Unfortunately “AIDS” is here to stay.God help us!!!

Have you lost someone you know to HIV/AIDS?

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Early winter: Its very cold in London





Well I woke up at night freezing wondering what was going on; the heater was still on but I was feeling very cold. I looked at the window bit all I could see was the vehicles parked on the street covered with snow. But why snow on the 28th October; I wondered!! I thought winter has not yet started; we just changed the clocks on Sunday (3 days ago) .
In the morning it was obvious the winter had started, the temperature was only 2 degrees. The newspaper reported this is the first winter in October since 1934.
As I sat on the train to work I was wondering why I was here this time; I should have been back in Malawi where the temperatures are very warm ;This is the 5th consecutive winter I am spending time in the UK,not fair.
I can’t wait to get back to Malawi and continue with my Eye community work.
I will go and look for winter clothing tomorrow.

How is the weather where you are ?
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Thursday 28 August 2008

Certificate of Appreciation



The International Agency for the Prevention of Blindness (IAPB) has honoured me with a certificate of appreciation; this was done in Buenos Ares Argentina.

There were over 800 invited guests from all over the world; and the whole week was a very exciting one.

I had to do 3 presentation; one was about the Research I doing in Malawi and how we hope it will change the lives of blind children; the second one was about my research related experiences in spending time in London UK and how I think the training has benefited me ;and lastly I had to display a poster of the filed work that was done in Ngabu ,Chikwawa District Malawi .

Buenos Ares is a big town ;with roads having more than 10 lanes ; it is an expensive town as there currency (Peso) is very strong (1 USD= 3 Peso);Well I bought a Polo jacket for about 600 peso (USD 200) there and I regret because I could have saved that money .Everyone talks about Tango here; there is a culture show about Tango dancing but I will not tell you exactly what it is .But I have bought a souvenir in remembrance of it .

IAPB meetings are held once very 4 years and the last one was held in Dubai in 2004.
IAPB is responsible for monitoring all the Blindness prevention Programmes in the world.

This certificate will be displayed in my little office in Malawi .Its for all those eye patients whose sufering keep me going and without whom my credibility would not be known.

Isn’t that good that I at least got something from Argentina?

Don’t you think I am lucky ? Who could have known that the same primitive bush living boy will be visiting such a place ?

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Wednesday 27 August 2008

When am I leaving Malawi for good?






Honestly I do not know how to tackle this topic .I am frequently asked that with my qualifications and experience as a specialist Doctor I could be making much more money elsewhere than still wasting time in Malawi and writing about rural Malawi .So why don’t I leave? I suppose I am a coward; not willing to take the first step and not willing to contribute to the brain drain in Malawi .having to more than 10 developed countries in all the continents I should have stayed now. Well I brew up in the early nineties when I studied medicine in Australia ; stayed there for half a decade and still decided to come back to Ezondweni , Mtwalo , Mzimba.Now I am much more used to living in poverty in Malawi (and even do enjoy the poverty) that I do not have strong reasons why I would want to leave.

Do you think I should leave and make more money elsewhere? Is my stay making any difference ?
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Kachebere Major Seminary in Mchinji






I have come to see this famous place in Malawi where all catholic priests and bishops train ;and while I am here am told I cant take any pictures. But why? Well they do not to expose this institute to the outside world for fear of the unknown. After urging with them for a few minutes and convincing them that I am of no harm; and that my interest is in community eye health I have been allowed to take a few pictures .The institute is allocated on a very hill area and the scenery is beautiful. I am told Kachebere is the name of the river that I just crossed.

I have been touched by the seriousness of this place ;am standing wondering ; and I am wondering whether I should stop saving eye sight and think of joining the school so that I can eventually be serving souls. Have I been called? Well I have spent a the whole of my life in school I am told it will take me another 5 or so years to complete the course as a priest so I will ignore the calling this time; but may be take it later .
Enjoy the scene. And if you happen to visit Mchinji in Malawi make an effort to see this place.

Did you know that my job /Work has taken me to every district and also to many many countries and continents outside Malawi ?

Don’t you think I am lucky ?

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Tapiwa my daughter 2 years later






While away from Malawi I am thinking of my daughter and how I am missing her . Because of my constant work related trips I do not get to see much of her ; I wish I could spend more time with her. I remember it was only 2 years ago when she was weighing like a loaf of bread but now you cant say anything to her; she grown to be a bubbly girl.
And he behaves like me in a lot of ways ; but smiles like the mother .Here she is ;at our rented house in Blantyre , Malawi

What do think of her ?Does she look like she is from Mtwalo,Ezondweni,Mzimba,Malawi ?
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I like Brazil better than Argentina




I like Brazil better than Argentina

Today I am writing from Sao Paulo in Brazil. The football culture is so high here that very screen that one sees around is displaying football.I am visiting my ophthalmologist friends ;Prof Carlos Arieta and Cecilia Nakanani both of whom work and teach at Sao Paulo in Argentina .I met Prof Carlos last year in Nampura ,Mozambique when we went there to conduct the first VISION 2020 planning workshop for Nampura .Cecilia on the other hand visited London in 2006 and we met there.
I have a bit of problem adjusting to due time difference (it is 12 noon here but I am told its 6 pm in Malawi); and the food is different here –so I have developed diarrhoea (travellers diarrhoea).

I have to go as I need to find some medicine.

Why cant you
Email me!
if you need to know what has brought me here.

Well as usual I am a globe trekker. Imagine I have come straight from Kayesa inn in Mchinji.

Well , I haven’t seen much of the USA ; I was only in transit while passing through JFK.
I have been asked to talk about the survey so I will give the trachoma presentation tomorrow.
Got go; have to email my family home!!

What this first Trachoma survey of such a big magnitude in Malawi?







Well for an eye survey with large number of people such as this; may be it’s the first one in Malawi. This time we had nine vehicles and a total number of 30 people .Small surveys have been done in the past in Chikwawa, Nsanje and Salima .You can clear see that during the training of the teams thee were many people. Prof Robin Bailey from London school of Hygiene and tropical Medicine ,UK and Dr Sam Abbenyi from International Trachoma initiative(ITI ), New York USA were the two external people that joined us during the survey. It was a fantastic experience for all of us.

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for your comments .