Can I do consultancy in other health related areas?

A few people have contacted me on my blog and asked whether I would be able to do some field work and get health related information for them that is not related to eye care .Instead of contacting them individually, here is my response.

My interest is in Community Eye Health, and I have done local and International consultancy (Mozambique and Zanzibar) and research in this area for a number of years. I have been in the eye filed for 10 years.

Prior to this I did general medicine private practice and had my own clinic in Blantyre: and prior to that I was a District Medical Officer for Chirazulu for 2years;I did operate on women during child birth (caesarean sections) and did many other general surgery and medical work. I also did a lot of health administrative work .I have a clear knowledge of the health service delivery in Malawi .I have also trained and I am certified to give anti-retroviral drugs for HIV/AIDS in Malawi.

I am also trained as a Public health specialist and have been equipped to review / evaluate any major public health interventions/research.

I do not like doing desk evaluations; I like visiting the communities and getting the facts as they are on the ground.

So if you would like to have someone get information from the grassroots community (baseline information) in Malawi ; monitor or evaluate the effect of your interventions in the community in any health related field ;my research team will be capable of doing it for you on a consultancy basis .
But we will have to agree on the time; because I can be busy and I travel a lot.

In summary, yes I can do any health related work as long as it involves the community.
I have made my point clear so I will be waiting for you to contact m if you need to get any information from Malawi.

Contact me.
What do you say?
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Defining all odds

My daughter Tapiwa was born only after my wife carried her in the tummy for only 6 months and the decision to operate on the mother was based on the fact it was important to save life of the mother; initially there was doubt as to whether the baby would survive –and I remember crying in that ward while my sick wife was trying to comfort me. She was only weighing slightly more than a loaf of bread (950grammes) when she was wheeled to that intensive care unit at Saint Mary’s in Manchester where she spent the last 3 months of her growth in the incubator. The doctors cancelled my wife and I about the poor prognosis expected for her if she survived (maybe would end up in a wheel chair in all her life) and I did understand the situation (being a doctor and having read about the problems of very very premature babies ) but never understood why. Fortunately Tapiwa did not accept all this easy; and she decided to define the odds and change the way we think. She hardly gained any weight for the 3 months she was in the incubator and was discharged home at only 2 KG.
Today Tapiwa despite being still smallish is a bubbling girl who is walking when she is in the company of people she knows, but alas she doesn’t like strangers who were busy discussing her fate.
Miracles like this happen for a reason.
Tapiwa is now 23 months old; and so far everything has been well. Any complications initially thought of have not risen.
There is a God out there who has been keeping her live and we do not know the reasons.
She now gives me more reason to help the less privileged.
Have you experienced a miracle like this?
Let me know about it.
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Are you a Malawian nurse working in the UK? Willing to be interviewed?

A team of film makers from London approached me a few months ago about their intention to try and capture the effect of nurses brain drain from Malawi to the UK by filming and conducting interviews with nurses who have migrated to the UK and also nurses in Malawi who are intending to migrate to the UK. The film would then be used for advocacy to either persuade Malawian nurses to stay in MALAWI or may be persuade the UK government to pay for the loss to Malawi Government .They though I could help them in identifying such nurses and well since I know a few nurses (some of them married to fellow doctors) in the UK I said I would introduce them to the team. Moreover with my interest in writing about health issues on Malawi; I thought it would be good and easy for me to do this. I have proved myself wrong. Despite many attempts to speak to any of these nurses they have all refused to give an interview.
Well, are you a Malawian nurse working in the UK? Or do you know Malawian nurses working in the UK?
Would you or they be willing to talk to the film makers from London?
If so I would appreciate if you contact me so that I link you up.
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Blantyre Institute for Community ophthalmology (BICO) - a dream or reality?

BICO will be formed in late 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.
The idea to start the institute 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.
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.
BICO is currently looking for organisations /persons who can be involved in supporting research related and eye service delivery fund raising activities.

If you know of any contacts or are interested in the idea please communicate with me.
If you have objections to this the idea also contact me stating the reasons why you do so.

Will be waiting for your comments!!!

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Mangochi revisited

I have been missing because I have been very busy moving around in Malawi. But this week I have decided to revise the blog following comments from fellow bloggers that I need to update them of activities happening in the field of eye care.
Last week I was in Mangochi District hospital where with my hospital team we operated on 75 blind people .A bigger success of this eye camp was partly due to the publicity done by “Radio Maria” a Christian broadcasting radio station that is based in Mangochi but broadcasts all over Malawi. They kindly agreed to freely advertise on their radio that my team was coming to Mangochi to do eye operations from 21-24th April .As a result most blind people were brought to the hospital and had their sight restored. The activity was funded by Sight Savers International.
As a follow up patients who regained their sight were interviewed and this was followed by a radio broadcast. Since then I have had several phone requests being asked when I can see so and so.
I am note sure how far I can go with this as I am now getting fatigued and becoming overwhelmed with other research activities .But as for now I can assure you that I am next operating at Mulanje district Hospital from the 5th -9th May and will bring you news from there.
Do you think these activities are good?
Should they continue?

What do you say?
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How was your Easter?

As for me I couldn’t have asked more than what I got for this Easter. For once I had a break from the busy work schedule in town. For 4 days I forgot as I was an eye doctor and a researcher.We went out to the North of Malawi with my family to visit other family members at home. We left Blantyre at 6.00am on good Friday ; had a stop at Jenda police road block in the afternoon, and bought some potatoes, onions and tomatoes to take home, proceeded to Chikangawa forest and had a short break for a drink and arrived in Mzuzu around 4.00pm . Yes a very long distance to cover (about 700km). In Mzuzu we did some more shopping; getting meat , fish and bread only left Mzuzu around 6pm for Ezondweni, Mtwalo. Upon seeing our vehicle the whole village warmly welcomed us; slaughtering local chicken for us to eat. With only candles used for lightening (no elcetrcity) and no TV to watch,
We spent most of the evening charting with old friends; some of them currently having 3 wives. In the morning I went to see Chief Mtwalo to pay him respect and for him to update me about the developments taking place in the village.I noted that his house now has electricity; thanks to the rural electrification project .
I then drove to Phwezi Boys secondary school in Rumphi Distrct to see my brother who is still in high school there;and on my way I stopped at Enukweni to see an old friend and primary school classmate who works as a medical assistant at Enukweni Health centre (he is nicknamed the Doctor).
In the afternoon we proceeded to Mpherembe through Sokopo but stopping at Luvwere to see my aunt who is married there.
At Mpherembe we went to Malidade at Chipwafu estate, where my mother inlaw stays.Our visit was followed by more partying and eating fresh corn. I visited the farm; with a lot of good tobacco , groundnuts and maize.
Having spent a night there we went back to Ezondenin to bid farewll to my mum; spent one more night there and on easter Monday we left at 6.00 am back to Blantyre and arrived in Blantyre at 5pm.
It was a good week for me and my family.

What did you do ?

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Empty Promises

A Malawian lady based in USA came across my blog site and emailed me that she was touched with the good work we were doing in the prevention of blindness in Malawi and asked whether she could fund some of the activities in one district of her choice in Malawi. She said she had good fiend in the USA who would raise some funds for us to use.A date for the planned activities was set in March and after so many email communications she confirmed that she would be raising the funds.
As usual I moblised my team to start announcing /publishing about the upcoming event ;and when all was almost done I contacted this lady to transfer the money but she did not respond to my emails. I tried every to get hold of her but did not succeed. Even though I knew she was based in Washington it was harder to know the exact adress. In the end activities were cancelled after already publishing as that did cost us some money.
Even though we do need money to do the various activities in Malawi we do not routinely ask for momey.We wait for well wishers to come forward on their own and we engage on negotiations with them on how they can help us fund the activities. Being as busy as I am; and considering that it takes time to communicate on email and get back to many people ;I hope that people who approach me should be serious if they intend to help.It is not nice to waiste so much time and at the end pull out without explaining the reasons. Sometimes it is good to communicate and apologise that things did not come up as they were meant to be and that we should cancel the programme.
We are always in constant need of equipment and other logistical things and whatever you will you may help with is welcome to us Currently we need to replace our outreach operating microscopes, we need theatre gowns and attire, we need computers for the research team and financing for such activities .If you have anything you can offer even a dollar , please get back to me –but not with empty promises.

I will be waiting for your email.

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Helping Malawi without blowing a trumpet!!The amazing case of Norway

If you follow what I have been writing about the health sector in Malawi, you will notice that human resource crisis remains a major challenge in the delivery of health services –and perhaps services in other sectors. You will also probably realise that due to the crisis of HIV, Aids, Malaria and TB and many other diseases in Malawi, the government is unable to invest adequately in human resource. And if you were a good wisher for Malawi and had resources to help and contacted me, you would probably be advised to invest your resources in Human resources.
I want to alert you about Norway, a small country that has never blown a trumpet about what they are doing in terms of human resource capacity building in Malawi; however I feel they need special recognition and probably to be given special honours by the Malawian government. Many times we always think of the superpowers (USA, Britain ,China,e.t.c)as having the biggest impact in Africa; and we forget those who do not talk but give billions of dollars to help Africa.
So what has Norway done for MALAWI? I have not done a detailed research (maybe I need to do so ) but by just mentioning a few confirmed projects that Norway has done for Malawi you will understand what I am talking about.
Held of NORAID? Well it’s a short form of Norway Aid and comes with bug monies.
For example ,take the multimillion dollar sports complex just recently built at College of Medicine campus along the Mahatma Gandhi Road in Blantyre; everyone notices this building which is the first of its kind in terms of sports activities in Malawi. mention of indoor tennis, baddington, erobics, gymatstics and anything you can think of; the college of mecine of medicine premises are the best in Malawi. By the way apart from being meant for students, the centre is open to staff and the public at a few.The centre has dedicated trainers to take you through any sports activity you wish to be involved in.But you have never seen Norway bosting that they are the ones that have funded this project.
What about the new eye hospital in Mzuzu build through Lions Aid Norway and opened late last year ; and the upcoming eye hospital in Zomba? And the various training of staff that has been done at these hospitals?

Norway has been providing salary top up for dollars at College of Medicine;and recently is funding a re-entry package for Malawian specialist doctors who are abroad to come back to Malawi (by offering them up to UD60,000 per annum) .Norway is also funding a 2 year masters of political science programme at chancellor college by offering scholarships to more than 20 students per year.
Well, this information are the facts that I have about Norway obtained without doing a detailed research ;and I am sure this is a gross underestimation of what they are doing in Malawi .
You are not the only one who thinks wow they are doing a lot!!! Perhaps our governments need to give special honours to such countries-especially that they are not doing this for their own benefit.
I would really like to visit Norway to understand more about this county.
Ready to fund me for a ticket?

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My Chart with Blind Children in Chirazulu

Wondering while in this picture most children are not smiling or looking in front?
Well this is a group of intelligent blind and severe visual impaired children from Mont fort school for the Blind in Chirazulu district in Southern region of Malawi

This visit was organized by my research team in order to find information and be able to come up with a list of activities that normal children do in comparison to visual impaired /blind children. The visit was organized through the headmaster of the school.
11 visual impaired /blind children aged between 8-13 were interviewed during the focus group discussions which lasted up to one and half hours. All conversations were recorded.

Blind children reported to be involved in similar activities as normal sighted children all though in some cases the conditions were modified to suit their environment. In most cases they were assited by a normal sighted person to do similar activities. Exceptions were rarely made for the blind students and they were expected to perfom as normal sighted in most cases.
In terms of needs what they wanted most were clothing,soap and body lotion,school uniform and sunglasses.

Though they were using Braille and sylish for learning they often sought help for mathematics from the normal sighted children.
Some reported friends despising them and running away from they because they were blind.Most of them however did not mind as they had accepted their situation.

Amazingly all the things that the normal sighted children mentioned that would be difficulty to be done by a blind person were not considered that difficulty and doable by the blind children as long as they were assisted.

In terms of career blind children have same ambitions as normal sighted children;to become doctors, policemen, army, teachers, nuns and many other professions.They did not think they disability dimished their chances of success; it was rather the support to achieve their goals that they thought was lacking. In terms of wishes ,they felt that only if people around them would understand that they were blind and did not chose to be so then they would be able to get on with their lives.

Next time you see a blind child in Malawi, treat them well!!!

Well I am still struggling to analyse the rest of the recorded conversations.


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Why more mothers die during child birth in Malawi !!!

Malawi has being quoted to have the highest maternal mortality (highest number of mothers dying in child birth) in the world, with more than 1000 women per every 100,000 dying during child birth. This figure is quite alarming, but when you visit some of the Health centres in rural Malawi and take note of the conditions there; you understand why this figure may be an underestimation.
A classical example is Namphungo Health Centre, a government run health centre in Mulanje District, southern Region of Malawi .My team recently visited this place for our eye research . It takes about an hour to drive on the dusty bumpy road from Mulanje District hospital to the Health centre .The population catchments area for the Health centre is 40,255 and there are 53 villages surrounding the centre. In terms of infra -structure there is a nice facility with a separate maternity unit which has about 6 beds, even though the unit is not functional.
Staff wise- there is only one medical assistant at the centre who sees general cases; and there is no nurse to attend to maternity cases hence the closure of maternity unit. There are 21 health surveillance assistants (HSA’s) who do health promotion but most of these are untrained. Recently the ministry of health have recruited more HSA’s with intention of having one HSA per village but this has not been achieved for Namphungo.

Unfortunately during our visit, the only medical assistant was away from the centre so there was no one to attend to patients; but we believe the untrained HSA’s were attending to patients and prescribing even though they are not allowed to do so.
A highly pregnant mother who has started labour walks into the centre only to be attended by untrained HSA. Due to our presence she is advised to go to the nearest health centred where there is a nurse so that she can deliver; and my enquiry reveals that this centre is Namilenga Health centre and the woman will have to walk there for at least an hour -that is if she doesn’t deliver or collapse on her way.
The critical shortage of health staff (nurses, doctors, paramedics) is much worse in Malawi that the Government would like to admit –imagine no nurse in a highly fertile population of 42,000! The brain drain and influx of medical staff to the West continues; with the west continuously paying a blind eye to the health problems in Sub-Saharan Africa.

Now you understand why more women die in childbirth in Malawi than anywhere else in the world.

Well , I am only a researcher and an eye doctor so I can only communicate this information for authorities to know how to address the situation.

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