Tuesday, 29 December 2009

Ending the year 2009 in Thyolo with a bang

Today is 30th December and it’s just a few days from New Year. I am told the former President of Malawi is not well and I wish him a quick recovery .
I am currently in Thyolo district, home of the new president , and I am completing the blindness research that I stopped due to absence of fuel in Malawi that happened for a few weeks . Now there is fuel in town .
Today I am in chiromo village ,near Luchenza , and this is one of the villages under the Member of Parliament honorable Mutharikka .Naturally apart from seeing a few blind people ,you expect everyone to be happy in this constituency ( as its where the big man comes from and the Mhlako wa Alommwe is strongest ).I see this old blind man ; and asks how the rains have been so far ; and he replies that you people in Government did not give us the fertilizer you promised because we did not cast a vote ; and so why do you care about the rain.
When I finally tell him that he has a cataract that needs to be operated on in Thyolo hospital, he doubts if he will come, as he says he has no confidence in this Government. I as an outsider, is surprised that this old man who did not get the free fertilizer coupons thinks that unless something happens he will not get the free surgery .
As I move round the village in a Government vehicle , I get numerous complaints about the big man-spefically to do with how the fertilizer issue ; and I am asked to donate some funds for completion of a church in the centre of the village . I definitely say “No” as it would be likely that I would be put in jail if I tried to defame the big man by donating small monies to his constituency (I don’t have the monies anyway).
But am glad we have harvested a good number of blind people and have asked to come to Blantyre in Jan 2010.I will be performing surgery on them.

By the way I have missed the job promotion again this year; and from rumours I get in thyolo am tempted to think that it’s probably to do with my place of origins; as colleagues from different Regions have all been promoted.If only the big man knew that this blind person i am treating is from his village, am sure he would have influenced my promoton.After all i am long overdue and qualified.But he has wrong advisors who only want to promote tribalism .

Imagine am mistaken as being a Lomwe and all these things are being said to me in confidence ; but I am only here for seeing eye patients and I am afraid to reveal that i am not from here incase i maybe stoned.

I have been told i should always remember I come from the dead Northen Region of Malawi ; though I may now probably settle near Ndata farm (to feed from the big man’s savings)in southern Region and be a Lomwe for life.

Kamuzu many times said we were all Malawians and completely discouraged regionalism; thuswhy i can confidently go and treat eye patients in thyolo . But things are slowly changing -who knows where i will be next ?

Will be posting pictures from Ndata farm soon

Any way Happy new year once again .

Any comment?

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Monday, 21 December 2009

Happy Christmas and merry New Year

It is that time of the year when we gather together with families and celebrate the birth of Jesus Christ I am particularly privileged to be at home in Malawi this year with my family .Last year I spent Christmas in Rwanda ,was conducting a survey of trachoma .This year i get to know a bit more about my daughter Tapiwa.

All I can say is that the Lord be praised for keeping me healthy throughout in 20009, and I do not take it for granted .if you are in Malawi you would know how many well deserving people have left this country (died) ; most of them if given a chance would have loved to go on with their lives . But I was among the many chosen not to be a statistic (at least for this year) .I believe I have served him better.

The scarcity of fuel remains a big issue in Malawi; thanks to our politicians.

As from BICO, it is my hope that several people that I operated on will have sight to see this Christmas properly and that I will be helping many more in the New Year.
By the way, I plan to update my blogging profile in 2010; am just keeping my fingers closed.

God bless

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Tuesday, 1 December 2009

Thank you for your nomination about the blog

A recent opinion poll has ranked my blog as one of the top 100 interesting blogs from Malawi.
The internet research was conducted by an old classmate and friend of mine who is based in Virginia, USA and whom I haven’t seen for 21 years.
He has acknowledged that in 1982 when we used to swim together in the mad running water of Jubile river in Ezondweni , Mtwalo ,Mzimba while our cows went around eating others peoples maize stalks ; he did not know that those experiences would be shared through internet many many years later . He also acknowledges the fact that for boys who used to sit on the mad floor and lose writing pencils everyday at Ezondweni Model school,and constntly wishing if we were born in another country and blaming God for our problems ; it a blessing that I can have a blog with less blasphemy.
He goes on to say that at that time we had no reasons to thank God for, but now we have many.
His views are shared by many other respected Malawian bloggers; who suggest that if I only seriously took some blogging lessons ( for a few dollars) I could probably produce some blogs that are more palatable and more beneficial to the nation of Malawi .One blog in particular , quoted that “for a man who can manage to see the following places in Malawi within a week: Chididi in Nsanje , East bank in Chikwawa , Kunenekude in Mwanza , Namitambo in Chirazulu and Mulibwanji in Mangochi , all of them extremely boring – and still blog about them !!! deserves some special award “. I am glad that people have realized that the work I do and the places I visit are not all fun, but somebody has to do the job, unfortunately for this time its me. No matter how boring the areas I visit are –some Malawians come from there and they need a visit.
Some bloggers have rated the blog as one o the worst 100 and least likely to be educative .That is what opinion polls are about.
I dedicate this blog to the volunteers of Nancholi Health centre in Mangochi Distrct that appear in the picture "with me included" .They recently did a good job in identfifying a lot of blind children .
What’s the prize and suggestions for the future?
Most readers suggest that if I stop blogging about the past and boring communities that I visit and concentrate on the good life that there is in Malawi (Lilongwe, Blantyre) and how I am part of that, one day I may be nominated by the majority of bloggers in Malawi and appear at the annual Entertainers awards that takes place yearly at end of December, Mount Soche Blantyre. Moreover they advise that unless I change my writing styles I may never move from rural “Kwabaluti” in Blantyre where I currently stay ( I am sure you haven’t heard of where it is) to more important places like Namiwawa, Sunnyside and Nyambadwe where the rich and famous live .
I am still young in the blogging sector; and I like writing about blind people and the poor communities they live in; hence I prefer to live in similar communities.
Hence I refuse their award that is based on bribery about my writing skills.
However my colleague from Virginia thinks that if he ever gets back to Malawi, we should go back to Ezondweni Village Mtwalo together and have a good laugh of what lives we used to have .I personally do not think he will ever get back to Malawi.
You can also rank my blog. Do you think its one of the worst 100 from Malawi?
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Fuel crisis in Malawi affecting Blind people in Thyolo and elsewhere

You are not the only one wondering how this can be possible.
What do young and old blind have to do with fuel crisis in Malawi? After all they are from the rural areas of Malawi, never had a driving license in their life; and will never drive .More over they rarely see vehicles in their community.
The first time I heard that there was no diesel in Malawi was about four weeks ago when I was doing my research in Thyolo ; to be more specific around Bvumbwe area .When I went to the diesel station at Bvumbwe there was a lot of diesel around ; and I was told the problem was only in Blantyre. Continuing with my journey I visited villages around Bvumbwe health centre hoping to learn some Lomwe ; only to be told that the traditional authority (TA ) Bvumbwe is a Ngoni descent from Ntcheu and that all his people are Ngonis (did you know that?) .For me , my assignment was simple , to examine the blind and visually impaired so didn’t care whether you were a Ngoni or Lomwe (Muhlako ; as long as you were blind you were my client ) .We anticipated that we would harvest around 200 blind people from Thyolo and that they would all be helped through a sight restoring operation schedules to take place in Blantyre at Queen Elizabeth Hospital .
The next few visits were scheduled for Ndata farm, Makande tea estate, Luchenza, Mangazi , Boidi , Kwethemule ,Mauwa and Chitimbe and we were going to be there for at least 10 days . But we did not complete the work, only stayed for 2 days and I have not been back since then. Will tell you the reason why! Fuel crisis.
I overheard some people discussing that the present lack of fuel in Malawi was due to shortage of forex ; but with my ageing grey matter I could not figure how the two were related (excuse me , I still haven’t yet figured how ) . It was of course a relief when I heard the high authority announcing that the crisis was due to Mozambican Government blocking the passing of trucks with fuel from South Africa to Malawi and this initially made some sense to me .But eventually I started wondering that for my 40 years that I have been in Malawi (perhaps more important for the 16 years that I have been driving) I have never heard of a fuel crisis in Malawi ; even during worse days when Kamuzu the other “Ngwazi” was in bad books with Mozambican president the late Samora Machel ;we still had fuel in Malawi .At that point having smelt a rat , I decided to stop thinking about why we were having fuel crisis and concentrate on seeing my patients in Thyolo. After all, being a senior citizen and doing good work to help the poor and the needy, I did not think anyone would deny me fuel to go to the field but I was wrong again (excuse me I am old).
Within two days the fuel crisis had accelerated, and all diesel in Thyolo and elsewhere was gone.
I tried to maneuver around using my influence (“good” corruption) but could not succeed in getting fuel anywhere.
Unfortunately all Chiefs from areas scheduled for visits were told to mobilize and gather patients at particular places on the given dates; and with this fuel crisis everything came to an end .
I have been rendered a liar ; have had people calling and asking when the trips will be rescheduled, and as long as the current situation continues I do not see myself doing any more community work.Please do not arrest me for my freedom of speech.

I am still drawing my small salary and working in Blantyre (I dont think I should stop) , but of course I am no longer going to the field as a Community Ophthalmologist.So do you now see how the blind from Thyolo and elsewhere have been affected by fuel crisis? Unfortunately they do not have anyone to speak for them; some of us may lose our jobs for being their advocate.
I can be sacked for other reasons , but not for my incompetence, because I am not the one responsible for the fuel crisis.

Meanwhile I have time to sit down at the lake and take some drinks while I wait for the numbers of blind people to continue rising up. Hopefully with the good policies of the current Government (that I fully voted for and support) that gives enough free fertilizer to all its citizens (compaired with only a starter pack from the previous Government), those blind should still be able to farm and get a bumper harvest next year. Otherwise I instead of the “fuel” crisis may be blamed for not having visited them and advising them to go for an operation, yet I know they can see again.
I rest my case on fuel .

Any good advice on what I should do?
Or do you just want to comment?

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December 1 depressing AIDS DAY

Another World AIDS day is here.
Unfortunately this year am unable to blog about it .
I am overwhelmed with the amount of relatives I have lost to AIDS in Malawi this year .
Moreover , I am saddened by the news that my fellow Malawians have started ABUSING the life saving ARV drugs .Some of them are using them for brewing local brewery ; while the others are using ARV's in chicken feeds so that their chickens lay extra large eggs which will fetch more money when sold. The society we are in is unbelievably corrupt .I lost an Uncle when ARV's were not available and have lost several brothers and sisters since the ARV's have been around. I know several relatives who are currently on them now.
Well , I have been asked to wear something RED tomorrow but I am not going to do it because its so depressing to me .Imagine a young working professional lady aged 36 years and living not far away from where we are will be buried tomorrow in her village. She died 2 days ago.
Imagine how many articles on HIV/AIDS we scientists have published since the advent of HIV 28 years ago (1981) ; and the Nobel prizes we have received ; yet we are nowhere near solving the mystery .People are still dying everyday.

But there is a GOD out there ,who knows when and how the enemy will be destroyed.

As for now AIDS/HIV is here to stay .

Rest in peace all those who have been affected .

have you been touched too or you know someone who has ?
do you just want to comment?

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Monday, 23 November 2009

Primary Health Care (PHC): Fantasy or reality for Malawi

From the recent political blog, I am back to my senses after sobering up and ready to report on more community work. Today I am writing about Primary health Care, PHC in short.

There is a long definition of what PHC is supposed to be as given by World health Organisation: (WHO, Alma Ata Declaration. WHO1978 p.3-4) that includes 5 sets of principles, viz: affordable and sustainable health systems development, appropriate(user friendly) technology, intersectoral collaboration, community participation ,and equity to access of services –whatever these mean!!! “Remember the Health for all by the year 2000” this was one of the WHO initiatives that was going to use PHC.
Heard about Millennium development goals (MDG’s) - most of these need PHC to be achieved.
So why is an eye doctor in the forefront talking about PHC? Well, for your information we are supposed to be integrating primary eye care (PEC) into Primary Health Care (PHC).There is now renewed call by “WHO” for implementing PHC in developing countries.

But how are countries like Malawi doing on PHC at grassroots level? This is a political question so need to be answered by politicians; but I will only be giving my views based on my experiences with the communities mainly in Southern region of Malawi. For this blog I will concentrate on my experiences during my recent visit to Mangochi district.
Fact 1 : Health Surveillance Assistants (HSA’s) are the main provider of primary health care in all communities in Malawi .I was introduced to this group of workers in 2007 when I started my research in eye care and since then I have interview over 200 HAS’s and trained about the same number on primary eye care. They fall under two levels of employment by the Government; those employed before 2007 –referred as normal HSA’s and those after July 2007,referred as the Global HSAs’s (because they were deployed under the global fight against HIV/AIDS initiative).They all are supposed to undergo a 10 week orientation training in everything (preventive ,curative and rehabilitative services) and then attend other on-job trainings .
Fact 2: At most 50% of all HSA’s recruited in 2007 have not after 2 years formally attended their 10 week training in Mangochi, Zomba and Mulanje and are actively doing their day to jobs without training .
Are we sure these personnel are doing what we intended them to be doing? Are they doing standardised procedures?
Fact 3: Some of the health centres with a catchment area of higher than 10,000 persons have no medical assistants, or nurses and are left to be taken care by HSA’s who attend to and treat all sorts of patients including maternity patients . I witnessed this in Mangochi at a health centre I visited to screen blind children , I was told there was neither a nurse or medical assistant there ,the senior HSA was in charge and was doing all the clinical work (and he was staying in a beautiful institutional house that would have been used by the nurse of she were there)
Can these HSA’s treat patients even if they were trained for 10 weeks? Is this what PHC is for Malawi –HSA’s taking place of medical personnel?
For once they are not recognised and registered by any nursing or medical body in Malawi ,yet they are doing what they are not supposed to be doing .Is this what PHC is all about ?
In my view one cannot be qualified to offer medical treatment when they are only high school (secondary) leavers and have only attended 10 weeks orientation.
Fact 4 : the Maternal mortality (number of mothers dying in child birth) for Malawi is the highest in the world ; the same non trained HSA’s are supposed to be in the forefront in preventing these deaths.
Are you surprised therefore that the numbers of mothers dying is not reducing in Malawi (unless we start cooking up the figures so that they shrink)?
These HSA’s are underpaid, have poor skills and are not clinically supervised. They can only be motivated to do best by improving these?
PHC is supposed to be strengthened at grass root /community level; this is definitely not the case in Mangochi. I visited some health posts and health centres in Mangochi where they had not had any supervisory visits from the district hospital since the start of this year. In another busy health centre, I found an intern (trainee medical assistant ) running the hospital after being posted there 8 months ago; he told me he had never been supervised or told what he should exactly do.
Unless our leaders invest wisely in PHC in Malawi; we are doomed to fail.

Remember “Failing to plan is planning to fail”

Those who believe and say that we are achieving a lot through PHC should go and spend time in the communities and witness what is happening there; we may be making some progress , but some of us have collected figures that prove the contrary .Show me your statistics ,and I will show you mine. I was very optimistic about PHC when I started my research, now I have become pessimistic.
Do you more data from me?
Do you want to debate?
Or do you want just to comment?

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Check for my next blog? Which MDG’s can be achieved by 2015 in Malawi?

Sunday, 15 November 2009

Poor Malawi, My beloved country!!!

I have not been able to blog for the past few weeks due to pressure of work and travelling , and indeed I am overwhelmed with the current assignment I have been undertaking on behalf of Sight Savers International; Malawi office .
We are conducting a blindness survey in the South West Zone of Malawi (Thyolo, Blantyre, Chirazulu, Mwanza, Neno, Chikwawa and Nsanje) and because my teams and I have been staying in the field it has been impossible to have time to sit down and write a blog.
But the recent developments in politics in Malawi and the future implication on technical persons like myself have made me find time to blog while I am here in Thyolo ,the Muhlako was Alomwe headquarters ,and the chosen home of current rulers of my beloved country (the president ,army leaders ,police, immigration , senior lawyers and doctors e.tc) .
Apart from wishing a colleague from the Muhlako “best wishes” as he has been appointed to be the “Presidents physician” (and he deserves it) and has now moved to State house , I had to bid farewell during the past weeks to the colleagues classmate (my colleague too) who was a senior physician and lecturer in Medicine at the College of medicine ,in Blantyre and has migrated to Canada last week , partly because of the racial comments that are being brought foreward by the big man.
As I sit and examine these poor patients from Ndata farm, Thyolo ,I wish to say that I have never looked at them as being from the East ,West ,South,or Central Malawi , but as Malawians who need services of a community eye specialist. But now I am being told am wrong – I need to have in my mind views of where people come from before I give them a service and if they come from a particular clan or area ,I am entitled to give them a substandard service. Well for the last 14 years as a medical officer, I have never benefited people of my own clan (despite coming from there) and have never looked at it as an issue. Already another senior colleague who is Dean of Medical colleague has indicated that he is planning to migrate from Malawi sooner than later ; and has told me that people do not appreciate my effort and services in the South because I come from a particular area of the country. I do not doubt this anymore since the big man himself has indicated that unless you are from Mhako wa Alomwe clan ,you are unlikely to be promoted or appointed to senior positions in Government . It is not surprising then that despite there being many senior vacancies in Ministry of Health; some of us have not moved an inch for the last 7 years just because we are told we were born of the wrong clan.
So , one of these days when you here that I am no longer in Malawi , do not be surprised as I will just be following what other colleagues from such wrong clans are already doing .After all ,why be patriotic of your country if you are going to be castigated by the same leaders that you vote into power .
My earlier blog indicated that I may be interested in politics in future , but for now since I have realized how dirty politics is ; I am going to stick to helping blind children in the community –and will stay in the Muhlako ; despite the big boss (President) saying that I will not be considered for any promotion because of where I come from .
And if you do not know what has been happening in Malawi recently in terms of politics and nepotism, I refer you to the websites like Nyasa times
Please do not quote any of the items in this blog as “they may result in me and my family being exiled” .
Meanwhile I remain in the Muhlako wa Alomwe area (Thyolo) for a few more weeks while I examine blind people despite being aware of comments people are making about me.
Should the president be interfering with lives of technical people like myself and threatening to kick us out of Malawi?
What do you say?
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Saturday, 3 October 2009

Time does fly.

Imagine seeing the younger sister that you’ve been sending to school all this time now getting married and the little daughter that has been in the children’s intensive care unit now with a big smile and also going to school. It just shows that time indeed does fly.
I remember it’s not long ago when my sister Alice was asking for pocket money for her upkeep in secondary school ,and also the day she was saying she had been selected to University of Malawi ,the Polytechnic, to pursue a degree in Electronic Engineering and me saying you better work hard because it wasn’t going to be easy in a male dominated profession .Imagine today she is not only a qualified Engineer who is working ,but she is also married (see her wedding photo) .And if you see my daughter Tapiwa in my early blogs and how bad she started her life in the intensive care Unit in Manchester, being born only at 7 months,you wouldn’t believe she is the same girl today.She is our Miracle and Glory be to God the almighty.
Well I have been busy traveling up and down in the communities focusing on finding blind children and helping them ; only to realize that I have missed my daughter growing up –and can't even recall seeing her crawling or starting walking,and didnt take pictures .What a pitty!!!!!. If only she didn’t have such a good mum, what could have become of her with a father who is constantly away from home? God bless the mum (who happens to be my lovely wife).
Today I am in transit, but when I get home will try to spend a whole day with Tapiwa and also visit my young inlaw who has married my sister .Then I am off again for the eye survey in the community.

Maybe I should try to create more time to spend with my family?
But where can I get time from?

Recently I have been advised that I need to go to a rehabilitation centre and be treated for being alcoholic (am told I am a work alcoholic ,but when you are the sufferer ,you don’t know).
Am sure my wife Victoria will agree with the diagnosis when I tell her.

What do you say?

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Monday, 28 September 2009

Dinner and dance in honour of Prof Robin Broadhead

Well you may wonder who Professor Robin Broadhead is in Malawi or at the University of Malawi,but ask any Malawian doctor and he will tell you everything about this man who has moved medicine well beyond where everyone else would have imagined it to be in Malawi within the last few years. To me this pediatrician he is a teacher, a mentor, a colleague, a friend and all you can say .To others he is the Principal of College of Medicine ,former head of paediatrics department at medical college ,blaah , blaah ,blaah!!!.
Well we will be having a dinner and dance in honour of him at Ryalls hotel in Blantyre on the 9th of October because I am told this has been his last term of office as a College Principal .I look forward to dining with him.
If you want to know what he has been able to achieve for college of medicine , visit the website at College of Medicine and you will see how far the college has moved.
I hope during the dinner we will have a moment to reflect on the life of Dr George Kafulafula ,his vice Principal who passed away at a very early stage only a few weeks ago .Dr Kafulula ,a young Malawian Obstetrics and Gynecologist had made a great contribution to the college together with Proffessor Robin Broadhead. If I was a good writer ,I would have written lots about these two and the College of medicine.But I am handicapped and tongue tied ,I don’t even know where to start to mention many of their success stories !!!!
For now ,I can only wish Broadhead a good retirement as the Principal of college of Medicine .
He will be missed by many.
Have you heard about Prof Robin Broadhead and his achievements in Malawi ? do you want to comment?
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Another success story from training community health workers in rural Malawi in identifying blind children

This young girl in the picture has cataract, and has been identified by one of the community health workers that we trained in Mangochi district. The girl was struggling in school but did not know what problem she was suffering. Through the study being conducted by support from British Council for prevention of Blindness (BCPB), our team has trained over 400 dedicated community eye health workers.
As a thank you for the good work we have given the health worker the t-shirt that he is wearing.
We have also advised the girl to come to Lions Sight First Eye hospital, Blantyre for eye surgery .We do refund the transport cost for the girl and the guardian if they get to Blantyre –through funds donated by Future Vision Ministries (FVM) in Canada. But we are running low on the funds and will not continue doing the good work unless other well wisher comes along .We appreciate any donation to BICO (Blantyre Institute for Community Ophthalmology) and will acknowledge you.BICO relies 100% on charity donations.

Do you want to help ? or just comment?
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Scotland revisited

This time the trip to Scotland has been a very brief and short one. We are in Glasgow at York hill children hospital as part of our links programme and we have been invited for two weeks .We will be going back to Malawi weekend of 6th October .For the 1st time I have travelled with my boss, who happens also to be the hospital Director at Queen Elizabeth Hospital, in Blantyre .My boss and I have known each for a long time (we first met at University of Malawi in Zomba in 1988) ,and did internship around the same time; we shared a flat in Nairobi Kenya in the late 90’s while studying to become eye specialist, and have been in the same department in Blantyre since 2004. Today we visited the town of Blantyre that is in Scotland; indeed a small town where the famous Dr David Livingstone was born and where our Blantyre city came from . As you can see from the picture ,a sign saying welcome to Blantyre is displayed on the entrance.Susan the orthoptist at Yorkhill hospital and the husband kindly agreed to take us to see the original Blantyre town . Apart from the David Livingstone Museum the town looks to be deserted. But it has a lot of stories to tell.This man did a lot for Africa .And indeed he discovered lake Nyasa (now Lake Malawi).We have to thank him for christianity that has now wide spread.Did you know that during the entire trip and expeditions in Africa Dr Livingstone only manged to convert one person(an local African chief) to christianity? The rest of the developments only started after he had died!!! Isnt that amazing looking at how many churches we now have?
Are you suprised?
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A short meeting between Dr Khumbo Kalua , Senior eye specialist from Lions Sight First Eye hospital , Blantyre ,Malawi and Mr Kashinath Chatruvedi , MD for First Merchant Bank (FMB),Blantyre has resulted in over 120 blind people from areas surrounding Zomba and Machinga district having their sight restored through eye operations performed at Zomba central hospital from the 14-18th September 2009 .
Since the worsening of the global final crisis earlier this year , a Malawi Ministry of Health partner who was heavily involved in supporting eye care in the South East Zone ( Mulanje ,Phalombe, Zomba ,Machinga and Mangochi) has pulled out unexpectedly early this year and as a result there had been no surgical sight restoring eye camps conducted in this zone the whole of the year. Reports that many blind people were suffering in this zone prompted Dr Kalua to approach the MD for FMB, and find out if he would help to solicit funds to support eye operations. Supporting Eye care has not attracted good funding from Ministry of Health because of priority in other life threatened diseases like Malaria and HIV/AIDS. However those who are blind can more than often be helped with very little resources compaired to other diseases .
Dr Kalua had approached the MD as an appeal from the private to support the public (private- public partnership) and reading the newspaper that the private sponsoring things like Golf and other sports ,and the MD agreed to talk Rotary Club of Limbe; who inturn agreed to support eye operation in Zomba and Machinga districts .A generous donation to cover logistics involving the identification of patients ,transportation to and from hospital ,and transportation of staff from Blantyre was solicited by the mD from the Rotary club .
Patients with cataract were mobilized from Machinga and Zomba , picked from their homes, had eye operations done at Zomba Central hospital and were ferried back to their homes . Operations were done by a team of two dedicated eye specialist doctors from Lions Sight first eye hospital, Blantyre.
It was all happiness and smiles the next day when patients who had been blind for sometime (up to 5 years) were able to regain their sight and see again.The staff were thanked for the good work that is being done and these good stories were reported in the “Nation” newspapers.
Cataract is the commonest eye condition that causes blindness in Malawi and a painless operation of less than 15 can result to total reversal of blindness with patients completely regaining their sight.
Currently over 20,0000 of all adult aged 50 and above in Malawi are blind or have severely visual impairment from Cataract and are waiting for cataract surgery . Supporting one cataract operation to restore sight cost less than USD 50 per patient and up to 20 patients can be done per day by one surgeon.

All well wishers who would like to come forward to support the eye operations in Malawi should contact Dr Khumbo Kalua at LIONS EYE HOSPITAL, BLANTYRE!

There are currently only 8 eye specialists based in Malawi , and training to be an eye specialists takes a minimum of 10 years of medical school (6 years of undergraduate and 4 years of specialization).

Patients with eye problems can go directly to any one of the tertiary hospital in Malawi in Blantyre, Lilongwe and Mzuzu and can be seen there.
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Thursday, 24 September 2009

Hit hard but still kicking

Been very quiet because not only did my computer crash ,but my blog site was attacked more than once making it impossible for me to access my site .
But I am still around ,having returned from Livingstone ,Victoria falls in Zambia a few weeks ago where wee spent a substantial amount of time examining people in the community.Community Ophthalmology is indeed advancing.
Unfortunately I lost most of the good pictures .
Should people be taking an active role destroying blog sites like mine?
What do you say?
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Tuesday, 4 August 2009

Blogging from Malawi: VISION 2020 –MALAWI

I am privileged to be one of the first people to be asked by the Communications Manager, VISION 2020: The Right to Sight through their new blog VISION2020 Communication Manager to share stories of VISION2020 activities in Malawi.
Malawi has been active in VISION 2020 activities since 2000, and has successfully organised VISION2020 workshops for Malawi, Zambia and Zimbabwe.
Malawi completed the VISION 2020 five year Eye care plan in 2004, and progress has been made towards achieving goals to eliminating avoidable blindness by the year 2020 in Malawi.
Based on the 3 pillars of VISION2020, in terms of disease control, Childhood blindness was set as one of the major priorities and a Paediatric Ophthalmology unit was planned to be developed in Blantyre .As of now,through the VISION2020 Links Programme , Blantyre was linked to York hill in Glasgow and the team from Glasgow have helped in building up capacity to develop the Unit .Infrastructure and equipment has been provided by the Team from Glasgow and also Sight Savers international Malawi office .In addition a study of how blind and visually impaired children can be identified in the rural communities in Malawi to feed back to the Paediatric unit was started in 2007 ,as so far 3 districts have been covered (Mulanje ,Zomba ,Mangochi) with a good number of children identified .
Another disease listed was Trachoma, and to determine the burden of Trachoma in Malawi, a trachoma prevalence survey was done in 2008 and currently plans are under way to start trachoma control activities. In 2009 plans are under way to do a rapid assessment of avoidable blindness study and determine the magnitude of cataract in Malawi

The greatest achievement is perhaps in the field of Human Resource Development. Two new ophthalmologist joined the team in Malawi (one based in Mzuzu-Northern and the other in Nkhoma –Central Region ). A Paediatric ophthalmologist, a Vitreoretinal ophthalmologist and a public health Ophthalmologist (myself) have been trained within the last two years .In addition a postgraduate training programme for Ophthalmologist has been started at College of Medicine .Of more interest is that the first Malawian ophthalmologist and pioneer of Ophthalmology –Moses Chirambo has retired in 2009 from Ophthalmology and become the Minister of Health in Malawi .
A school for training ophthalmologist has been established in Malawi under a consortium led by International centre for Eye care education (ICEE) International Centre for Eyecare Education (ICEE)

Blantyre Institute for Community Ophthalmology was established in 2008 and is responsible for all the logistical and technical support for the community eye researches that are currently being done in Malawi, and as part of the capacity building programme has made links with Kilimanjaro Centre for Community Ophthalmology (KCCO)

VISION 2020 is here to stay, and will continue providing platform for eye care to advance in Malawi

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Saturday, 25 July 2009

Euro tunnel

Having spoken so much about blind children in Malawi and my field tips in the rural areas in line with VISION2020 requirements ,which now has its own blog that i will talk about later ,
I am attempted to talk about the Euro link –the train that takes coaches, cars with passengers inside from one side of the tunnel to the other side but I am afraid that people will look at my blog and laugh at me as to why am amazed with this. But let me explain then maybe you may not laugh.

Having been born in Malawi and brought up there , in a rural area called Ezondweni in Mtwalo ,Mzimba we were so much used to seeing cargo ( a few pieces of firewood or a few bags of maize) been carried on an Ox-cart driven by two fat bulls and we could admire how they managed such a lot of work .But recently when I arrived at the French English border by Euro line ,I was told that we would while still on the bus go on the train and that this train would take 20 of such buses with 60 people in each and cruise at 120 km per hour to cross the tunnel .For once ,my simple arithmetic told me that the weight of one bus and passengers was around 10 tonnes and that the weight of 20 buses would be around 200 tonnes .So how could such a big and long train be able to carry such a large cargo and still cruise.
I was on the coach and saw it being driven into the bigger train ,and in front of us there were several buses . Eventually the train closed, and there were announcements that all the buses had to have their engines switched off and hand break on ,and that crossing over the tunnel would take around half an hour while cruising at 120km/hour .

To cut the story short I ended on the other side safe, one by one the buses started coming out of the train and when our bus was out the driver started the engine and off we went.
I have been on a ferry before in Mombassa, Kenya but I tell you this is nothing compared to the Euro Train. Up to now we are still using oxcart in my village, hence this was a good surprise. And when I finally saw tower Eifel ,I knew I was finished .

The trip gave me more reasosns to continue fighting for blind children in Malawi.

Should we still be using oxcart in Malawi ?
Do you agree that I should have been surprised?

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Pirates are hijacking my blog

Who would think someone would want to pretend that they are me and even try to post blogs on my site on my behalf .And what would be their motive behind all this be?
These are the questions I am being faced with but it is true that someone has attempted to hijack my blog and post articles which would not be my favour. Defamation of my character is a possible reason for their attempt.
My advice is that if you see a blog with blasphemous words (uttering bad names /things against god) or swearing words on my site, know that the blog has not been posted by me and contact me immediately to remove it from the site .Blasphemy and swearing are not in my character , and I would not want to be associate with such words .
Today I did come across evidence that someone is tampering with my blog and have reported to the responsible authorities.
Honestly, Blogging is free, why can’t you just create your own blog if you are not happy with what I write .Alternatively, why bother reading my blog when there are so many things out there to be done.
The blog is here to say even if it doesn’t please other people. Anyway, am sorry, it was never meant for such a purpose.

On another note, some days are not meant to be good. In addition to being hijacked on my blog Imagine recently I was charged one Euro (approx 1.4USD) to use a toilet in a shopping mall called PRINTEMPS in Paris, France. I asked where I could get a free toilet to wash my hands and I was told forger it, it doesn’t happen in Paris .So I reluctantly paid and decided to spent a substantial amount of time in the toilet ,to get value for my money .

Life is much simpler there where there is less technology and development like rural Malawi ,thus why I am going back to the field in Mangochi next week.

What do you say?
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Wednesday, 22 July 2009

Facts about Community Health workers in Malawi

Health surveillance assistants (HSAs) implement the bulk of community health projects in Malawi; and they do a good job if trained properly and given the appropriate incentives . I can help in organising such trainings if need be.

Challenges involve motivating them to continue doing the work in the community; and providing adequate supervision.
In Zomba district, one particular group that we trained did extremely well in identifying many children from their communities with eye problems.

There is a World Health Organisation document which talks about guidelines for incentives for health workers, and I am currently studying it to find out which ones can be available to motivate the HSA’s

Without HSA’s ,I believe the health system at community level would collapse in Malawi .But can HSA’s do everything and do it well? Have you heard about Task shifting? If not ,that will be the subject of my next blog. Have a good day.

Did you want to comment?

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I must admit I have limited professional skills

Thanks for your enquiry .I will be lieing if I say as eye doctor I know everything about eye diseases and community health workers. If I did, I wouldn’t still be studying in London trying to get more skills. The truth is that my expertise is limited to eye diseases in the tropics and also to those affecting the poor people. Please do not ask me things that are beyond my capacity like requesting whether I can do laser eye surgery on you.

And I am not the only Ophthalmologist or the cleverest one in Malawi .there are many colleagues who have better skills than me, and I continue learning from them.

I can also not give the accurate information about other diseases like HIV and malaria in Malawi. There are other people who have expertise in this area and I would be willing to direct you to them.
But if you want to know about blind children in the rural areas of Malawi and how community health workers can be used to find them, am willing to share with you my experiences .

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Monday, 20 July 2009

Impressive CVs but no one to hire me

I must admit I know Malawi very well especially the rural community.
In response to the question most people have been asking me, YES I have been to all districts in Malawi and have slept in many substandard rest houses that most of you reading this blog would never ever dream of visiting .The outstanding ones that I remember are the Nsanje discovery lodge –where a night in an ensuite was only costing USD 7 but you could not get water from the tap. Surprisingly you were woken up at 5 am only to be told that water was available for bathing .I have also being to Karonga , Chitipa .Most of these arrears were visited while I was conducting eye outreach camps and operating on people with cataract in the field .
In addition and as part of work and continued medical education , I have visited some countries outside Malawi, viz : Zimbabwe ,Mozambique, Zambia ,South Africa, Botswana,Kenya, Rwanda, Uganda, Tanzania ,Egypt, Australia ,UK , Argentina , Brazil, India ,Switzerland ,Holland , Germany ,France .

I speak Swahili which I learnt in East Africa (Kenya) when I stayed there for 3 years.

I have vast experience in community health programmes.

Of all the places I have been to, my best moments are when I am in the rural community in Malawi dealing with local people at that level. I also had a very good time in Rwanda when I was involved with the trachoma survey.

Ready to hire me for an assignment in Malawi or elsewhere .

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My involvements in community Health

I had had several informal requests as to whether I could get involved in other health related projects in the community .The recent email from Domasi Zomba invites me to visit a community project dealing with HIV/AIDS and help build capacity .
One fact I can clearly state is that I am neither a donor nor a supporting funding partner. Infact I am looking for people or organisations who can contact me to give me tips of how to convince some donors or individuals to give money to me to help the poor blind children in Mangochi.
For certain of you have some monies and want me to assist you in setting up community projects or coming up with monitoring and evaluation indicators , I am nore than happy willing to assist you. Much as I focus in blind children ,I am more than available to be involved in any community health projects especially those that involve training of health workers and volunteers.
For those NGO’s interested to know about my detailed experience in working with health workers in the community, email me and I will get back to you . If you have a proposal send it to me then I can look at it and advise. If you have an idea send it to me then maybe we can develop the community proposal .

I have been involved in community projects in Rwanda, Mozambique , Tanzania and Zanzibar in addition to the many I have done within the country and I am more than available to go to new areas or countries. I can be involved in the designing , implementation and evaluation of the programmes .

I cant just leave without thinking about the community .

What do you say?
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Wish I could write a book

Ignorance is a disease; lucky enough some of us know and acknowledge that we suffer from such a disease. For once I wish I was a writer, but I know I am useless when its comes to putting words on the paper .If I did not how to write I could write a few books about all these ideas I have in my mind, books such as “guidelines for training health workers in Malawi”; “Eye diseases and their prevention in Malawi”; “How to make money while working for less hours ” and many other books.But God did not bless me with such talent ,so everytime I decide to start writing a book I write a paragraph and my head goes blank. As an alternative I have ended to writing blogs –which I still do not do well. But why is this the case ? You see I am always in the field seeing and experiencing all these things, and I tell myself when I get home I will write them up but I don’t.I wish I could be at least a better blogger ,if not a writer .Has this got something to do with my origin or culture?

Is there anyone there who can give me good tips ? easy ones and not referring me to books and blogs to read .Sorry I do not have such time. Unless your blog is talking about blind children ,or poverty in the rural villages in Malawi ,I am unlikely to read it.

I will be waiting for your email .Right now in my head I have all these wonderful ideas about what could be done to the primary health workers in Malawi but cant just spell them out .On the contrary I have noted that when it comes to going to the filed to do the work I am the one who packs the bag first .Its a pitty that so much is done ,but only the tip of the iceberg is reported.
Any suggestions on what could be done ?
What do you say?
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Mzimba Heritage

I should have joined “Muhlako wa Alomwe” because I know that unless I am seen at such gatherings, my hard work and sweat is not going to yield anything in the next 5 years. Rumours say that members of this group can perform well as managers in various capacities in Malawi , but membership is very strictly restricted .

Having been frustrated that I can not join such a beneficial group I have decided to show my face at “Friends of Mzimba Heritage” whose membership am told depends on whether you consider yourself or your parents to come from Mzimba.Well I was born there ,so am qualified to be a member .I need to be noticed at this time and everyone must know my name and that am a doctor ;This is incase this group also gets the same powers and privileges to be board chairmen and directors ,I should not be forgotten to be given such a post.
We are meeting at Michiru for lunch one Sunday afternoon and about forty people have gathered here .The chairman welcomes us in Tumbuka (I am told he is the professor and vice chancellor of the Catholic University ) and asks us to introduce ourselves in Tumbuka as well.
When a man named Dr DD Phiri rises everyone applauds and I ask them why ,am told he is the one who started the association and that he has published over 18 books and a million articles .They ask me that didn’t you see him getting the national achievers award on Televison Malawi during the celebrations day? The name person to be introduced is the so called lady whose career as a professor of law in Zambia was interrupted by being imprisoned together with the husband and sons and that the husband died in jail. She runs an NGO and am told she also got the medal at Celebrations day. In absentia but also recognised is the lady called “Rose Chirambo” who am told is dead but was the first female minister under the first Ngwazi regimen.
Then comes a list of all the prominent people in town who are here, Chief Executive of X,Y, Z and MD’s of P,Q.
And then there is this “bayethi”-all of us standing up and clapping hands to who? I am told the man is Inkosi Mabulabo even though he looks younger than me .
Its my turn and all of a sudden I am tongue tied .I thought I was going to be noticed as an important person but there are too many here so I introduce myself as Mr Kalua ,also from Mzimba and working at the hospital and luckily enough no one bothers asking what I really do .I know I take care of blind people but in this gathering that role is unnoticeable.
I have learnt one thing in this meeting; there are already too many people from Mzimba with positions in Blantyre that even if the opportunity presents that they have to chose some directors, my name would still not be considered. For once I wish I was a Lomwe ; surely I could have been going to the embassy .

I am told the Mzimba heritage welcomes everyone so you are free to join. As you can see my late grandfather is seated at his house in Mzimba so I cant deny my roots .

What do you say?
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Sunday, 19 July 2009

On Holiday to Paris France but still Blogging

Following the recent bad experience I had with the training of HSA’s in Mangochi (see my previous blog), I have taken a few days off to sit down and reflect on what went wrong and how I can improve the trainings. I also want to explore how I can best disseminate this information to other people who may be interested in training such cadres in Malawi. Well this will give me a good break about communities in Malawi and the blind children.
Remember I am an addict to travelling and indeed by Malawian standards (even by some Afican Standards) I have travelled a bit compared to the average globe trekker.Look at me in the picture taking at my home village.
Well I have not been to Europe for some time now and this being summer I have decided I will make a trip to France and visit Paris .I am not how to get there but having obtained my Schengen VISA I should be on the move anytime .
Who knows I may send a blog from Paris, otherwise I will blog after that .

Any advice on where I should and should not visit in Paris?

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Oops!!!! Disaster in training HSA’s in Mangochi

Are you involved in training Health Surveillance assistants (HSA’s) in health projects in Malawi? Do you have evidence based facts of their success in implementation after training?

I have just returned Mangochi where we trained a group of 30 HSA’s from Mangochi Zone and another group of 30 volunteers from Chilipa Zone where I faced major challenges with the HSA’s .Relax and I will share my experiences with you.

Having trained HSA’s in Mulanje and Zomba (a total of over 300) I thought with my vat experience, the training in Mangochi would be smooth. I had overlooked a number of issues which I would advise any one willing to train HSAs in Mangochi to seriously consider before rushing doing anything. Mangochi district ,in Southern Malawi is 190 km from Blantyre and has the beautiful Lake Malawi on one part of it and lake Malombe on the other. Lake Malawi has various tourist resorts and Hotel and the environment is very friendly .I stayed at the mini Martins Lodge
The district though very rural has various health research projects including the College of Medicine department of community Health and the Malawi Liverpool Welcome Trust. Most of the community projects involve training and using HSA’s

HSA’s take the invitations to attend the trainings as a privilege and look forward to the financial incentives that are associated with the training.
Some HSA’s claim from Mangochi that in order to win to win their favours and loyalty some NGOs pay them an allowance of up to USD 50 per day despite the government lunch allowance being USD 7.

We thought we had done our assignment well ;had talked to the responsible officers and agreed we would give an allowance of USD 7 for the one day training but in addition we would provide drinks and snacks .As a background in 2007 I had done a situation analysis in Mangochi on why HSA’s despite working in the community were not involved in identifying children with eye problems .I spoke to a group of representative HSAs (20 in total) and they all indicated what they lacked was the skill and if trained they would be willing to do such a job. So this training was organised as part of my study and in response to the findings .We conducted the first training to a group of 30 Volunteers from a different area on day one ,gave them the allowances and snacks. During day 2 we arrived at a different place to train HSA’s ;started the training but noted that the participants were not attentive. In probing why ,we learnt that they wanted to know how much money they would get at the end of training ,and whether we had brought t-shirts and other incentives for them. After explaining that we would only give USD 7 as per what volunteers got the previous day, the whole workshop turned into chaos with the HSA’s threatening to boycott the training and forfeit the highly needed skills if they did not get all their monies .

So how did it all went at the end ? Not very well – I sustained a few emotional bruises .I would like to write a whole blog about this –when I am better.
For now you can gues!!!!

Have you experienced difficulties in conducting training? What did you do? Or are you just interested to comment.

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Primary Health Workers for Malawi

If you are an NGO or an individual interested in community health issues, you probably be wondering how much impact the role of community health workers have in improving the health of Malawians. In particular to this cadre are the so called Health surveillance assistants (HSA), who are said to be the backbone of the health system in Malawi .HSAs are employed and paid by the Ministry of Health. But what skills do HSA’s have to implement health care; and if trained do they actually do their work.
There are currently an approximately 12,000 HSA’s in the Malawi public service ,as a result of the recent scale up (2007) with almost half employed by the ministry of Health under the Global fund and other funding parteners and the rest through normal employment. HSA’s are responsible for implemented most of the health initiatives in the community, and for disease surveillance .By education ,the newer HSA’s have reached at least high school (Form 4) ,while the order groups may have not been very educated .HSA’s only undergo a 3 months training in Preventive, Diagnostic and Curative measures and upon completion they become experts in all community diseases .
With all the community interventions in Malawi relying on HSA’s ;is there evidence that HSA’s have contributed to the reduction in morbidity and mortality of the common Malawians .What are the implications and limitations of using HSA’s in health programmes ?

A look at the maternal, mortality figures in Malawi indicates that Malawi has the highest mortality rates (1120deaths per 100,000 mothers delivery) despite the many health promotion messages being spread by HSA’s. Many causes of these deaths are attributed to low levels of maternal care.

Unicef States of the world children 2009 that over a period of 16 years (1990 and 2006) of intensive community programme interventions, Malawi has only managed to reduce under five mortality by 40% and that the main causes of deaths still remain preventable at the community level. HSA’s are taught the integrated management of childhood infections (IMCI).
Since 2007 I have been involved in training HSA’s in identifying blind and visual impaired children in rural communities in Malawi; and have been comparing their performance with a matched group of trained volunteers .
I have very interesting results –which will be published later ,but certain issues desrve to be mentioned at this stage.

I have noted that most NGO’s and government institutions assess the outcomes of HSA’s training through reports submitted to the interested parties ,and that rarely do the trainers observe and access the skills attained by HSA’s after the training. I have also noted that most HSA’s rate the trainings based on the amount of subsistence allowance received during the training, and not on the skills attained. The mismatch in expectations between the trainers and the HSA’s has more than often resulted in not having proper measures to measure the outcomes of trainings .
In my next blog I would like write about what incentives HSA’s have mentioned to be being necessary for them to do the work ; and whether when given such incentives they have successfully accomplished the desired tasks. I will also be introducing the tracking tools that we have developed to assess whether HSA’s are doing their work and the incentives that we give. In the picture I am listening to a group discussion by HSA’s from Zomba. The forms we have devised can be used for any time of training and I will be more than willing to share with you.

Are you involved in training HSA’s in health projects in Malawi? Do you have evidence based facts of their success in implementation after training?

Or do you want me to share our results with you? Or are you just interested or want to comment.

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Wednesday, 17 June 2009

Good Retirement for the Minister of Health in Malawi

As per my prediction on the earlier blog, indeed Prof Moses Chirambo, after retiring as the first Malawian Ophthalmologist is now not only Member of Parliament but also the Minister of Health in Malawi.
Join me in congratulating him in his job as he continues to be my boss.

Well, no one should ever doubt that he will not perform for the ministry of Health; He did wonders in Eye care, am confident he will do the same.
Read his profile on my earlier blog and you will understand we need such people in Malawi .The link is


In one of the pictures I am just next to him, he is the one with the flash disc on hi neck.This picture was taken was in 2004 when we had a refresher course for Ophthalmic clinical officers in Mangochi.

If you are still in doubt or just want to comment

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Tuesday, 16 June 2009

Are you a health worker based in the UK ? Will you help?

A film for the World Health Organisation (WHO) is currently being produced by a company in the UK. The film will look at the improvements to Malawi's health services that the WHO has been helping to implement. The film makers would like to talk to Malawian doctors, nurses and midwives who are currently based and working in the UK. With your help, they would like to discover what impact the WHO's interventions are having on the ground in Malawi. Have your say on what needs to be done to improve the Health System in Malawi .

I have accepted to participate in the film.

Are you available for a chat with me before being introduced to them?

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Monday, 15 June 2009

Meetings with Agenda but no progress

I was in Lilongwe the capital city of Malawi over the weekend.We had a meeting on 12th June.One of those where people talk and talk but nothing happens on the ground.I hate meetings .i couldnt go to Zomba for my programee because the Ministry of Health wanted to hear the results of the Trachoma survey that we did in Chikwawa and mchinji last year in august.Imagine they are asking about that now.
I am back in Blantyre ,this week i am busy doing surgeries most of the days ,but next week am off to mangochi ,the lake to introduce my programme of identifying blind children there . i am loking forward to the trip -swimming on the fresh water lake, and ofcourse seeing the children.One has written an article in the Malawian newspapers that the credit crunch is not affecting the ordinary Malawian in the community.Ask me i will tell you the truth.

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Wednesday, 10 June 2009

Needed: Malawian doctors or nurses who are working in the UK

A company in the United Kingdom are researching a possible film for the World Health Organisation (WHO) and would like to talk to Malawian doctors and nurses who are currently working in the UK (preferably in the North West of England / Manchester area). The WHO have helped put various measures in place in Malawi to try and improve the health system. With the help of Malawian health workers who are working in the UK, the film makers would like to discover what impact those measures are having. I have accepted to partcipate in the film.

Are you a Malawian doctor or nurse working in the UK?Will you be available for a short interview at your own convinient time?

Please Email Ashley Morris!

or cal him directly on 0208 969 1616

Or do you have any comments to make, then
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Thursday, 21 May 2009

Greatest and first Malawian Eye doctor joins politics

Prof Moses Chirambo, the first Malawian Ophthalmologist is now a Malawian member of parliament and minister of Health.When I first heard that he was campaigning for a seat in Parliament; I thought it was a joke. I have always known him as a great teacher, eye doctor ,mentor and father and founder of Ophthalmology in Malawi .Trained as an ophthalmologist as Hadassah University in Israel in the early 70’s, Prof Chirambo started making a name in 1972 when he started conducting outreach eye camps all over Malawi .In 1983 , he established the SADC school of Ophthalmology in Lilongwe supported by Sight Savers International ; this school has trained over 500 eye personnel from all over SADC countries and beyond ; and now several countries including Botswana, Namibia, Zimbabwe and Zambia have started their own training programmes using the Malawi model with Prof Chirambo helping the in designing the curriculum. In 1993, under the initiative of the Prof , the 60 bed Lions Sight first eye hospital was built and opened up in Lilongwe .In 1995, Chirambo got an International ward from the American Academy for his fight in blindness; and continued to get several awards (too many to mention). He was instrumental in teaching medical students from Malawi in Lilongwe and when I initially met him as a student in 1995 I knew I would specialise in Ophthalmology. Sight Savers Projects in Malawi flourished under his leadership as a Regional advisor and we have several buses and vehicles for outreach brought under his initiative.
Prof Chirambo was instrumental in establishing other Lions eye hospitals in Mzuzu , Blantyre and Zomba. He enjoyed doing surgery, and was very fast in theatre.
Later on when we become colleagues, we socialised every time we went for outreach camps, and he enjoyed a beer after work. I remember in 2005, we operated on 120 patients with cataract within 3 days in Mzimba District. His last assignment was coordinating the establishment of school of Optometry at Mzuzu University in the Northern Region of Malawi, and this school which started in 2008 with 5 international students has already started attracting International attention. He was honoured by the President at Mzuzu University as one of the greatest medical academic achievers in Malawi.
Prof Chirambo has published extensively International and has several articles on eye care in Malawi, and his work is quoted by most authors taking about eye care in developing countries. If you go to any University eye department in the SADC countries and say you are from Malawi, you will be asked about how Dr Moses Chirambo is? He is mostly remembered for his alcoholic working standards; being in hospital as early as 7am and leaving 8pm every day.

I have had several good times and taken pictures with him for my memories, and as he retires from the eye care sector and goes into politics I will always remember him as a great mentor. If it wasn’t for him, I would not be the community Eye Specialist I am today. But I will always wonder a man who has achieved more than a lot would want to join politics?
Are you inpired?
Should such a genius be in politics? Should I follow him? What do you think?

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Tuesday, 19 May 2009

Getting a pair of good glasses in Blantyre, Malawi

Since I have received an enquiry of where one can get a pair of good glasses in Blantyre, Malawi, I have decided I might as well write a blog about it.
There are several places that do sell all sort of glasses in Blantyre (for reading, for distance, for sunlight and a combination of these) and I will briefly mention all of them and give my opinion of what I feel is the difference between these places.

If you are looking for a good pair of any glasses my opinion is that you should check Penya Optical ,a private centre within the Lions Eye hospital at Queen Elizabeth Central hospital (Located at Ginnery corner) and you will get a good deal .There is a full time optometrist who will test your eyes for free within a short period of time , and if you are only looking for a simple pair of reading glasses you will walk out with the pair of glasses the same day for as less as USD 20 .If you need more complex glasses ,they will be ready within two –three weeks. This is the cheapest place in town despite having all sorts of glasses that you will get anywhere. Do not be cheated that the quality of glasses is poor; the quality of these frames and glasses is as good as you will get anywhere in UK, but at less than half of the prize.

If you do not want to go to Penya , there are several options : Prosight Optical at Mwaiwathu Private hospital and Eyecare centre located along Henderson Street ,both manned by private ophthalmologists will give you glasses but you have to pay for consultation fees to have your eyes tested and the prize of glasses will be slightly higher .You also have to book an appointment to be seen.

You can walk in at AC Opticals (located in Town at Henderson street and the other one at Shoprite, Ginnery corner), a private optical workshop manned by a private Optometrists but you must be prepared to cough in a fortune for a pair of glasses. Much as the centre claims to use a computer to test your sight /Vision (you tell me where the computer can do that!!!) and to have the latest designer glasses, you will be able to get the same ones of you ask at Penya but the prize will be much cheaper.A new place called Blantyre eye clinic has opened near TNM building Headqurters in town so you may check this one.

Mind you not many Malawians need to wear glasses (only 1 per 100 population needs a pair of glasses), unless you are above 45, then probably you need a pair of reading glasses.
Hopefully I have been of some help to you (but I don’t sell or keep glasses, and do not have a private clinic so don’t ask for a pair from me).

Do you want to get a pair of glasses from Lilongwe, Zomba or Mzuzu?

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Sunday, 17 May 2009

Reversing Doctors brain drain from Malawi

Just a few years ago, how many of us would have heard that there were more Malawian doctors in Manchester than in Malawi itself? Well, that was the time I was in Manchester too and knew many colleague doctors from Malawi (Dr Njobvu and Dr Kayira ,both paediatricians are still there ).I can now confidently report that there are more doctors in Malawi at the moment , thanks to College of Medicine ,University of Malawi who have now started producing large numbers of locally trained Malawian doctors .Last year alone 38 doctors graduated from the Medical school in Blantyre and by the end of 2009 another 60 doctors are expected to graduate .Most of these doctors are now remaining in Malawi ,as even for specialist training –this is being offered by the college of medicine too. As a record ,for the first time in the University of Malawi history ,in March 2009 ,the first 3 Malawian trained specialist doctors (2 paediatricians ,1 medical physician) graduated from the university and a further 3 are expected to finish their specialisation in September .Very soon we will be having a lot of doctors on the ground .
For those of you who are wondering why there are still very few doctors in the Governments hospital, the answer is this. The missions and private hospitals are absorbing most of the medical graduates due to their better enumeration, but this is no worry as these doctors are serving fellow Malawians than being out of the country And very soon the mission and private hospitals will become flooded and the overflow will extend to the Government hospital, benefiting the most disadvantaged of the Malawians. So we will be having all the specialists in the Government very soon.
Great thanks should go to all the Malawian doctors who have sacrificed to stay in Malawi and teach at College of Medicine.

Aren’t you excited that the Doctors crisis will be over in Malawi soon?

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Saturday, 16 May 2009

Sarcastic Blogging comments

An unknown blogger has sent me the following comments regarding my blog: Your blogs stinks , and I do not know why you still waist time writing , Infact you need to take lessons to write properly .In addition a lot of what you do (treating blind children)is exactly what you are trained to do as a Doctor in Malawi ,so there is nothing exceptional that you say.

I did not know I was upsetting other people, but I have decided am going not going to comment about their comments, but will let our bloggers say what they think. After all, I have had several other emails telling me of the good work and the hope that the blog brings to them, and these bad comments are the first .God forgive you ,wherever you are if you are the one who wrote the sarcastic words.

Do you think I should indeed shut this blog ?
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Monday, 4 May 2009

Labour day a sad day for me

1st May 2009 should have been a good day for me in Malawi and it was a sunny and quiet holiday , but when the Sight Savers International (SSI) Country Representative called to meet me at a short notice at the hotel he was staying ,I knew the day was not going to end up well. So I rushed there, ordered a mango juice and eager waited to hear what he would say. “Dr Kalua, I am sorry to inform you that MOOP is dead”. Decision was made to close the programme by 31st March as so as we are speaking there will be no more outreach surgical camps that we were supporting. This decision was made because our SSI UK office has been hit hard with the global financial crisis and were asked to cut some programmes to reduce our expenditure so we chose MOOP to go .”
You mean the prestigious Malawi Ophthalmic outreach programme that has enjoyed fame over a number of years has now been phased out?” I screened!!! Yes MOOP is gone, God save us, he replied. What happened to the donor from Ireland who said they would fund 20 eye camps in Malawi in 2009, I wondered. Why wasn’t I warned before about this doom?

Well ,in a nut shell ,some of you may not have been hit by this crisis yet ,but as for some of us we are finished –our jobs have been made redundant .We are planning to go back to the UK and start the cleaning and carer jobs once again ,assuming there are still there .
And you will not be reading those stories of old poor blind Malawians regaining their Sight through outreach programmes, as the outreach has been phased out .
As I try to get over this message, I will let you know what my next job will be.
I was proud to be associated with MOOP, and I hope my team and I will be. remembered for the efforts we made to prevention of blindness in Malawi

Has the financial crisis hit you in your sector? Would you like to share a story with me , or comment on anything?

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Death of MOOP: the biggest causality in eye care in Malawi resulting from the global financial crisis

I have been quiet for a few months as rumours kept on circulating that the biggest project I was associated with in Malawi was going to stop. Its now official, I would like to announce the death of the Malawi Ophthalmic outreach programme (MOOP) whose sudden death of that fateful day of 31st March 2009 has left some of us with more questions than answers. Some of them are philosophical and include issues of brain such as “Is it worth for Malawi doctors to stay in Malawi rather than follow where there is greener pasture?”

MOOP has been in Malawi for many many years , had reshaped itself over the years but always survived .In the 70’s and early 80’s Prof Moses Chirambo,the only Malawian eye specialists enjoyed the support of Blue peter and Royal commonwealth society for the blind from UK , which later become Sight Savers International (SSI) .Under their funding he went all over the country with those old landrovers ,operating on the blind and making them see. He impact was well known that in 1983 Malawi established the ophthalmic training school catering for the SADC countries but also for other countries in Africa was well .The focus of this school was to train local eye surgeons and under this initiative ver 65 eye surgeons from 20 countries in Africa were trained.
In 1997 MOOP was restructured and secured through Sight Savers International large funding from EU which made the programme expand. The country was divided into five zones and vehicles for mobilising cataract patients were bought for each zone and several eye camps were organised in many districts benefiting the majority of Malawians. As a young medical graduate I saw what MOOP was doing and decided that Ophthalmology field was going to be my destiny.

Today as I contemplate committing suicide after hearing that SSI has dropped supporting MOOP and that there will be no future outreach eye camps in Malawi, I can not just see what life will be for me in Malawi. Why? When I come back to Malawi as an Ophthalmologist in 2002 and settled in Blantyre MOOP had a lot of funding and asked me to organise as many camps so that we could operate on many patients. I travelled the whole year of 2003 from Karonga to Nsanje and operated on over 2000 cataract patients on that year alone restoring sight .Infact it was communicated to the ministry of health headquarters that all eye care activities in malawi were to be supported by SSI through MOOP and the ministry was delighted

Thats the year (2003) that I felt the biggest impact of working as a doctor in community and vowed that as long as I was in Malawi I would give a substantial part of my time to operating in the rural areas.My whole blog is full of stories of where I have been with MOOP, and it still hasn’t sunk to me that MOOP is dead,but why? Well I was in the UK when the stories of the global financial crisis started emerging, and we were discussing that Malawi being a poor country, we would not notice the effects of this crisis .Honestly if I knew this was coming I would have made a decision to stay in UK and work there .Here is a doctor and his team who are ready to operate on many blind patients who are out there, only to be told because of the financial crisis ,those patients can hung? So what will I be doing in Malawi? Is there a reason for continue to stay in this country when you have a valid 5 year VISA for the UK? I don’t know but I believe God has plans for everything and maybe he is asking me to move from Malawi.

I rest my case for you to judge.

+ MOOP rest in peace RIP.
Born 1971
Died Prematurely 2009
MOOP, how could you have gone so early at the age of 38?With your departure some of us have no purpose in life and we are contemplating on changing continents. What will happen to the many hopeless that you gave sight to ?
We loved you, but god loved you most.

Dr Khumbo Kalua is a Malawian Ophthalmologist whose passion for the community was being served through MOOP and is very frustrated and bitter with the global financial crisis and its major effects on poor countries like Malawi. Sight Savers International is a UK based charity NGO that was supported MOOP. The decision to stop MOOP was made at short notice and centrally at policy level (SSI) without consultation of the stakeholders, the technical staff and the Ministry of Health officials in Malawi.

Can you help? Or do you want just to comment? Do you want to call me on +265 999958176 and +26588830232 in Malawi to send your condolences?

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