When did Trachoma Survey in Malawi start ?

The external facilitators form the UK and USA arrived in Malawi during the last week of July 2008 ;and we had training of the team from 28th July-1nd August .They were 9 paired teams of clinical officers (18 in total ) and each team had a supervisor. We piloted the research in Blantyre at Chileka Health Centre and near the surrounding villages and proceeded to data collection in Chikwawa on 2nd august (straight after the training & pilot) and stayed in Chikwawa for 8 days .we went everywhere (Chang’ambika,Chithumba,Chapanganga,Dolo,Ngabu,Nchalo,e.t.c ) faced many challenges and proceeded to mchinji on 10th of august for another 8 days of data collection . By the time we got to Mchinji the teams had a lot of experienced so it was practically a bit easier in Mchinji .Want to know what challenges we faced? I will write about them later .I should point out that this was one of the few larger studies in the Eye field that has been done in Malawi while led by a local Malawian as a Principal Investigator and I am proud to have been the one.

With a budget of over USD 50,000; Should the Trachoma survey have been done at all?
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for your comments .

Trachoma Prevalence survey in Malawi 2008

I have a lot to write as I have not been blogging so I do not even know where to start explaining about this survey. Anyway I am the Principal Investigator of this Research but I have been supported by expertise form the London School of Hygiene and Tropical medicine(LSHTM) UK ;International Trachoma Initiative (ITI),New York USA, Department of Statistics ,Chancellor College ,University of Malawi , Zomba ; College of Medicine Research Support centre and Sight Savers International Malawi country office. In particular I would like to thank Dr Tobias Chirwa from Chancellor College who worked to ensure that the questionnaires were user friendly; and Dr Linda Kalilani from Research Support Centre who agreed to manage the data. The two of you have made my life much easier .Earlier this year ( in April ) as I sat in that conference room at World Health Organisation(WHO) in Geneva Switzerland listening to the challenges our friends in Zambia had in doing such a similar study; I was wondering whether I was competent enough to be the Principal Investigator but with the support I got from various people in Malawi my work was made much easier and I am proud that the Research has gone very well. How can I forget the chairman of the National health Research committee in Malawi ;who upon hearing the urgency to do this study ;approved our proposal within 2 weeks of submission.
Well I do not know whether any of this stuff makes sense to you, but
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for any comments .

Malawi Zambia -Mchinji Border

Where do I even start blogging? For the past few weeks I have been to the worst of the remote areas in Malawi; trying to identify eye cases of Trachoma .Trachoma is the oldest reported eye infectious disease (reported during the ancient Egyptian times); that causes acute conjunctivitis which if not properly treated can lead to long term consequences like problems with eye sight and complete loss of vision.

I have been commissioned by National Prevention of Blindness Committee and the Ministry of Health to find out whether Trachoma is still a significant public health problem as defined by the World Health Organisation. My role as the Principal Investigator is to coordinate this big study in Malawi .In order to do this I have recruited a total research team of 30 people (10 vehicles) and organised a one week training where participants will be taught how to conduct this research. Most participants are Ophthalmic Clinical officers; and I have taken all of them from Nsanje to Chitipa. In addition I have engaged senior personnel as supervisors (Programme Manager and Lectures) have also engaged the College of Medicine Research support Centre to back me up with data management.
Will all these people and a budget of over USD 50,000 you can see why I have been missing from the blog site. Infact I have had very little sleep since May when I started seriously preparing for this research.
Today I am blogging from the Malawi –Zambian border; the Mchinji border and I am just facing Chipata .Well; why am I here? I want to find out whether Trachoma is still a problem in this area.
Next time you want to visit any place in Mchinji ; Email me!

SO WHERE ARE THE BLIND CHILDREN?

Listen to the story below as given by me ,a project coordinator at BICO

This is a story of mother with four children living in Natchwatchwa village, Mulanje district. One day she was doing her daily household chores when a volunteer came to her house. The volunteer, one of the key informants had been trained for half a day to identify blind children in her community and she had started her work. She came to her house to ask if any of the children in the house had eye problems. This volunteer found out that there was a five year boy with eye problems who had never been to hospital ;on checked the child she found out that the child had had cataracts in both eyes and was not able to see well. The mother was told by the key informant to take the child for screening on the 9th June at a place in Mulanje whether the screening team (eye doctors)would be coming .
Determined to solve the problem of her child’s eyes she showed up on the 9th June. When Dr. Kalua screened this five year old child, it was truly confirmed that the child had cataract in both eyes . Interestingly, the mother was also carrying a four month baby boy, and out of curiosity, Dr Kalua decided to check the little baby's eyes as well. Unfortunately enough, the baby also had cataract. And Dr Kalua while talking and curiously taking a close look at the mother, noted that herself too had cataract in both eyes . This was so interesting to note that a key informant only after half a days training can identify indirectly, at least three people with cataract from one family.
The mother and her two children where referred to Lions Sight First Eye Hospital (LSFEH),Blantyre . The following day, the key informant went to their house to assure her to come to LSFEH and help them prepare for the trip ;and while there she also noted out that another 2 year old boy from the same mother also had cataract . The parent reported that this boy was not present the first time they came for screening because he lives with his grandmother. In total the Key informant referred a family of four (all with cataracts) to LSFEH in Blantyre for surgery which was performed by Dr Kalua .
The mother and all children have been happily discharged from the hospital and I will be following them up in Mulanje soon.

Are we doing a good job in training volunteers?
Want to know more about our work ,
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FINDING BLIND CHILDREN IN MULANJE

Well its really getting difficulty to maintain writing on my blog yet keep up with the filed work in Malawi .
Since Blantyre Institute for Community ophthalmology ( BICO) was launched early this year at the Lions sight first eye hospital in Blantyre ;we have been very busy doing Community eye health work in Southern Malawi ; starting with Mulanje as a pilot District .In may this year we conduced several trainings of Village volunteers and also Health surveillance assistants on how they can identify blind children ;and now they have started doing their work in the field and we are busy travelling up and down following what they are doing; We have recruited a project coordinator who is doing a marvellous job ( being a University of Malawi graduate I expect them to excel anyway).We were privileged in May to have observers from the International Centre for Eye health, London who visited us and observed what we are doing in Mulanje. I am pleased to report that that they have been convinced we are on the right track ;and we look forward to having services of BICO expand to the rest of southern Malawi .

If you have money to spare; do us a favour ! help us print BICO tee- shits for volunteers and Health Surveillance assistants at a cost of USD 8 ( £4) per item; these will help us spread messages about blindness in children and also
motivate the staff.

If you want to help please
Email me!

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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