Thank you Rotarians of Limbe

We finally did it.

It was nice seeing so many people from Mulanje regain their Sight after we did Cataract surgeries at Mulanje district hospital on 20^th and 21^st April 2012.

Frank Mbewe my right hand man did most of the work and I am very proud of him.

Bravo to the team that went to Mulanje.

Rotarians, please support more of these eye camps.

Cataract remains the common cause of blindness in MALAWI with over 20,000 blind from the disease.

An operation to remove cataract takes less than 15 minutes (in the experience hands) so these people should not suffer unnecessarily.

What is needed is to support the team to be able to go and perform surgeries. In 2011 Malawi had a zero deficit budget; which meant zero community eye activities.

Blantyre Institute for community Ophthalmology BICO   my unit couldnt  help.

 

Should more Malawians be supporting cataract surgeries from their pockets?

Comment at : director@bicomalawi.org

Email me!

Happy Birth day

Today 2nd February I am a year older.I wish myself a happy birthday .
As usual i am out of Blantyre on a field trip within Malawi .

And I can feel that my body is quickly been worn day by day ;

Thanks to the many days spent in the community fighting blindness, at the expense of my health.

I think it is time to retire and give chance to the young ones to continue where I will have left . maybe I can spend more time with my family and lovely daughter

What do you say?

Email me!

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?

Email me!

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?

Email me!

OVER 120 BLIND PEOPLE HAVE THEIR EYE SIGHT RESTORED IN ZOMBA AND MACHINGA, MALAWI

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.
Do you want to comment?
Email me!

Primary Health workers: Is Quantity better than Quality in Malawi?

Am no politician, but Health is politics, and if you are interested in health issues in Malawi then follow discussions and debate below.
How often do researchers aim to publish findings from our findings from studies in Malawi in top journals /magazines like the “New York times” ,“British Medical journal” ,"The economists” and many others ? Well not many Malawians have access to such papers and may not even read about issues affecting them.
This is why I am publishing our preliminary research results on this blog, hoping that a few people interested in Malawi will read the whole article.

I am trying to design methods/ways of how primary health care workers can be used to find blind and visual impaired children in the villages early and bring them to our hospital for surgical intervention .Health surveillance assistants (HSA) are the lowest cadre of health workers in Malawi and most of their work involves working in a community surrounding a Health Centre .In 2007 there were about 6,000 HSA’s in the whole country (1 per 2,000 population).Within the last 3 months the Ministry of Health through a grant from Global Fight for TB , HIV, and Malaria have almost doubled the number of HSA by employing another ?6000 (no one knows exactly how many more but this number is supposed to have been achieved) on a temporary basis.

Is it a matter of increasing the numbers or improving the quality of performance of the existing ones? To answer this question lets discuss what HSA’s do in the health system in Malawi?

HSA’s are the first level of contact with the patients in the community and they are supposed to give health promotion (HSA were first recruited in Malawi for Cholera prevention programmes), but unfortunately currently they do a lot; give immunisations to children, treat fever in children, treat pneumonia, malaria, supervise patients on TB and ARV, give support to home based care, implement NGO’s programmes and many other duties. Talks about them whether being qualified to give ARV’s have been debated with no consensus reached.
HSA’s only undergo a 3 month short training medical course and currently they need to have a certificate (MSCE/JCE) to be accepted for the course. After graduation they become experts on every disease in the community and are supposed to offer primary health care (first level care) and then refer difficulty cases.

Well my Research Team last month (January) conducted Focus Group discussions (FGD) in 3 districts in Southern Malawi interviewing 30 HSA’s on what they know and do about eye diseases .We started in Mulanje (Chisitu and Chonde health centres), and then went to Mangochi (Chilipa and Nkope and Namwera Health centre, 40mKm from Mangochi Boma,), and finished in Chirazulu (Monfort /Nguludi Health Centres).

What did we find?
Almost half of the HSA’s at health centres were new having been employed with the last 3 months. They had not attended any form of training and they did not know when they would go for the 3 months course. Most of the old HSA’s had been trained, however surprisingly some of the HSA had not been formally trained 2 years after they started they job (work was all learned on the job).
Concerning Eye care both the old and the new HSA did not know the causes of eye diseases and how to treat or prevent them .The trained ones indicated that the 3 months course did not cover any eye diseases. There was no difference in the level of knowledge of eye diseases between the trained and untrained ones .Asked what they do when they see eye patients in the community, most of them just gave any eye drops available.
More than 50% of HSA’s believed that traditional herbal medicine can be used to treat eye conditions, and reported knowing either a relative or themselves using herbal medicine .The herbs used mainly in form of powder or eye drops included pepper leaves, green tomato leaves, fresh urine from patient and mothers expressed breast milk. Two HSA had personally used these herbs for treating their own eyes.

All HSA’s admitted to seriously needing some form of training in primary eye care and plans are underway to train some of them hopefully starting by June.

We did not deeply access the HSA’s knowledge and performance on other diseases.

Conclusion
The numbers of HSA has indeed drastically increased in Malawi but their quality of performance in eyes diseases is very poor.
Massive training and evaluation programmes are needed to assess future impact of HSA on eye diseases and further research is needed to assess their knowledge and performance in other diseases.

Research funds provided by International Centre for Eye Health London

What do you say?
Email me!

More than 10,000 Blind people in Malawi

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

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

We treat;but God Heals.

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