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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Teaching Key informants (local volunteers) in identifying Blind Children in Mulanje

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





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

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Blantyre Institute for Community ophthalmology (BICO) - a dream or reality?

BICO will be formed in late 2008 with the mission of contributing to the prevention and control of blindness in Malawi through conducting practical research, teaching, training, consultancy and advocacy in eye care delivery.
The idea to start the institute was conceptualised after realising that despite nearly 10 years after the launch of the VISION2020: THE RIGHT TO SIGHT ,the global initiative to eliminate avoidable blindness and the various successes/ achievements in other areas of the world;Malawi has still not made much progress especially in the area of research on practical preventative community eye care blindness programmes.
The centre aims to conduct and disseminate findings of research being done eye care professionals and other stake holders in the region and transfer the best of its expertise and experience to an ever-increasing number of eye care institutes across Southern Africa. The centre will strategically be located within the University of Malawi College of Medicine teaching eye hospital, the Lions Sight first eye hospital in Blantyre.
The planned activities of the institute contributing to eye care in Malawi and other neighbouring developing countries can be broadly classified under the following areas:
• Capacity building of community eye care health workers
• Training Programmes – focussing on community eye care delivery
• Research capacity building through conducting practical local research (operational and health services research )
• Publications
• Consultative support to countries with no expertise in community eye health
• Advocacy and contribution to Eye Care Programmes at National and International level through the Government and International NGOs.
• Fund raising for eye care service delivery
BICO as a centre within the Lions Sight Eye hospital, College of medicine, University of Malawi, Blantyre will work closely with the collaborating Community Ophthalmology centres within the region (Kilimanjaro Centre for community Ophthalmology-KCCO in Tanzania) and also with International Centre for Eye Health (ICEH, London); which continues to take a leading role in developing Community eye health workers for Africa and elsewhere.
BICO is currently looking for organisations /persons who can be involved in supporting research related and eye service delivery fund raising activities.

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

Will be waiting for your comments!!!

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Empty Promises

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

I will be waiting for your email.

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

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

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

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Good services in Malawi can be a model for neighbouring countries

Considering all these bad things that you hear about Malawi
Have you ever wondered whether there is anything good that comes from Malawi and spreads to the neighbouring countries?

When I received an email in June 2007 from an International Eye Organisation that my name had been suggested as one of the team members that would be useful in setting up a new Eye care programme in the rural part of Mozambique; a few thoughts came into my mind. Firstly I wondered whether the current eye service delivery in Malawi would be a model for Mozambique (in the context of so many things still not being efficient in the Malawi programme) and why my name was given and who gave it. If they wanted a neighbouring country ,Why did they not look for a consultant in South Africa where there is so much expertise, I wondered ? The only plausible explanation I had at that time for being chosen for the job was that this was not a very interesting and well paying assignment (imagine spending two weeks in rural Mozambique where the main language is Portuguese and not English).Anyway somebody had to do this job so I wrote back that I would be interested to go.
Arrangements were made to meet Mozambican counterparts in Nampura Province at the Provincial hospital. I did not know what to expect when I arrived in Nampura .A language translator had been organised to be part of the team. I had my digital camera to record all the adventures

Interestingly there was so much fun when I got there and there were not many obstacles as I had anticipated. I observed that Eye diseases do not respect the political boundaries and do not need a VISA to cross borders so every other eye condition that I have seen in Malawi was there in Nampura. Unfortunately Nampura did not have an effective eye programme in place so the problems were much worse there (lots and lots of blind people) . However their villages,districts ,and health services were so similar to Malawi that more than often I forgot I was miles away from Malawi. Getting to the famous Nacala City (where the port is and the Nacala corridor -which the Malawi defence forces had been defending for years ) I expected to see a lot of unusual things. But all I met were nice friendly people and some of their food was the same as we have in Malawi (Nsima). It was during the meeting that we had at the District administrators offices that it transpired to me that these people had heard of so much good eye work that was being done in Malawi and were wondering why the same thing couldn’t happen to them and were hoping I was the solution.
A report about how a programme could be started in the Nampura province was submitted to the NGO a few weeks later and fortunately most of our recommendations were taken seriously such that the programme has actually started.
Looking back ,it would have been a difficulty assignment if a consultant from a well developed country who is not used to working in the community could have been chosen.And somebody,somwhere knew that this assignment could better be tackled by eye workers in Malawi.
The little good things that are happening in the eye sector in Malawi are being watched by many; and in this competitive world it is a rare opportunity for Malawi to spray its wings to the neighbouring countries and become a role model.

Lions Eye Hospital Blantyre Malawi

This is where I work in Blantyre.The hospital is part of Queen Elizabeth Central Hospital and is also a teaching hospital for College of Medicine and other Health teaching institutions in Malawi