Malawi Clinics

Tomorrow marks the start of a very busy week for the Project team in Malawi. Sylvester and his colleagues at the College of Health Sciences in Zomba are driving a truck loaded with new computers to all the remaining clinics in the Project network without a fully functioning computer. Globe Internet Malawi will be on hand to complete Internet installation at Bangwe, Chilomoni, Namadzi, Domasi and Bvumbwe clinics.

We are privileged to have the full support of the District Health Officers in Blantyre, Zomba, Chiradzulu and Thylo for the safe delivery and maintenance of the computers. The Project team will be available to arrange training dates for staff interested in improving keyboard and wordprocessing skills.

All of the new computers have been donated by Glasgow City Council and we are very grateful to them for this.

We hope to have ’switch on’ at the new clinics by next week and look forward to sharing photos of the distribution journey with you …

Why not send a welcome message to your fellow Malawians or twin counterparts using the comments sectioin of this blog post?

District Health Officer John Chipolombwe said that apart from the establishment of sputum testing centres, healthcare professionals would be visiting all prisons every month for sputum tests as one way of reducing the disease.

“We are also expected to go to all the six traditional authorities in the district to sensitise them on the importance of going for sputum tests,” he said.

MP for Mulanje Limbuli who is also Deputy Minister of Education, Olive Masanza, called upon chiefs and politicians to take part in stopping TB in the country:

“Health ministers across the world met in 2005 and agreed that TB must be stopped by 2015, but without coordinated efforts, the disease cannot be stopped”.

A randomised clinical trial conducted in Malawi has found that extending prophylaxis with nevirapine (Viramune), with or without AZT (zidovudine, Retrovir), from one week to fourteen weeks of life, significantly reduces HIV infection in infants born to HIV-positive mothers. Put simply, the study shows that the HIV and TB epidemics go hand in hand and, very often, fuel each other. Thus, emphasising the role of prevention.

Read more here

See also a debate in this month’s The Lancet about how HIV/ tuberculosis co-infection is threatening to negate progress made against AIDS in the last decade.

Computers from Glasgow City Council

Health workers from clinics which are twinned with Scottish General Practices will be all smiles as the much awaited computers are in the country and safely delivered and kept at Malawi College of Health Sciences. They are 20 Compaq computers in total, from Glasgow City Council as a donation to Malawian clinics through the Scotland-Malawi Twinning Project.

Distribution has started with Matawale Clinic as the first to get one of the computers. Globe Internet is the Interner Service Provider in the twinned clinics.

More to follow….

We often discuss fears of an African medical ‘brain drain’ on this blog. An article in this month’s Human Resources for Health journal analyses data on the extent of healthcare professionals working abroad.

You can read more here.

See also the launch of the World Health Organisation’s first ever ‘Guidlines on Incentives for Healthcare Professionals‘ that aim to help retain skilled medical practitioners within their country of birth.

Clinical Officer at Ndirande, Francis Phiri, has reflected on the recent troubles affecting some Malawians in South Africa.

Hundreds of Malawians arrived in the country over the past week from South Africa where xenophobic attacks against immigrants have claimed of tens of immigrant lives. The government of Malawi is carrying out a Repatriation campaign hoping to evacuate all Malawians desperate in the south most African country. It is estimated that about 6000 Malawians have sought refuge in Police Stations, Churches, Mosques and other hide outs and wishes they could get home as soon as possible. The Malawi government hired buses from South Africa to evacuate its nationals. The first fleet of two buses arrived on the evening of Sunday, the 25th of May with 118 passengers. A total of 605 Malawians have been repatriated by Saturday, May31st. Six Buses have left Durban in the early morning hours of Sunday, June1st and are expected to arrive home to Malawi by Tuesday night.

Those arriving home are being screened at the dilapidated Kwacha in the heart of Blantyre. Those screening these people include Immigration officers, the Police, Social welfare officials and Medical personnel.

Xenophobic attacks started on May 11 in Alexandria Township in Jo’burg and have spread to other towns and cities, claiming over 62 lives. We are not sure as to how many Malawians have been killed. Talking to those repatriated, you get a different picture from that has been in the Press. But they have very sad stories from down there. Stories about both the common South African and the Police/Medical Personnel. Should we treat each other like this?

Francis Phiri

Lauren Harris has just finished her student placement at Selkirk Medical Practice in the Scottish Borders. The Practice is twinned with Chileka Clinic in Blantyre, Malawi, and Lauren has kindly shared her experiences of placement with the project.

“When I first arrived on placement a few short weeks ago, with less than a year of university knowledge behind me and minimal clinical experience, I really had no idea what to expect. The first few days passed in a blur as I was introduced to the general workings of the health centre and the various members of the multi-disciplinary team. Everyone was so welcoming and it didn’t take long for me to feel like I was part of this team.

My days were spent within the physiotherapy department where I was able to observe and treat a diverse range of people and problems. It was great to be able to put the principles learnt within university into practice and see the beneficial effects that physiotherapy can have on the patient’s quality of life. It was interesting to treat patients who present with multiple problems and to realise that in practice, nothing is definite and various approaches can be employed. I learnt that as a medical professional you should never make assumptions based on your own perceptions but rather ascertain the patient’s personal problems and base treatment around this.

I was also given a privileged insight into the workings of the multi-disciplinary team as I observed the reception staff, treatment room nurse, occupational therapists and district nurses. This allowed me to see the importance of being able to liaise between the different professions, observe the areas where these professions overlap and appreciate the significance of all medical professionals in a patient’s recovery process.

I have thoroughly enjoyed my first placement at Selkirk Health Centre and feel I have gained so much from working with the various professionals here. I have learnt valuable skills which will serve me well as I continue my education and embark on further placements.”

Lauren Harris is a 1st Year BSc (Hons) student in Physiotherapy

If you have questions about studying physiotherapy you can ask Lauren questions by posting a comment beneath this post.

The Malawi Communications Manager for the Project, Sylvester Chawala, is in Scotland for two weeks to learn about healthcare in Scotland and to meet some of the twinned general practices. Highlights of the visit so far have included shadowing a practice nurse in Edinburgh, meeting Dundee medical students and a trip to the David Livingstone Centre in Blantyre.

Some of the Scottish general practices, such as Whitefriars Red Practice in Perth and Stockbridge Blue Practice in Edinburgh, have donated items of high quality medical equipment that is no longer needed in Scotland. We are very grateful for this and will make sure that the donations are put to effective use in Malawi.

Sylvester and Jemma at Edinburgh Castle

Research from the London School of Hygiene & Tropical Medicine in the UK and the Karonga Prevention Study in Malawi suggests that deaths from AIDS in rural parts of Malawi were averted by the rapid scale-up of free antiretroviral therapy. There was no change in the mortality rates of adults older than 6o years.

The Lancet has the published findings.

Researchers writing this month in the US journal Science have questioned the evidence base for current interventions aimed at reducing rates of HIV/AIDs. They argue that “Substantial investment in condom promotion, HIV testing and vaccine research has had limited success in Africa. Instead male circumcision and reducing multiple sexual partners should become the cornerstone of prevention.”

Others argue that too much is being spent on HIV prevention compared with diseases which kill more people and donors should consider shifting funding priorities.

Read more here.