It was with great excitement that I boarded the plane in Heathrow to start my trip to Malawi last week. Although we’ve had regular phone calls and zooms with our local partners, there is nothing like meeting and spending time together again in real life!
Last year we had the pleasure of working in partnership with The Dental Association of Malawi, Smile North, Smileawi, The Maldent Project, ProDental CPD and The Ministry of Health to produce and run an online training programme for Dental Therapists in the Northern Region of Malawi. The aim of this trip was to see how the Therapists were putting their new skills into practice and to ask our partners “how can we help” with any future oral health training projects.
After a short stop-off in Addis Ababa, we arrived in Lilongwe on Saturday afternoon and were met by our fabulous driver for the week – Andrew. After resting for a few hours, we met one of our partners, and good friends – Dr.Wiston Mukiwa – and his wife – Rose – for dinner. You can’t help but feel enthused and uplifted after a few hours in the company of Dr Mukiwa. He, and his colleagues at The Dental Association of Malawi, have been working tirelessly for many years to reduce dental disease within their communities, and increase access to safe dental care within the rural communities. He visited our Dental Training Programme in Tanzania in 2019, and is a huge advocate for up-skilling remote and rural healthcare workers. With only 50 dentists and 300 Dental Therapists to care for the whole country, he recognises the importance of raising oral health literacy and preventing oral disease through sharing oral health messages, and for increasing access to emergency dental care within the rural population. Through the work of Dr Mukiwa and his colleagues, for the first time, oral health is now part of the Malawian Ministry of Health’s Essential Health package (EHP) and so is now recognised as a top priority.
We had an early start the next morning for the 6 hour drive to Mzuzu in Northern Malawi. Once there, we picked up Dr Martha Chipanda – Malawi’s National Oral Health Coordinator. After a wonderfully warm welcome and fabulous lunch in her home, we set off again for Nkhata Bay – on the shores of Lake Malawi.
For the next 2 days, we had the privilege of taking part in the second Oral Health Promoter Training Programme that followed the Dental Therapy online course last year. Two Dental Therapists from the district -Mr Chavula and Miss Sekwisse – joined Dr Chipanda in training 14 village volunteers in the delivery of oral health promotion messages to their local communities. These were carefully selected volunteers who already carry out work for the Red Cross and Operation Smile.
On the first day, they learnt the basics of tooth identification and anatomy, how to prevent dental caries and gum disease, ways to improve oral health and key messages to share. Part of the day was a discussion around common myths that needed “busting” in their villages. These included:
You shouldn’t go to the hospital if you have a swelling – you won’t be seen. You need to wait for it to go down before seeking help
You can’t extract a tooth from someone if they are pregnant
It is good to use baking soda or sand to brush your teeth
You can cure dental caries by putting an aspirin on your gum, or on the infected tooth
Bad teeth are inherited from your forefathers and there is nothing you can do to make them healthy
There are plenty of herbs available to cure dental disease
People don’t suffer tooth decay unless they’ve been bewitched
If people have teeth germs, their whole body will be infected and they should be avoided
The volunteers were interested, engaged and enthusiastic throughout the day, and demonstrated a real thirst for knowledge.
On the second day, it was the turn of the newly trained Oral Health Promoters (OHPs) to hold mock community education sessions in front of their peers. They were confident, once again enthusiastic, and demonstrated an impressive understanding of the knowledge they gained the day before. Their classmates asked difficult questions, and on the whole they were able to answer them well. Thankfully Dr Chipanda was able to translate their presentations, so we could give constructive feedback and make small suggestions for improvement.
By 4.30, all presentations were done, certificates had been handed out, and the newly trained OHPs were each equipped with a presentation flipchart, teeth models, a demonstration toothbrush, and a t-shirt to wear when they went back to their communities. Mr Chavula and Miss Sekwisse were pleased with how the training had gone and had put a plan together to supervise and monitor the OHPs moving forward.
Feedback from both the trainers and trainees was very positive. Everyone felt that the skills they had learned would make a massive difference to the oral health literacy and behaviours within their communities.
A few comments being:
This education will ensure that my community will have a good and healthy life
What people thought was genetic and inherited from their fore-fathers – they now know is a disease that can be treated
Now I have this knowledge people from my area will be free from oral problems
This knowledge will improve good oral health and will encourage people to go to the hospital for check-ups. It will reduce tooth decay in the community and reduce the incidence of dental disease
The next morning we visited the Red Cross Coordinator for the Region, who had selected volunteers for this week’s training programme, as well as the programme that had been run in the Mzimba North District in March. He was pleased to be working with the partnership on this project – his only difficult task being selecting volunteers to be become OHPs, from the 3000 Red Cross Volunteers he co-ordinates in the region.
Then it was off to observe one of the OHPs trained in March – Mr Msofi – deliver a session to his village. Once again, I was surprised at the engagement and interest shown by those attending the meeting. They asked lots of questions and Mr Msofi could confidently answer them. The Village Elder said that she wished she had heard these life changing and life saving health messages years ago and that the programme was essential to stop oral pain and disease amongst her community and future generations.
She was keen to let us know that she thought we needed to roll out the programme throughout the whole of Malawi!
After the talk, Mr Msofi was keen for us to visit one of his “Tooth Clubs”. Since his training in March, he has set up 10 tooth clubs in 10 local primary schools. The children meet with him and their teacher once a week to discuss all things oral health!! We visited Msongwe Primary School, which has over 1000 pupils. Whilst there, Dr Chipanda tested the children on their knowledge. You can see the results here: https://bit.ly/toothclubs
To be continued..
