Posted by Rachel Perrin, Becky Pierce-Jones, Mary Miller on 05 July 2013
We're visiting Malawi to explore our Action Meningitis
project which aims to prevent death and disability from meningitis and septicaemia in Malawi.
Our team visiting the country consists of Rachel Perrin (International Development Officer), Becky Pierce-Jones (PR Manager) and Mary Miller (Scotland Manager). They'll be reporting regularly as the trip progresses.Sunday 30 June
After a journey of 24 hours via Addis Ababa - Becky, Mary and Rachel arrived at Chileka Airport and were met by Thomasena O’Byrne.
As we drove from the airport to our accommodation we saw examples of townships on the roadside and locals going about their business on Sunday lunchtime.
After a couple of hours rest in the sun we met for dinner to go through itinerary for the week and what we all hoped to achieve from the visit .
It became clear we have different objectives for the trip. Rachel is keen to find out more about the data from our pilot project and the how the bridging phase will work in the rural clinics, Mary needs to learn more about the whole project and, in particular, the difference the money from the Scottish Government Malawi Development Programme will make, and me, the PR lady – I need to find the human side of the project and how the work we are funding is enabling sick children to be treated more quickly, which in turn will enable better outcomes. Monday 1 July
Today we visited QECH (Queen Elizabeth Central Hospital) and were given a guided tour by Dr Queen Dube, a consultant Paediatrician) at QECH who was trained in Bristol and the South West of England.
Queen took us to A&E and explained that all patients are referred to the hospital from clinics in the surrounding districts and QECH is the only referral hospital in Malawi so patients come from miles to be treated.
As we walked up to the hospital the first thing we saw were groups of family members (guardians) in the surrounding gardens of the hospital, frantically busy washing clothes and cooking, to provide food, clean clothes and care for their sick children.
We saw the Paediatric A&E admissions department as well as high dependency unit, the malnutrition unit, orthopaedic unit, the nursery ward for babies under six months with mothers waiting to be seen by the doctors as they fed their babies.
There were a few tears after seeing a boy of 14 in the malnutrition ward who had hydrocephalus and a spasm as a result of meningitis. In our first day in Malawi it really hit home how important Action Meningitis is and how we can really help to make a difference.Tuesday 2 July
Today we visited two of the five primary health clinics where our Emergency Triage Assessment and Treatment (ETAT) intervention project is in operation, Zingwangwa and Mpemba.
At both we saw mothers with their children being triaged by Health Surveillance Assistants (HSA) with the mobile phone app. What struck us was how slick the process was, taking less than a minute per patient.
Earlier this morning two children had been identified as emergencies and quickly referred to Queen’s Hospital for treatment. It was great to know that the mobile phone app is making a difference.
Khazia Katoma has worked as a HSA in Mpemba for seven years.
Whilst in Mpemba, we attended the handover of three ambulance bikes to the Village Health Committees of Scott Village, Chilunduka Village and Mabala Village, in the areas surrounding Mpemba health centre. These bikes will enable people to access the primary health centre far more quickly than on foot.
We were part of a hugely interesting traditional ceremony, where Mary spoke in front of Village Chiefs, and we handed over a bike each to them. The District Health Officer was also present and Sakarementa the bike providers gave bike maintenance training to the Health Committees.
We also enjoyed a play by villages showing the importance of knowing the symptoms of meningitis, getting medical help quickly and how the bikes would enable this.
The whole event was covered by Malawi Broadcasting Corporation, Zodiak Radio and the Daily Times Newspaper. Becky is eagerly waiting for the coverage. Afterwards there was much dancing with Fanta and coconut biscuits!Wednesday 3 July
Today we visited the remaining three clinics – Ndirande (the busiest clinic with a large catchment area), Bangwe and Chilomoni. Many of the health centres are so hard to access – even in a car. The road to Bangwe in particular was bone-shaking and it’s hard to imagine how people manage trekking up and down to the health centre on foot. In rainy season the road is impassable. On the way back to Blantyre we had to call in KwikFit to get a puncture repaired!
At the primary health clinics all services are crammed into one place, bursting at the seams with patients queuing to be seen - sick people, vaccination clinics, TB & malaria testing and treatment, laboratory, pharmacy and a maternity unit. Chilimoni Clinic - waiting to be seen
We again saw the phones in action and chatted to the staff who use them – “It’s a good idea, it is helping us a lot. We are working as a team to manage the patients better and seeing the urgent children quicker than before.” Mrs Doris Sakambewa (Medical Assistant)Using the triage tool at Bangwe clinic
Becky was out and about all day meeting families who have experienced meningitis and was given examples of meningitis being misdiagnosed as malaria in so many cases. It was an honour to meet local people and to be invited into their homes.
Thomasena and Rachel met with Marije from D-tree (our partner who designed the triage app) and had a good discussion about how we can start to implement the triage tool in health clinics in the rural district, Chikhwawa. We’re visiting the Chikhwawa District Hospital Friday.
We finished off an extremely busy day with a dinner with our stakeholders, including four members from the Blantyre district health office.Thursday 4 July
Rachel and Thomasena stayed in Blantyre to work through the pilot data with the MLW team. Meanwhile Becky and Mary headed off on a road trip to Balaka to visit a Radio Listening Club (RLC). They took along with them two medical students from Bristol Uni who we’d met earlier in the week. Sarah Bury ran the London Marathon for MRF in April and Becky had been dealing with her PR. Sarah spotted us in our MRF t-shirts and we got chatting!
The journey took almost three hours but was well worth the visit. The RLC meet and listen to health programmes provided by MLW. MRF fed into this and there have been 4 programmes specifically on meningitis, with more to follow. We were welcomed by the club, village chief and members of the community with singing and dancing and they told us what they’d learnt about meningitis. Mary even got up and danced with them!The Radio Listening ClubDeborah Nyirenda
, researcher from MLW who's working with us on the Action Meningitis project. It turned out that the President of the RLC had personal experience of the disease and encouraged her to stand up and tell the village her story. Another case study for Becky! A very long but worthwhile day. The President of the Radio Listening Club tells of her experience of meningitis
Friday 5 July
Following an hour’s drive to Chikhwawa down in the Lower Shire Valley, we spent the morning at the District Hospital. It is this district where we are rolling out the next phase of the project.
We met with the District Medical Officer, Dinkau Mbichila, explained the Chipitala Robot triage system and tool to him through the app on the phone - he was really interested in what we are doing and keen to get involved.
We also met Florence Neminga, the ETAT co-ordinator, who we will be working closely with to implement the next phase of the project in the rural clinics. She gave us a tour of the hospital and we saw first hand in A&E the need for the project to reduce waiting times for sick children. Florence said “It will make a difference as health centres are so congested and we can reduce the waiting times for emergency patients and get the right treatment more quickly.”MRF team and Florence
We didn’t have time to stop off for anything to eat on the way back to the press briefing so we stopped off on the roadside to grab some sugar cane to keep us going!Sugar cane lunch on the road
We invited the local media to meet with us in the afternoon for a press briefing to explain Action Meningitis, how it came about and our future plans. Nic Desmond, Lead Researcher on the project from MLW spoke about some of the research that led to this being implemented in Malawi. Nic's paper was just published today
Thomasena and Rachel talked about the work that we’ve been doing in the health clinics, and Mary talked about the Scottish Government grant that has enabled us to do this. Medical students from St Andrews joined us for the afternoon to learn more about the project. We then had a Q&A session where the media had the opportunity to ask more. Media present included: MBC TV, Daily Nation Newspaper, Zodiac FM, Malawi Voice, Blantyre Newspapers, Blantyre Daily News Agency and Capital Radio Malawi. We are waiting for the press clippings to follow the one-to-one interviews they did at the end of the briefing.
We’ve had a really intense week and learnt so much about the project and the important and invaluable work that we’re doing in Malawi. We’re looking forward to getting back to the UK to tell everybody about it.
Mary, Becky and Rachel
You can show your support for our work in Malawi on our Action Meningitis page