1. NHS Fife – Malawi Project

2. Project Background Sheffmed visited ENT unit in Fife
Owner is keen to help in Malawi as was brought up in there
Offered to fund reconnaissance trip by ENT Fife staff

3. Malawi Country of 16.5 million people in southern Africa.
1 ENT surgeon and 1 Head and neck surgeon.
Based in Blantyre, the country’s main business centre

5. Medicine Malawi Medical school in Blantyre
Surgery not popular – public health
Main hospitals in Blantyre and Lilongwe
District Hospitals in country

8. Staff Layers of “Medical” care Nursing Care Consultant
Registrar equivalent (Medical degree)
Clinical Officer (3 year course)
Medical Assistant (less trained)
Nursing Care
Matron in charge
2 trained nurses
3 trained scrub nurses in general surgery

10. Needs
Simple
Bottom up
Shelves – trays – organise theatre – more efficient lists
Not fancy kit (microscope graveyard...)
Maintenance: screwdrivers, bulbs
Don’t miss what they don’t have
We do not want to parachute in to do operations
Surgeon very capable...

13. What we achieved Identified equipment they have
Cleaned rooms and set up as ENT room in Fife
Utilised kit they had
Set up microscope room
Again kit they had
Gained a good overview of what they need

15. Proposal Malawian nurses to visit Scotland and obtain training
reciprocal visits from Scottish nurses: implementation
Malawian Clinical Assistants to spend time in Scotland
broader knowledge and new skills.
Malawian registrar to visit Scotland for training
Perhaps Scottish ENT trainees to visit Malawi.

17. There is huge potential
Enthusiastic, able staff: surgeons and the nurses are very capable.
Unfortunately the juniors do not miss what they have never had.