October 2018 | Deireadh Fómhair 2018

Student Reflection | Research in Malawi

Fri, 12 October 18 14:21

Photo (Left to right): Dr Joe Gallagher, Mr Master Chisale and Dr Chris Watson

 

Master Chisale has just completed his MSc by research on childhood pneumonia in the community in Malawi.  He spoke about what he has learned when undertaking this research in UCD. 

I grew up in a rural area in the southern part of Malawi (Zomba) which is the old capital city of Malawi.  I currently live in Mzuzu in the northern part of Malawi which is around 600km  from my home area.  I am a second born in a family of four children and I attended both primary and high school in the southern part of Malawi.  My country, Malawi, has one of the lowest literacy rates in the world.  Currently only around 60-70% of adults can read and write. Access to education is limited in Malawi particularly beyond primary school.  Even in primary school there can be over 100 children in a class for one teacher.  At the time I was selected to go to high school, I was the only person in the whole zone, which is comprised of around 10 government primary schools, to go to high school. In my whole clan, and the whole area I am from, I am the only one who has made it to University and it is exceptional for the whole region that I have now obtained an MSc.  

I did my BSc in Biomedical Sciences at Mzuzu University from 2008 to 2012 and currently I am working with the Ministry of Health at Mzuzu Central Hospital, which is a tertiary referral hospital for the Northern Region. I am working as a medical laboratory scientist and lead the TB laboratory for the region. This position involves both on-bench technical sample analysis and management of the laboratory and staff. I am also head of research and publication at Mzuzu Central Hospital and I act as a mentor for students in Biomedical Sciences. I also teach at Mzuzu University in the Department of Biomedical Sciences and undertake practical sessions with students there.

I undertook an MSc by research in childhood pneumonia in UCD as I have been working  for a number of years in respiratory disease, mostly focusing on TB. However, whereas TB receives much attention nationally and globally, I feel that childhood pneumonia is a neglected condition even though it is a very common condition in Malawi. Pneumonia remains the leading infectious cause of death among children under five, killing approximately 2,400 children a day worldwide. Most of its victims are less than 2 years old. I was interested to find out what effect new vaccinations provided in Malawi since 2012 (in particular pneumococcal vaccine) had on the cause of pneumonia in children.  Also there are no definitive diagnostic tools to distinguish bacterial and viral infections quickly in childhood pneumonia, leading to high rates of antibiotic prescription. This is a major problem as antimicrobial resistance rises internationally. Finally most of the studies on childhood pneumonia have been undertaken in hospitals but in Malawi most children present and are treated in primary care alone, so we felt it was important to study pneumonia in this setting.  My supervisors, Joe Gallagher and Chris Watson from the gHealth Research Group, obtained funding from the Bill and Melinda Gates Foundation to undertake a study of childhood pneumonia in primary care in Malawi.  This allowed me the opportunity to undertake an MSc as part of this research project.  

I had an opportunity to visit Ireland as part of my MSc and very much enjoyed my time in Ireland and at UCD (even if it was very cold!).  It has been a great experience and I have formed a number of friendships with my colleagues and supervisors in UCD.  We continue to work together and from a clinical aspect we have formed a link in Mzuzu Central Hospital with the Palms GP Surgery where Peter Harrington and Joe Gallagher are working.  This project was supported by ESTHER Ireland and is now an ESTHER approved partnership which means that it is recognised that we work effectively and equitably together.  This partnership is focused on improving the care of non-communicable diseases in Mzuzu.  We are leading Malawi in developing innovative ways of providing care for these conditions in Africa and it is an exciting time for the hospital as we work together to develop initiatives in this area also. 

However, primarily I like laboratory work (the most exciting moment of my MSc was when I got the first results of my swab PCR!) and I hope to focus on developing diagnostic tests for bacterial infection in childhood pneumonia in my PhD.  I am currently seeking funding to undertake a PhD in this area and have formed links with a number of African countries through my work as an Ambassador for the American Society of Microbiology. 

I very much appreciate the opportunity afforded by UCD in undertaking this MSc.  I believe that Malawi, just like many African counties, has a lot of unanswered issues which can be best addressed if local research is prioritized. And I believe partnership with universities such as UCD can help us achieve this quickly and effectively.  By working together we can build capacity in Malawi and achieve sustainable outcomes in science and health.  Zikomo!