COLLEGE OF MEDICINE - The first decade

DepartmentalSnap-shots

also our staff in particular.When we realisedthat mosf of the rural hospitals have no cold rooms to keep their dead, the

From the Anatomy Department

Depafiment conceived a course for Mortuary Attendants to

ProlessorBC Msamati

a n s w e rt o t h e n e e do l M a l a w i a n sl i v i n g i n t h e r u r a la r e a s .

'L'he Departmentcame into being on lst November 1993 when

in November 1999 with 6 Mortuary Attendants.To the best of

the founding. head of the Department, Prof Msamati, took

our knowledge,this is the first courseof its kind in Sub-Saharan

The first embalmingcoursewas successfullylaunched

appointment. However, it was not until Monday 19th Africa. Becauseof lhe success ol-rhatprogramme.morecourses ':leptember 1994that rhe doorsof the Departmentwere opened will be organisedevery year. ro the first cohort of locally trained undergraduatemedical students.

Developmentsunderway

Of this first group of 2l medical students, 18 g r a d u a t e idn J u l y 1 9 9 9 . Teachingis centredon training undergraduate medical

In order to addresslhe staflingconstraints.the Departmentis launching an IntercalatedBSc (Hons.) Degree from January 2002.

studentsat the moment but we are on the verge of,recruiting

The idea is to build an academicbase of upcoming

B S c l n t e r c a l a l esdl u d e n t sM . a s t e r ss t u d e n t a snd.those for PhD

young men a4d women, who will not necessarilybe Medical

programmescoupled with our contributionsto the Masters of Medicine (MMed.) Deglee programmes in Clinical

capableof holding academicand clinical positionsin all areas

Departmentswhen thesecome into being.

of medicine.

Scientists,but rather to preparea large pool of young doctors

However, experiencehas shown that such candidates tend to gravitateto Basic Medical Sciencedepartmentsas well. C u r r e n t l yw . e a r e p r e p a r i n gt h e s y l l a b u sf o r u n M S c . D e g r e e Course,which again we hope to launch next year. In order to realise these developments the. department is intending to recruit nrore stafT to support both the staff development programme (IntercalatedBSc and MSc Courses) and to consolidate ihe researchbase in the fields of Forensic and P h y s i c aAl n r l r r o p o l o g y .

ProfcssorFapalusi Anutrtn,- Dep0rtnrcnI

The Departmentof Biochemistrycameinto existencein 1994, Research

h a v i n g b e e n e s t a b l i s h e da l o n g w i t h t h e A n a t o m y a n d

T h e m a i n t h r u s t o l r e s e a l c hh a s b e e n t o o b r a i n b a s e l i n e PhysiologyDepartmentsto teachBiochemistryin an integrated a n t h r o p o m e t rd i cu t a l b l M a l a w i a n sa s t h i s i s l a c k i n g . T o t h i s Basic Medical Scienceprogramme.The Departmentis also end l8 papersl.ravenow been published in refereedjournals

responsiblefor teachingclinical biochemistryto the third year

while 7 are under review. Collaborativeresearchwith clinical

studentsin the Division of Pathology: Biochemistryis an ever growing subjectuihich covers

departmentsis aiso taking place while other areasof researchin sleeping sickness,gut endocrine system, albumin levels and nutritionai studieswait funding. Clinical practicehasbeenlimited becauseof the heavy teachingworkload as we are very few, but with the openingof the College of Medicine Clinic. more input will be expected f r o m t h eD e p a r t m e n l . Embalming services Embalming service to the generalpublic startedin July 1998. The driving fbrce behind this venturewas financial constraints. The College of Medicine budget was increasingly getting smallerand smalleras yearswent by. Admittedly the constraints in the budget affected not only the University as a whole but

II

not only the needs of all the medical disciplines such as medicine, dentistry, pharmacology,pharmacy, physiotherapy etc. but all other biological disciplines.It is in this contextthat the programmes and future expansion of the Department of Biochemistryshoulclbe viewed. . The quality and aspirationof an academiqdepartment as a centre of excellence must focus on the postgraduate programmewhich ideally must contributeto the quality of the graduatingproducts and researchcapability of the department. The Departmenthas designeda curriculum for higher degrees such as MSc and PhD. It is also envisagedthat the Department will be able to produce first degree(BSc) holders who can be useful in a rahge of medical and non-medicaldisciplines. Clinical chemistrythat is at presentbeing taughtby the Malarri Medical Journal

COLLEGE OF MEDICINE - The first decade Department,would normally be taught by clinical scientists. From the Departmentof Haematology The future growth of the Department of Biochemistry is expected to have a sub-departmen!of clinical biochemistry ProfessorJM Mukiibi (chemical pathology) which is hospital based. Forerisic medicineshouldalso taughtin the future. It could be in form of The Departmentof Haematologybecameoperationalin April a short course for law officers who are to be trained in aspects 199I when the College of Medicine was, for the first time, of crime investigation. establishedon the ground in Malawi. At its inception,the The BSc programme is to be linked with income generation from industries and other entrepreneurs.The

departmr,nt'sestablishmentwas one professorand one secretary operating fiom a tiny room in the Department of Medicine

researchcapabilitiesand dividends should normally start from

teachingannex.To dateits establishmentis: two professors,one the BSc programme up to PhD level. Having BSc honours senior lecturer,one lecturer,two staff associates, one secretary, studentsbrings somedynamicsto the discipline.Thus, BSc and one chief technicianand two senior technicianshousedin the other programmes(MSc and PhD) will enablethe disciplineof new haematology block at Mahatma Ghandi road campus. Biochemistry to be relevant to modern scientific trends. The Stafing at academic level has been difficult and plactically programmes will contribute to the economic and industrial only one haematologistat prof'essoriallevel has hitherto srowth of Malawi.

s e r v i c e dt h e d e p l r t m e n l . rt

&" From the Department of Community Health

'-, #" * +,, ,

.,

,**tt,#

Dr C Bandawe H a c n r a t o l o g yi s t a r - r g h ti r r a v e r l i c a l l y a n c l I r o r i z o n t a l l y

I

Since its openingin 1991,the Collegeof Medicinehas had a community orientation,and this orientationfinds expre,ssion in

integratedlashionto ycars I to 5 of the MBBS progranlne[o givc stuclerrts an unclerstarrding ol' the ."ui.-r. prescntation ancl

every aspectof the undergraduateteaching.Community Health nlanagement of blood disordels.Thc bulk o{'tcachingis done teaching spans the whole five years of the College's in year 3 al the end of wlrich a barricr"I'inal prol-essional undergraduatemedical education and takes up 25o/oof pathology(hirematokrgyinclusive)examinaticlnwith exterrral curriculum time. Orientation is designeclto achieve vertical examincrshipis lrelcl.Fol the nrontent.thereis no lraema{olog1, integration within the subject and the horizontal integlation postgraduatetraining firr slal'l'dcvclopmentbut twcl lccill with other basicmedical and clinical disciplines.

eligible cancliclates have beenscleclecllbr trainingabroaclarrtl

It is important that the teachingof every aspeclof Community Health is in relationshipto direct on-going experiencesof the

a c a d e m i c a c h i e v e r n e n t sa n c l c o m r n u n i t v a c l i v i l i c s I r a v c

will form thc nuclcusof lirture haenratologists.Othel rna.i,rr'

needsof the people.Communityhealthteachirigtakesplace in

inclucled:Blantyre and the surroundingareas,as well as in Mangochi. 'r' Reselr,h into hacnratological and oncologicaldiscase corlrnorrlyseenin Malawi and the southernAflican legion wherethe Collegehasa satelliteunit with full tenchingfacilities resultirrgin severallocal,regionaland international conl'crcnce plesentations and pLrblication ol' ten papers rnostlyin leputablcjoulnal.

and hostel accommodationfor stafTand students.There is also a teachingsite at Lungwena Health Centre,23 kilometreseast of Mangochi. Our ethos is to irnpat't an appreciation of

'r'

community issuesin our medical students. Subsequentlyour first years spendtwo weeks in a village "Learning by living". We have a dynamic teaching staff specializing in various * disciplines such as Psychology, Nutrition, Demography, OccupationalHealth,Public Health,Biostatistics,Bioethicsand Health Economics. Our vision of the departmentis that within the next 5 years,the

Providing labolatory and clinical serviceat QueenElizabeth TeachingHospitalwith the establishment of haematological arid oncologicalin-patientand out-patientservicesfor patientswith blood diseases. External examinershipat undelgraduateand postgraduate levels in haematologyat the Universitiesof Makerele, Nairobi, Dar-es-Salaanr and Zirnbabwe. Completion of the new ultra-modernhaematologyblock at the Mahatma Ghandi road campusin preparationfor setting up high-technologyhaematologyand oncologyteachingand researchlaboratories.

Community Health department will be a self-sustaining division, training leaders for Malawi and the Sub-Saharan region at both undergraduateand postgraduatelevels. The The field of haematologyis still virgin. There is a vast number division will prompte and maintain servicesto the community of blood disordersthat need intensiveresearchto provide the in the spirit of uMunthu (African philosophy of community). The division will also encourage a vibrant international collaborative environment.

Malawi Medical Joumal

necessary answers.For the haematology department, the foundation has been laid and the essentialinfrastructurefully established.As for the future of the depafiment,the sky will not ' b e t h e l i m i t b u t t h eb e g i n n i n g .

COLLEGE OF MEDICINE - The firsr decade

From the Collegeof MedicineLibrary

I.ibrary materials

Mr Ralph Masanjika

As soon as I returned from the attachment in the UK, I embarked on the acquisition of books and audio visual materials with K1,500,000 which the Medical School Project

I was appointedCollege Librarian for the new College ol Medicine in May 1990. In July 1990, I left for the United Kingdom where I was attachedto the Medical School Library of the University College London until October.Whilst there I visited severalmedical Schoollibraries in the London area as well as the Medical Audio Visual materials specialistsand

had set asidefor that. Whilst in the UK, I contactedsomeof the key medical booksellersand suppliersof medical audio-visual materialswho provided me with a variety of catalogues.Orders were prepared and sent to the suppliers mainly in the UK anel soon books started coming in. Within the first three years of the Libraryis existence,the stock grew to 6,838 volumes of books.

medical book suppliers. At the Book AID International, I selectedbooks and periodicalsfor the new College Library. In 1991, I visited African Medical Libraries at Makerere

What was more pleasing was that extemal examiners and visiting professorswere satisfiedwith the Collection as being

University, University of Zimbabwe, Medical University of SouthernAfrica (MEDUNSA) University of Witwatersrandand

In the secondyear of the existenceof the College, the Libray subscribedto joumals, which were mostly of interestto

University of Cape Town. In Europe,I went to the University of Limburg Medical School,which has a community-oriented

clinical studies,sincethe basicmedicalscienceshad not yet started. It was only in 1995that periodicalssubscriptionsrelevantto basic medicalstudieswere ordered. At our peak the Library subscribed

cumiculum. These visits helped me plan a medical Library suitablefor the new College.

very supportiveof what was taught in the College.

to 140 titles of periodicals,which in recent years have dropped tremendouslydue to inadequatefinancing.

Accommodation .and Staffi ng The first problem to be tackled was ihat of accommodationfbr the new Library since the new College had no such facility. Arrangementswere made with the polytechnicLibrary to lend

Information and Communicaton Technology (ICT) Realisingthe inrportanceof ICT in medical education,the Library

took a decision to irrfioduce Information and Communication us the ground floor on the easternside o1'the building. The Technologyinto its servicesright from the onset. An IBM PC 386 initial plan was for this to provide us witlr spacefor threeyears, computer with two CD drives was procured. Subscriptionwas after which our own building would have been constructed. entered fbr Medline and Popline databasesto enable staff and After arrangingthe spaces;the Libraly haclsitting capacity of studentsto searchthrough thesemost populardatabases sincethen 60 readersand shelving space for 15000 volurnes display theLibrary hasacquiredmore electronicdatabaseswhich amountto shelvesfor 450 periodicals,. room for up to l-5 computer.s. over50 at prcsent. photocopiesand a loans counter. Thesespacesare now almost

Recentlythe Library has acquireda digital projectorfbr full. Shouldthe Library remainat the Polytechnicfbr another computers,which is used mainly during College workshopsand two or threeyears,the problemof spacewill becclmeserious. seminars. The new Library had initially been allocated one p o s i t i o n o f C o l l e g e L i b r a l i a n .o n e S e n i o r / C h i e L l ' i h r a l . y E l e c t r o n i cM a i l Assistantand one Liblary Assistant. By the end of 1991,the number was increasedto allow for the appointmentof an A/V

In 1993, the University of Malawi electronicmail known as "UNIIf,tl" systemwas introduced The Library was one of the

technicianand a secretarv.

first institutionsto be connectedto it. Later. HealthnetMalawi was establishedin April 1995 with its node in the College of Medicine Library. Its servicesquickly spreadto district and rural hospitalsin the country,but due to technicalproblemsthe servicebroke down in 1999. By that time, full Internet public serviceknown as Malawinet had alreadycome to Malawi . The Library appliedfor a connection,which has since revolutionalised the information searching habits in the Library. To date, the L i b r a r yh a s I 0 l n t e m e ts t a l i o n sa l l u s i n gP e n t i u mc o m p u t e r s . The service has recently received a boost when Malawinet increasedits band width resultingin increasedspeedand better service.

rc w*

Audio visual materials The Library has a very rich collection of audio-visual materials relevantto the work of the College.

Currentlibrary

Theseinclude videocassettes, soundcassettes. films. colour Malawi Medical Joumal

C O L I - E C EO F M U D I C I N E- ' l ' h c l i t s t c l c c a d c slides, picturcs,microllche, niclofilms und severalotlrersequipment,sttch as video togetherwith thcil accolDpanying

From the Departmentof Medicine

equipment,vicwirg boxesand slide projectors.Realisingthat ProfessolEE Zijlstra the stock of the Library is small and that some of the rraterials are not allowed ou1on loan, the Library has acquircd adequate The Deparlmentof Medicinc wrs establishetlirr l99l by photocopling hcilities to erriihlL'u\ers lo mirke phulocollies ProfcssotTony Harries.lt lrasgrown sinccthcnlo a culrclrl lilll ' 'whenevel t i m e s l i r l lu l 2 A . s t r , . i r r lP. t r r l c . : r , r ' Ir . l e , t t t t c ti t t l t l. t : r ' ' ' i s l r t i l l necessaly. I Health information services are urtdcr developed in lecturett;aswell as 3 pilt'l-tilllcme|nbclsol siall':I ptofessor'. Malawi and the Collegeis thc only nredictlschoolin the land. seniorciinicalspecialistand I lectulcf. The Collegeof MedicineLibrarythertfbreundcrtooka number of measuresaimed at shaling its metgrc resourceswith less provided for neighboursin the health sector in Malawi. It providesflee rcferenceselvices.free litelatureseatclresitr its severalelectronicdatabases. 11provides currcnt lwiltcness scl'viceto disllict and lural hospitalsby sendingthcnt cotrtents pages of iournals of their choicc I'ront the Librtry's list ol' peliodicalsreceived. The extcnt to which lhesescryicesale o l l e l e cdl e p c n d r: , t tt l t er r a i l l h i l i t y r , l i r d e r l r r r rl ittcl r t t t e ci st l t l t c College. In addition.tlreLiblary hasin thc plst solicitedbooks fiom donorssuch as Bottk Aid IntcrnationalanclTHEf in thc UK which it hasdistributedtl) dislricl an(lrtnitl lrospitlls. Problems thc Libtary hltsnlct scvcrlllptoblcnls. In spiteol thc successes. It hrs no buildingol its owtr. Whclc it is ltrcalctl.lhe spaccis

P.ii(nl\

dni t(ldlitct

r t t t l . t i t l cl l t t t n . t t \ t . l t t t l i t l t l r t t t t l

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makingit inpossiblc li)r illtlovati(nlsin scrvices1o inadeclurte, 'l c r c hi n g be intloduccdl Thc PolyLcchnicis ltlso cxprtndittgantl woultl 'l'hc 'l' I ln(lclgll(luitlc lcacltittg: othcr the t,ibrllr'yis occupying. like to take b&ckthc'.\pitce problcrnis urclerIinitncingwhich has led to lcrvcl hooksthiln e x p c c t e c bl c i n g b o u g h l a n t l l i t i l t r l c t o r c n c r v p c t i r t d i c a l s y c u l s I i t t r r lI I : 'lhctc is l nccdlo hilvclwo nl(nc in cilllin yctls. subscriptions p r o l ' c s s i o n r l l yq u a l i l i e d s t a l l r c l t l c d t o t h c l - i b r r r y 'Devclollnrents in lC'l' rpPlicationsrctlttitcstall rvclllrllinc(lilnd t0 bc ablc to;-rro!iclc colnpctentin thc ncw lcchrtologics scr:viccs thc lirtureusclswill tlcntitttrl.

of MedicineLibr ry will hrvc to cxlllllldits scrvices10incrcasc accessto Intcflrctclcctlonicdiltabilses.Thcsclacililiesrlrustbc suppo{ed adctlurtelywilh boqks.peliodicalsand audiovisual matefials. Thc selvicesk) be ollitctl will tccluireadcquate the ol harncssing tfaincdstafl'capLthle numberof appfopr.iatdly rnd t tnodernbuiltlingequippctltdequately new teclrnologies prrirphernallil. rvith all the necessaty

bloc ks

ycar'lll:

h i s l r ) r ) 't i l k i r r g . l ) l l ) ' s i c i r l c r i l n r i r r r t l i t ) r l

ycill lV:

liltnral lcitclting itt ttlt'clicalsllb sltciillisl irfcrls s c t t i o lc l c t l i s h i l l :i l l l . l ' f l l l i ( n(lr l y c i l l l l l l l l l ( ll \

v c r r IV : 'r' [ ' o s l S l i t t l t r l l ltcc i r c h i n g :i s l T c i n gt l t ' r t ' l o P t ' rilr r t l t r ' l i r n t i t l t l l a M a s l c r o l M c ( l i c i l r cl ) i l f l | ( i n N ' l i l l r l \ \ l ) i l r r r l pr

The Future nrcclicrlIiblaricswill be thosc{hr{ will invcstil lol Successl'ul tcchnologics.1'hc Collcge in igfbrmationanclconrnrunicaliotl

l c ( t t r r c so l l c l i t t i c i t l r l l i c s i t l l l t c b a s i t : c i t t t ' . r

'r'

l l ( n { ) w :i t l t t o a d :i n t h c l t l l t l r c :i t t l \ 4 i t l i t w i )

D i p l o n r r i n l i r r P i c t l M e t l i c i t r cc o u t s c :r r l ) f i \ ' l & l l (Mrlrwi) cotr$c will hc dcvcl(ltd lo rlllrtct caudidltcs lrrnt Malawi

n(l othcf coLllrtricsin lllc

legion. Thc course will be built ott rn iclcrtl

ol locallyrtvrilablccxltltisc (supPlcrDorlrJl cornbination as wcll rs clitticaltrlalctiill with lecturcfs[totDabtoacl) lcachingscssionsl(n' Thc Depaflurentot-{anizes ctinicalollicel trainees.who do thcir intclnshipin thc Dcp!utmcnt.

Research Conclusion The overall departmcntallgsearchstratcgy can be desctibcd as has done Library As a young Library!the Collegeof Medicine inadequacies and lackof its own building. lbllows: well despitefinan_cial This has been confirmed by iltternationalvisitors.such as "Clinicql rese(rrchon topics of major local relevtrte" visiting professors and external examiners. However, the Library needs more resources to be able to meet future demands.

N

Malawi Mcdical Jflmal

Planned/ongoingresearchincltrdei + prophylaxisof opportunisticinfeitionsin HIV infected patientswith smear-positivetuberculosis

COLLEGE OF MEDICINE - The first decade * *

*

prevalenceof Cryptosporidiumparvum andIsospora belli infectionamongmedicalin-patientsar eECH

had reasonablerepresentationover the years. Ophthalmology, plastic, paediatric and minor surgery have all had single

study on the contributionof Schistosomcinfectior,in consultants.The absence of an ENT specialist is still a non-traumaticspinalcord disordersas seenin medical significantgap in the program. inpatientsat QECH Despite such difficulties, undergraduate teachinghas randomisedtrial of (a) dexamethasone againstplacebo flourished.The curriculum has developedover the years in a (doubleblind) (b) intravenous versusintramuscular way appropriateto the needsof the graduatein the context of cefiriaxone(openlabel)in bacterialmeningitisin an futuredistrict hospitalappointment.Researchhasa clinical bias areaof high HIV prevalence with a particularemphasison auditand on the studyof common

*

modulationof humanalveolarmacrophage function during Mycobacteriunt tuberculosisand HIV co-

sepsisand HIV related ploblems which are major problems facedin daily patientcare.

infections *

investigationof the humoralimmuneresponseto pneumococcal polysaccharides and the role of a

Postgraduatetraining has combined clinical training within the departmentand formal continuation of training abroad; The department is recognised for the clinical preparationfbr the MRCS (Ed) exam and one of our lecturers, Dr Kumiponjera, has successfullynegotiatedthis hurdle. A

conJugatepneumoccalvaccinein secondary preventionof invasivepneumococcal diseasein HIVinfectedMalawianadults * *

study of SaLmonel/a disease pulmonarydefenceand susceptibilityto infectionwith Strelttococcus pneutnoniaein HlV-infectedMalawian adults

Clinical duties The Departmentis responsiblefbr the clinical servicein eECH

secondcandidateis currentlysitting the exam and two other registrarsare preparing fbr the first part later this year. In addition, there are two post-graduates undergoingtraining in South Africa. The first fully-trained orthopaedicsurgeon,Dr Mkandawire,returnedfiom UK over a yearagoand is a lecturer in the department. ' The advent of the College of Surgeonsof East and CentralAfiica (COSECA)is eagerlyawaitedand will hopefully

for internalmedicineby runningthe in-patientwards(200 beds) set the standardsfor surgical training'in the region. The and a numberof outpatientclinics.Daily admissionsare-30-40 Departmentis developingan M Med programmethat will be with a total of over 9000 admissionsyearly.patternsof disease closelylinkedto this regionalinitiative. mainly includeHIV relatedillness(702oof in-patientsare HIV positive);tuberculosis,respiratorytract infections,bacteraemia and malariaare the most common diagnoses.Other conditions include diabetesmellitus,heartdisease,asthmaand poisoning. Prof'essor OO Komolafe Dr E Borgsrein

Microbial diseases remain,despitetheinpus of antibiotics,vaccinations

andpublichealtfr,themajorcausesof humanmorbidityandmortalityon The tenth anniversaryof the College of Medicine comes not a globalscale.In sub-Saharan Afiica includingMalawi, overlWo of all long after the departureof the foundationprofessorof Surgery, ttre inf'ections are of microbialongin and this immalately catapults Adelola Adeloye.At his farewell symposiumearlierthis year, diagnosticmicro.biologicalservicesto the cenfe stageof any planned the history of the departmentwas held up to the light. At its healttrcaredeliverysystenl inception,the Collegefound a strongclinical departmentat The Deparrnentof Microbiology,establishedin September Q E C H w i t h a n u m b e r o f M i n i s r r y o f H e a l t h c o n s u l t a n t s 1994,becamefunctionalwitlr thejoining of Dr V R Subrramanyam from responsible for a high level of clinicalcare.The pendulumhas the kdian Instituteof MedicalResearch. However,lack of independent swungwith the passage of time and now all cliniciansarefull_ laboratory facilities and being a lone member becanre the major time membersof the academicdepartment. constr-aints in ttredevelopmentof ttredepartrnentFortunately,with ttre There was always the feeling in the past that the help of fundsfrom the departrnents of Paedian:ics andMedicineand a demandsof servicecommitmentout-weighedthat of teaching grant fiom the Beit Trust, a laboratorywas built and set up in tlre activities.Onty in recentyearshasthischangedwith the arrival departmentwhich even till now remains the only functional of middle gradestaff. To be able to teachsurgeryin any other microbiologylabontory,asthe new laboratorybuilding complexis yet than a dry theoreticalsenserequiresan active and functional to be completed.The number of clinical specimensrefenedto it has departinentwith a cbntinuousthroughputof a wide variety of continuedto increase,not only from QECH which it primarily serves, patients.This particularly applies to the learning of practical but fiom otherhospitals, clinics and individualswithin and outsidethe proceduresthat must be part of the armamentariumof'every City of Blantyre. Our laboratory is paltlcularly renowned for its graduate.Of all the surgicalspecialties,only orthopaedicshas activitiesin theareaof mycobacteriology especiallytuberculosis. l5 Malawi Medical Joumal

COLLECE OF MEDICINE - The first decade Although our missionin the departmentis "servingto improve the overall health care of the community," we

gonococcusisolatesat the QECH, Blantyre. Immunologicaland viral load changesin a co-

specifically aspireto be a eentr'eof excellencein the areasof research.The HIV/AIDS/STD, tuberculosisand onchocerciasis first of Buruli of the cases in our laboratory confirmation recent

int'ection of HIV with Malaria. Presently,with a stafTstrengthof six and an arrayof equipment yet to be installed, the issue of space still remains the

ulcer (Myeobacterium ulcerans inf'ection)in Malawi is an departmentismajor problem.The departmentis involved in a attestationof our resolveto changethe public healthlandscape number of collaborativeresearchprojects within and outside the College and there have been ofl'ersof collaborationfrom of the country fbr the better. Furthermore,the departmentwhile initiating its own severalinternationalresearchinstitutionswhich are preparedto researchactivities continuesto provide technicalsupport for provide every other requirementbut laboratory space. This researchesbasedin other departmentsand also collaborating issueof spaceis our major constraintand a seriousimpediment with othersinitiatedtiom outsidethecollege.Somecompleted to our capacity building. The departmentthereforewishesto appeal to the governmentthrough the College Management to include: and on-goingresearches Completed Research * Effbct of essentialoils on the viability and morphology coli ( SP-I I ). of Escherichia * oils fiom Antibacterialactivityof essential *

cymbopogon;inter- and intra- specificdifl'erences. Parentalfilariasisas a risk tactor.fbrfilariasisin

providefunds to completethe Microbiology laboratory building to enable the departmentattain itsfull potential.

From the Department of Paediatrics ProfessorEM Molyneux

children. * *

The paediatricdepartmentwas founded in 1991.The current stafT include a professot a senior lecturer and 2 assistant Thereare also 2 honoraryseniorlecturers,2 part time C h l o r a n r p h e n i c o l - r e s i s t a n t b a c t e r i a l m e n i n g i t i s i lecturers. n Nunrberof sputumsmearsfbr diagnosisof smearl positivepulnronary.tuberculosis.

Cryptococcalmeningitisin Atiican children.

seniorlecturersand a part time assistantlecturer.The founding Head of Department,Prof'essorBroadhead,has recently been

Bacteriologyand demographiccharacteristics of

appointedas CollegePrincipal.

Malawi.

chronic wounds/ulcersat the QECH. Sexuallytransmitteddiseasesat the QECH.

Teaching

Children as outpatientsat the STD Clinic, QECH,

Undergraduate:First and second year medical studentsare introducedto the blinical aspectof some of the basic science subjectsin their curriculum.Third and fifth year studentsdo 7

Blantyre. Bacteriologyof burnsat the QECH (with the Dept. of Surgery) Epidemiologyand mortality of burnsat the QECH (with the Dept. of Surgery). Mycobacteriumulceransinf-ectionin Malawi. Bacteriologyand clinical courseof crocodilebite wound infectionsat the lower Shire,Malawi. The prevalenceof tuberculosisamonginmatesat ChichiriPrisons,Blantyre. * *

i

Evaluationof the antimicrobialpropertiesof garlic.. Mycobacteraemia and bacteraemiain febrile adult medicalpatientsat the QECH, Blantyre(with the

week clinical attachmentsin the department. Postgraduate:Postgraduatecourses leadipg to a Postgraduate Diploma are being developed. Meanwhile seminars and teachingsessionsare aimedat encouragingand helping middle grade staff to acquire postgraduatediplomas from overseas. have obtainedthe MRCPCH and 3 more Sevenpostgraduates are in the processof acquiringit. Clinical Oflicers:Clinical officersdo 3 monthsinternshipin the department.Paediatric staff members also examine clinical officers in their final examinationsboth in Lilongwe and

department of Medicine).

Malamulo. F.lective students: Students from many other countries do

Knowledge,attitudesand pr.actices on tuberculosisin

electivesin the department.

Blantyre schools. AlDS-relatedknowledge,attitudeand practices amongresidentsin rural Malawi. : Research in progress x Influenceof HIV on burnsoutcome.(with ihe departmentsof Surgery& Medicine). Drug susceptibility/resistance patternsof Neisseria

Research The departmenthas been active in research.The researchis clinically driven and relevantto local problemsand perceived needs. On goingresearchincludes: The long term prognosisof twins both with and withoutHIV infection Measlesimmunisationand measlesantibodytitres in

Malawi

Medical

lorrm^l

T COLL. .-i OF MEDICINE - The first decade

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childrenwho areHIV positive Rotavirusas a causeof acutedianhoeaantl the role of

programmein Physiologyat the Collegebut inadequatestaffing situationand laboratorybasisare limiting factorsin developing

and implementingthis programmeand therefore sending of an