It is often said that more Malawian doctors work in Manchester than in Malawi itself
In actual fact, nobody really knows how many Malawian medical employees work abroad. Now a new initiative is reaching out to the Malawian medical diaspora, encouraging them to engage with the health system back home.
According to World Health Organization estimates in 2012 there was only one doctor for every 40,000 people in Malawi, compared to 1 per 400 in the UK (and 7.9 per 40,000 in Kenya, another country in the region). This shortage is undoubtedly very damaging for Malawi’s healthcare, where 64 children in every 1,000 die before the age of five, compared with four per 1,000 in the UK and 49 per 1,000 in Kenya. The country’s only College of Medicine at the University of Malawi in Blantyre was set up 25 years ago to address this severe shortage of doctors, but a 2007 study which followed up the college’s first 250 graduates found that two-fifths of these had left the country to work abroad.
Launch of Mednet Malawi
Launched on 2nd March 2016 at the University of Malawi’s College of Medicine in Blantyre, MedNet Malawi is the first professional networking portal of its kind in the country. Similar networks have been tried elsewhere but MedNet Malawi’s uniqueness lies in having such a network operating in a low- resource setting. Ranked 174 (out of 187) in the 2014 UNDP Human Development Index, Malawi is one the poorest countries in the world.
The aim of the new portal is to bring together experts from within and outside of Malawi to strengthen specialised medical care in the country. It is an online forum for sharing information, ideas, research and job opportunities. Although many Malawians are already enthusiastic users of LinkedIn and other social networks, up until now no platforms existed specifically designed for medical staff.
Strengthening specialised medical care
The idea of MedNet Malawi grew out of the “Strengthening of Specialised Medical Care in Malawi” project, funded by Germany’s Federal Ministry for Economic Cooperation and Development (BMZ) and the European Union.
The network was developed and designed by the ICT team at the University of Malawi’s College of Medicine with technical advice from the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH. The site initially focuses on seven areas of specialised care – anaesthesia, internal medicine, obstetrics and gynaecology, paediatrics, pharmacy, radiology and surgery – the areas of specialised care supported under the EU/BMZ co-funded programme “Strengthening of Specialised Medical Care in Malawi – but could be expanded in due time to other areas of expertise and interest.
What MedNet does
MedNet provides an exchange and knowledge management platform for specialised medical care, connecting College of Medicine alumni, medical specialists within Malawi and the diaspora, international experts, and health development partners. Members can connect with and contact others easily, exchange information, ask questions and initiate discussions. MedNet also provides a platform for blogs, up-to-date information and news stories, as well as online discussions about how to address current challenges or even specific medical cases.
MedNet also informs students and medical experts about career development opportunities in specialised medical care within and outside Malawi and provides a market place for upcoming project and research opportunities and needs.
As final year pharmacy students at the College of Medicine, Twambilire Mhango, Thembisa Sibande and James Ng’ombe volunteered to help get MedNet Malawi up and running, to publicise the portal amongst their peers and to help iron out any teething issues. They are a tech-savvy generation, excited by this new platform, which they say is more relevant and local than LinkedIn and other networking sites.
They also hope it will help them to find good jobs when they finish university. “It’s long overdue”, says James, because people often don’t know about job opportunities within Malawi and outside. All three say they would love to work abroad – but only for a short while to gain experience, and then come back home.
Engaging Malawi’s diaspora
Ultimately, in the absence of any reliable database about Malawi’s medical diaspora, MedNet Malawi helps to map where they live and what they have to offer in terms of skills and expertise. Members can upload profile pages in the same way that they do for LinkedIn or Facebook, and this in turn saves the time and expense of building up and maintaining an expert database.
The Ministry of Foreign Affairs also hopes MedNet Malawi will provide an opportunity for Malawi’s medical diaspora to engage in the health sector back home, and maybe even incentivise people to return. It is planning to publicise the existence of MedNet through Malawi’s embassies abroad.
Gloria Bamusi, the Ministry’s Coordinator for the Diaspora Affairs Unit, says the portal will be a key strategy for engaging medical experts abroad. She admits the country faces many challenges, especially in the health sector. None of the most recent batch of doctors to graduate from the College of Medicine could get jobs within Malawi because there was simply no money to employ them, so many have gone to Botswana, Lesotho and other countries instead. But, says Gloria, people are now keen to move forward and there is a role for the diaspora to become part of the solution. “It’s an issue of patriotism”, she says. “We are expecting the diaspora to play a key role in the future of their country.”
She hopes that MedNet Malawi will be the first step towards developing a cross-cutting platform for all Malawians abroad. However, the diaspora is not necessarily easy to reach out to or to engage with – they usually left for a reason, usually economic and for many, independence from government interference will be crucial for MedNet’s credibility.
Attracting medical staff to work in rural areas
When many of the country’s health facilities do not even have running water or electricity, some might question whether investment in a high-tech online portal should be a priority, but Titha Dzowela, Head of Health Programmes for the Christian Health Association of Malawi (CHAM), believes the two go hand-in-hand. He’s very enthusiastic about MedNet Malawi and its potential for building up expertise and information. “People need to know what is happening in Malawi,” he says. He was one of the first members to sign up, and now checks the site regularly for updates and new information.
CHAM is a not-for-profit network of 180 mostly faith-based health care organisations which partners with the government to provide 40% of all health care in Malawi, especially in remote or rural areas where there is little or no state provision. Many of CHAM health care providers also face acute shortages of human resources, especially in rural areas, but far from being worried that MedNet’s job adverts will be a further drain on these scarce resources, Titha Dzowela believes that the platform could be a useful tool for attracting new staff to work in these areas and informing them of training opportunities available. “There are positive things happening on the ground, and if we can publicise these stories on MedNet it will help”.
He’s already negotiating for MedNet to be expanded to include a link to a special page for CHAM.
Connectivity issues, erratic electricity supplies and a lack of computer hardware are all potentially limiting factors for developing the network within Malawi itself, but the next stage will be to design the system for use on smartphones, which are increasingly in use all over the country. Twambilire Mhango, a final year pharmacy student at the College of Medicine, believes this is the way to go, since most graduates like her will access the site via their mobile phones rather than PCs.
Another challenge will be to ensure that the portal can keep functioning on a local Malawi server. The site has a Malawi registered domain, but upload and download speeds are slow, and if electricity shortages take the site down for any length of time, that could be a problem. External servers would have been much more expensive, says Helge Sato, a Technical Adviser with GIZ’s Malawi German Health Programme, but more crucially, it was important for Malawi to have “ownership” of the portal.
GIZ’s involvement in the project has come to an end this month. It is hoped the portal will eventually attract funding to enable specialised private companies to maintain the site. Meanwhile it will be administered by focal persons identified in each of the specialised medical areas. These are medical doctors who will maintain the site in addition to their regular work, so it will depend on a spirit of volunteerism. This will be both a strength and a potential weakness says Helge Sato, if people find themselves too busy with their “day jobs” to administer the network on a regular basis.
Making a difference
With only a few months to go before she qualifies as a pharmacist, and the College of Medicine celebrating its 25th anniversary, Thembisa Sibande believes MedNet Malawi will really make a difference – not only for her own job search later this year, but also for the country as a whole: “We really want to change health care in Malawi. Our generation has a heart for it, and MedNet will help us achieve this.”
To find out more and join MedNet Malawi visit http://www.mednet.mw
By Ruth Evans