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University of Edinburgh

The university of Edinburgh currently has more academics working and researching with partners in Malawi than any other country in Africa. Across a wide range of disciplines, these partnerships are supported by funders including the Scottish Government, National Institutes of Health , Wellcome Trust, and the Global Challenges Research Fund. Malawi is a core part of the University's Africa Plan and contributes strongly to its 2030 Strategy, which aims to build innovative global partnerships for research, teaching and impact.

Projects

Project 1: Scholarships support for online Masters’ programmes in surgical training in Malawi

Edinburgh Surgery Online

Area of work: Health, Education, Research, Gender equality, Poverty reduction, Economic growth
Location of work:
All districts in Malawi

Project lead:
Prof James O. Garden
Contact details:
o.j.garden@ed.ac.uk

Lead for ESO Outreach Strategy/ Co-Lead: Dr Oluseye A. Ogunbayo
Contact details:
oogunbay@staffmail.ed.ac.uk

Partner organisation: Royal College of Surgeons of Edinburgh (RCSE); The College of Surgeons of East, Central and Southern Africa (COSECSA)
Partner contact:
College of Surgeons of East, Central and Southern Africa (COSECSA)
Contact details:
The College of Surgeons of East, Central and Southern Africa (COSECSA) 157 Olorien,
Njiro Road ECSA-HC PO Box 1009 Arusha, Tanzania

Funding:
Johnson & Johnson, the Scottish Government, the Commonwealth Scholarship Scheme UK, and the National Institute for Health Research
More information:
https://www.edinburghsurgeryonline.com/
https://www.edinburghsurgeryonline.com/scholarships

Description of project

Malawi, a landlocked country in sub-Saharan Africa, with a current population of over 19M people has the lowest physician-to-patient ratio (1:50000) in the world and less than 20 surgeons served the whole country in 2010. Current data however suggest that this alarming ratio remains unchanged. According to the Malawi Ministry of Health, major factors limiting the development of surgical services in Malawi include among others, inadequate production of medical graduates by medical training institutions to meet the country’s healthcare needs. This shortage of critical health staff is further worsened by the ongoing migration of young surgeons, whose personal training needs are not always met locally, to developed countries (the so-called brain drain). The resultant lack of surgeons on the ground and of specialist surgical expertise compromises further the training of the few available medical graduates. This shortage of surgical health care professionals is a trend in many other Sub-Saharan Africa countries. One novel solution by Malawi health Ministry, to address this critical staff shortage, is the piloting of cost-effective higher-qualification training methods, such as e-learning, distance learning, applied and part time learning. In 2007, in response to changes in surgical training which in some countries had reduced clinical exposure in the workplace, the University of Edinburgh in partnership with the Royal College of Surgeons of Edinburgh designed and launched an online, 3-year part-time Masters programme (MSc) in Surgical Sciences, to support trainees in the early years of their surgical training. Although this, and four subsequent advanced online ChM Masters programmes (General Surgery, Trauma & Orthopaedics, Urology and Vascular & Endovascular Surgery), were intended principally to support UK based surgical trainees, their flexible and contextual content and delivery now reach a global audience including trainees in Sub-Saharan Africa countries. The first three-year MSc in Surgical Sciences was based fundamentally on the professional curriculum of the Membership of the Royal College of Surgeons (MRCS) examination, and the later twoyear ChM programmes, on the Fellowship of the Royal College of Surgeons (FRCS) end of training curriculum. These online programmes augment in-the-workplace training without trainees having to leave their country. This has enabled surgical trainees to continue to practice in their own health care system, directly combating loss of regional workforce and increasing surgical practice capacity, especially in SubSaharan Africa, where unmet need is greatest, with 90% of the population having no access to basic surgical procedures. Our Malawian experience particularly has shown that trainee surgeons can be academically supported and professionally equipped through our educational programme. This has been facilitated through a generous educational grant from Johnson and Johnson since 2010, supporting two scholarships annually, for training surgeons. While the performance of these trainees remains very high and the level of applications is increasing, conversion to enrolment has been limited by funding, thus, highlighting the need for additional scholarship funding to support education and capacity building, and widen access to this academic and professional support. Based on the initial scholarship success and in response to this increasing need, we have explored ways of increasing financial support to surgical trainees in Malawi and other Sub-Saharan Africa countries. In 2017, funding was secured for 5 trainee surgeons from the Commonwealth Scholarship Commission (CSC), and 5 further matching scholarships were funded by ESO. This CSC support has continued to be made available but, in 2018, the University of Edinburgh, and the Royal College of Surgeons of Edinburgh launched its own ESO Global Scholarship programme, providing 20 additional scholarships to support surgical trainees from low and middle income countries including those in sub-Saharan Africa. In that initial year, 14 scholarships were awarded to trainees in the COSECSA region. In 2019, further CSC funding supported 10 successful applicants, and these were matched with 20 additional fully funded Edinburgh Surgery Online Global Scholarships from programme income. In 2020, some 50 scholarships will be available through CSC, the ESO Global Scholarship programme, NIHR funding and through philanthropic donation from the Caledonian Heritage Trust. The long-term support of Malawian surgical trainees has been a successful exemplar on which to build a sustainable scholarship programme in sub-Saharan Africa.

Project objectives:

  1. To support Malawian trainees throughout surgical training:

    > to acquire understanding of applied basic surgical sciences and the surgical specialties
    > to consolidate knowledge base for professional examinations
    > to support professional development
    > to complement in the workplace training
  2. To provide opportunity for ambitious trainees to acquire additional qualifications which:

    > enhance portfolio and promote career development
    > provide trainee with essential ‘academic tools’ to support life-long learning
  3. To provide opportunity for prospective academic surgeons to acquire qualification which would:

    > identify career intentions
    > provide possible academic base for career development
  4. To provide equity of access to academic opportunities
  5. To empower front-line individuals in Malawi and other Commonwealth countries to be involved in
    collaborative research and health care strategic development projects:

    > by encouraging participation in GlobalSurg, an online world-wide, NIHR funded initiative
    > by promoting publication of quality surgical outcomes data in peer-reviewed journals, to inform
    policies within host countries, and to better understand regional healthcare needs.
  6. To improve safety and care of surgical patients
Key successes and outcomes so far
  • Since 2007, our MSc Surgical Sciences and ChM programmes in advanced surgical training have
    met successfully the academic and professional developments of over 1981 trainee surgeons in 75 countries,
    with over 150 trainee surgeons from sub-Saharan Africa.
  • Since 2010, Edinburgh Surgery Online has supported 36 surgical trainees from Malawi with full
    scholarship funding (56% females). Of these, 19 have successfully graduated from our MSc programme,
    with 18 Full MSc and 1 student with Certificate award. Six students are currently enrolled
  • Our first Masters’ graduate from Malawi, Dr Lughano Kalongolera, graduated from Edinburgh in
    November 2013, having never previously visited the city.
  • ESO Graduates from Malawi are moving into key consultant leadership roles and continued to play
    a key role in teaching basic sciences to students on the BSc General Surgery for Clinical Officers (non medically qualified).
  • Dr Vanessa Msosa completed her MSc in 2017 and has now enrolled on to the ChM in General
    Surgery to support her sub-specialty training. As a junior consultant in Lilongwe, she is leading a local
    research project on the implementation of the WHO Surgical Safety Checklist funded by NIHR Global
    Surgery Unit.
  • Dr Wone Banda, an MSc Surgical Science graduate of 2015 is now a consultant and leads the
    specialist Burns Unit at Lilongwe.
  • In recognition of the quality of our programmes, the University of Edinburgh in 2010, gave the
    Chancellor’s Award for Teaching, and the 2010 national eLearning Awards for Best Online Learning
    Programme (Education), to our director, Professor James Garden.
  • The growing suite of online learning surgical educational programmes has continued to recruit
    strongly and was awarded the Queen’s Anniversary Prize for Higher and Further Education in 2013.
  • Over 89 novel articles have been published to date in peer-reviewed journals, from 467 of our
    students, as an evidence of the academic goals of our Masters’ programmes.
  • As part of the agreement for Commonwealth Scholarship Commission (CSC) funding, our First
    ever CSC Capacity Building Retreat aimed at students within one year of graduation was successfully held
    in Malawi in October 2019. Eleven Malawian Masters’ graduates attended the workshop at the Makokola
    Retreat, Mangochi, Malawi.
Future and ideas for partnership development
  • To understand where there is an increasing need for online educational support in Malawi and to
    target scholarship resource appropriately
  • To identify greater funding opportunities to support surgical trainees and widen access to Masters’
    programmes in Malawi as well as other Sub-Saharan African countries.
  • To continue to involve Malawian graduates and alumni through engagement with our
    commonwealth scholars at our annual capacity building retreat as well as at other conference opportunities,
    in this way, supporting the further professional development of surgical trainees, with our funding partners.
  • To determine the potential role of the newest online MSc in Patient Safety and Clinical Human
    Factors in supporting health care professionals in Malawi and in sub-Saharan Africa.
  • To develop individual modules that might be made freely accessible to trainees and trained surgeons
    for their continuing professional development
  • To develop new strategies to extend the global outreach of the Edinburgh Online Surgery
    programmes in Malawi and sub-Saharan Africa.
  • To explore the value to our masters’ graduates of a new University of Edinburgh portal, Platform
    One, which will enable alumni to keep in touch with each other and mentors, as well as to provide access to
    university resource that may be valuable for further professional development.
  • To further strengthen the relationship between Edinburgh Surgery Online and COSECSA.

Project 2: MARVELS

Understanding the role of the human microbiome in pathogenesis and prevention of respiratory infections

Area of work: Disease, Vaccination, Respiratory Infection
Location of work:
Blantyre

Project lead:
Prof. D. Bogaert
Contact details:
d.bogaert@ed.ac.uk

Partner organisation: Malawi-Liverpool Wellcome Trust
Partner contact:
Prof. Stephen Gordon

Funding:
MRC

Description of project

Malawi-Liverpool Wellcome Trust (Prof. Stephen Gordon) is establishing a human challenge model to help understand how the host, the microbiome and environment are affecting pathogen behaviour in a population and country with high burden of disease. Our role is to study the contribution of the human microbiome to this process. The long-term outcome is to test interventions in this high risk population as well.

Key successes and outcomes so far

This project is in a starting phase. Ethical approval has been obtained. The first validation studies have been started.

Future and ideas for partnership development

We intend to expand this line of research, amongst others, by providing training to collaborating scientists in Scotland as well as on location to ensure sustainable partnerships.

University of Edinburgh cover

Project 3: MPRU 2 day workshop on conducting microbiome research in low and middle-income countries

A workshop for early career scientists in Africa to provide a theoretical basis to help them with essential information needed to design and execute a microbiome-based study.

Area of work: Training, microbiology

Project lead:
Prof. D. Bogaert
Contact details:
d.bogaert@ed.ac.uk

Partner organisation: School of Public Health & Family Medicine, College of Medicine

Funding: NIHR

Description of project

We are collaborators of the NIHR global health research unit “mucosal pathogen research unit” led by UCL (PI Prof R. Heyderman and Prof D. Goldblatt). As part of this unit, we support and execute multiple studies, often with Malawi, and provide this workshop to partners and other interested parties in Africa.

The workshop is for early career scientists in Africa to provide a theoretical basis to help them with essential information needed to execute a microbiome-based study, to design such a study, and provide practical information and training on design, and execution of clinical components, laboratory pipelines, and data analyses.

University of Edinburgh 1

Project 4: Duration and density of natural pneumococcal colonisation in Malawian adults (PneumoDuDe)

Generating first data on understanding to interaction between microbiome, pneumococcal colonization and the host.

Area of work: Disease, Research

Project lead:
Prof. D. Bogaert
Contact details:
d.bogaert@ed.ac.uk

Partner organisation: Malawi-Liverpool Wellcome Trust
Partner contact:
Dr. Kondwani Jambo

Funding:
NIHR

Description of project

We are collaborators of the NIHR global health research unit “mucosal pathogen research unit” led by UCL (PI Prof R. Heyderman and Prof D. Goldblatt). As part of this unit, we support and execute multiple studies, often with Malawi, and provide this workshop to partners and other interested parties in Africa.

Project 5: DIPLOMATIC

Reducing mortality of children under 5 years through reducing pre-term birth and stillbirth and to optimise outcomes for babies born preterm.

University of Edinburgh 2

Area of work: Maternal Health, Preterm birth, Stillbirth
Location of work:
Lilongwe, Blantyre

Project lead:
Prof David Lissauer
Contact details:
david.lissauer@liverpool.ac.uk

Partner organisation: Malawi-Liverpool Wellcome Trust, University of Liverpool
Partner contact:
Professor Mia Crampin
Contact details:
mia.crampin@glasgow.ac.uk

Funding:
National Institute for Health Research (NIHR)

Description of project

DIPLOMATIC: using eviDence, Implementation science, and a clinical trial PLatform to Optimise MATernal and new-born health in LICs (Low Income Countries).

We are a Global Health Research Group based in the UK, Malawi and Zambia. Our vision is to reduce mortality of children under 5 years (one of the targets of the Sustainable Development Goals) by reducing pre-term birth and stillbirth and to optimise outcomes for babies born preterm. The project transferred to the University of Liverpool in March 2021 and has been taken forward by Prof David Lissauer.

Key successes and outcomes so far

Further funding has been obtained to build on the success of work previously completed. This has been via the University of Liverpool.

Future and ideas for partnership development

Work is ongoing via the University of Liverpool.

Project 6: PAPAGENO

The prevention of diabetes and hypertensive disorders in pregnant women.

Area of work: Diabetes, hypertension, pregnant women
Location of work:
Lilongwe

Project lead:
Professor Jane Norman
Contact details:
mia.crampin@glasgow.ac.uk

Partner organisation: MEIRU
Partner contact:
Professor Mia Crampin
Contact details:
mia.crampin@glasgow.ac.uk

Funding:
National Institute for Health Research (NIHR)
More Information:
https://www.ed.ac.uk/centre-reproductive-health/clinical-studies

Description of project

A feasibility study of a randomised clinical trial of metformin (compared with matched placebo) for the prevention of diabetes and hypertensive disorders in pregnant women. It was hoped that this study would help to determine if recruitment was possible and whether routine administration of metformin could prevent gestational diabetes and pregnancy hypertensive disorders in Malawi.

Gestational diabetes and pregnancy hypertensive disorders both cause significant maternal and neonatal deaths and long term problems, indeed pregnancy hypertensive disorders account for 17.3% of maternal deaths in low income countries, and are the second commonest cause of maternal death after haemorrhage (severe loss of blood).

Key successes and outcomes so far

Successful progress was made to enable the trial to get to the point of recruiting participants. However, COVID-19 halted the trial and when permission was given to restart, the IMP/Placebo already shipped had expired and funding/time constraints meant recruitment could not begin.
Important discoveries were made during the set-up phase e.g. difficulties regarding contractual and legal issues, remote training and setting up sites in another country, plus communication issues. This learning will enable other global research projects to progress more easily.

Future and ideas for partnership development

Proposed submission of report and a paper to enable another group to take recruitment forward in the future. A short survey of women was also proposed, to ascertain their willingness to participate in PAPAGENO.

Project 7: Global Challenges Research Fund Strategic Training Awards for Research Skills (GCRF-STARS)

Increasing research skills and capacity to deliver on the national livestock development plan (Malawi, Tanzania, Kenya and Ethiopia)

Area of work: Livestock, Animal breeding, Genetics
Location of work:
LUARNAR, MoAIWD, DARS

Project lead:
Professor Appolinaire Djikeng
Contact details:
appolinaire.djikeng@roslin.ed.ac.uk

Partner organisation: LUANAR
Partner contact:
Professor Timothy Gondwe

Funding:
BBSRC/UKRI (GCRF)

Description of project

We have partnered with LUANAR and DARS colleagues in Malawi to co-develop a 3-year capacity building plan focusing on:

  1. targeting researchers, postdoctoral scientists and advanced postgraduate students for short term training through annual summer schools in Africa
  2. exchange research experience and skills enhancement visits through short term placements in the UK.
Key successes and outcomes so far

The GCRF-STARS programme has contributed to the following:

  1. strengthening the collaboration between LUANAR, DARS and the University of Edinburgh leading to the submission of one other application for funding under the International Flexible Interchange Programme (I-FLIP) focusing on the following area: Genomics-driven small ruminants improvement program in Malawi
  2. Malawi joined eight other African countries and a group of leading animal breeders and scientists globally in the design and agreement to establish the African Animal Breeding Academy (AABA). AABA as designed is anticipated to revolutionize and transform livestock genetic improvement in Africa for productivity and resilience. Specifically, AABA is on course to become a platform and a leading entity for long term and sustainable animal breeding and livestock genetic improvement to support the delivery of an inclusive and sustainable African livestock development agenda.
Future and ideas for partnership development

In 2018 and 2019, two summer training courses sessions have been held in Africa and co-organised with Malawi colleagues. One round of UK research placement took place in 2019 and a second round is scheduled for Q2 of 2020. The last round of summer training and UK research placement will be conducted in in Q3/4 of 2020.

There is a very good group of academics at LUANAR (including Edinburgh alumni) and senior officials at the Ministry of Agriculture, Irrigation and Water Development poised to explore a wide range of collaborative opportunities with colleagues in Scotland.

University of Edinburgh 3

Project 8: Developing a sustainable programme of cervical screening using VIA and HPV testing in rural Malawi

Raising public awareness of cervical cancer, and its screening. Introducing same day treatment for women with early lesions.

Area of work: Reproductive health, cervical cancer, treatment and screening
Location of work:
Nkhoma hospital + 10 health centres in Lilongwe and Dezda

Project lead:
Professor Heather Cubie
Contact details:
Heather.Cubie@ed.ac.uk

Partner organisation: Nkhoma CCAP Hospital
Partner contact:
Mrs Beatrice Kabota
Contact details:
Beatrice.kabota@yahoo.co.uk

Funding:
Scottish Government International Development Fund for Malawi

Description of project

Malawi has an age adjusted incidence rate of 72.9 per 100,000 (second highest globally) and age adjusted mortality rate of 54.5 per 100,000 (highest globally). Many of these deaths from cervical cancer could be prevented by effective screening and treatment. The aim of this first programme was to reduce cervical cancer morbidity and mortality in the population served by Nkhoma Hospital, and its associated health centres, through the development of sustainable patient pathways for cervical cancer prevention - from primary education through cervical screening to treatment and care - and thus contribute to improving maternal and women’s health in rural Malawi. Screening services are based on VIA (visual inspection with acetic acid) and same day treatment for early lesions is based on thermal ablation, a technology which had been in use in Scotland for 30 years

The programme has resulted in a lasting partnership with Nkhoma Hospital and services have been maintained since the end of the funding in the hospital and 7 health centres.


Key successes and outcomes so far

The project used a ‘hub and spoke’ model, including approvals from local chiefs and the sensitisation of the wider community. It also explored ways to successfully integrate treatment with Reproductive Health Units, and to have productive engagement with Antiretroviral Therapy (ART) clinics.

The project provided a same day ‘screen and treat’ programme of cervical screening, using Visual Inspection with Acetic acid (VIA). It also included training for healthcare staff in thermo-coagulation for immediate treatment, and knowledge of robust follow-up pathways.

The project has developed into a new programme of capacity building of staff, service provision in all three regions of Malawi and creation of a cadre of experienced Malawian providers to ensure sustainability in the long term. This project, called ‘MALSCOT’, will be delivered between October 2018 – March 2023 (see Project 8 under Dr Christine Campbell’s entry).

Our end of project report gave the following achievements to end of 2016:

  • Reached 100,000 people through sensitisation
  • Trained 37 healthcare staff
  • Established daily Cervical Cancer Clinics at Nkhoma Hospital and weekly clinics in 8 Health Centres and screening campaigns in 2 others
  • Provided screening to >17,000 women ( to funding end point) previously unscreened women
  • Reassured >91% of women that they were VIA negative and could be rescreened in 3-5 years’ time as per Malawi guidelines
  • Treated 60-70% of VIA+ women on same day as screening
  • Encouraged attendance from ART clinics (>6%)
  • Confirmed VIA and HPV positivity were each twice as common in HIV+ infected women
  • Had positive feedback from Local Chiefs, clinicians, patients
  • Shared training with Partners in Hope, Ministry of Health, others
  • Provided an additional national trainer for VIA screening and treatment.

By the end of 2018, >27,000 women had been screened through the Nkhoma programme.

Future and ideas for partnership development

There have been many opportunities from Nkhoma to share their own learning and experience such that they are now recognised as an influential centre for cervical screening and treatment and also recognised in several African countries for their experience in use of thermal ablation

We have had opportunities to consider collaboration with academic partners from several countries including Netherlands, South Africa and USA and with NGOs such as MSF, Female cancer Foundation and Grounds for Coffee. While there have not been big grant awards as a consequence, quite a number have resulted in sharing of ideas and expertise.

Cross-fertilisation from entirely different groups working in Malawi can be stimulating and potentially result in new collaborations or ideas for progress e.g. with University of Glasgow in relation to lab facilities; water and renewable engineers to improve hospital facilities and nutritionists to help with malnutrition. Closer involvement with SMP, now as Chair of the Board, has given new insights into how people from very different professional backgrounds can work together.

My involvement with Malawi has been particularly important in the development of ideas and policies within the Scottish Global Health Collaborative, where I am currently Lead champion for retired healthcare staff who might consider using their own expertise in other settings.

Project 9: MALSCOT

Reduce the burden of cervical cancer in Malawi through strengthening cervical cancer ‘screen and treat’ services across the country

University of Edinburgh 4

Area of work: Reproductive health, cervical cancer, treatment and screening
Location of work:
Nkhoma CCAP Hospital and 6 other hospitals across Malawi

Project lead:
Dr Christine Campbell
Contact details:
christine.campbell@ed.ac.uk

Partner organisation: Nkhoma CCAP Hospital
Partner contact:
Mrs Beatrice Kabota
Contact details:
Beatrice.kabota@yahoo.co.uk

Funding:
Scottish Government International Development Fund for Malawi
More information: https://bit.ly/36YYHIe


Description of project

Objective 1 - Expand screening provision across Malawi.

Screening in 33 additional health centres/posts; Sensitisation, strengthening existing services in partner hospitals, and in rural health centres; Same-day treatment of VIA-positive lesions with thermal ablation, referral to partner hospitals, and routes to biopsy or palliative care will be set up and strengthened


Objective 2 - Capacity building.


Up to 80-90 additional VIA providers trained nationally; Training (both theoretical and experiential) delivered to nurses, midwives and clinical officers; Nine Ministry of Health training courses; Up to 14 experiential learning courses supervised by Malawian screening leads and Scottish clinicians; Work closely with the Reproductive Health Directorate.


Objective 3 - Mentoring, for building in-country capacity.


Develop a cohort of experienced and skilled Malawian providers who have skills and confidence to support their peers; co-development of a mentoring toolkit with experienced screening providers, field-tested by partners, then a revised version. The toolkit to draw on Malawian Ministry of Health guidance, best practice internationally, and critically on mentoring tools developed in Malawian context for providers of care for persons living with HIV


Key successes and outcomes so far

At one-year mark:

Four new hubs have been strengthened, and screening is now taking place in five additional health centres. Over 7,300 women have been screened for the first time and twenty-one new VIA providers have received comprehensive training. A screening database has been set up in REDCap and is used across all sites. A revised mentoring toolkit is close to launch, pending final edits and Ministry of Health approval. The Safeguarding policy has also been developed with training materials currently under development.

This project was developed collaboratively with Malawian colleagues, building on the experience in an earlier project (see Project 1), and addressing recognised needs in-country. Although still at a relatively early stage of the project, successes include:

  • The MALSCOT project is running well, with strong national co-ordination and leadership from Nkhoma Hospital and enthusiastic adoption of objectives and approach by project partners, including the Reproductive Health Directorate, Ministry of Health
  • A WhatsApp messaging group allows colleagues from across the country to share successes and to seek advice on clinical or practical queries
  • The extent to which the Hubs have embraced the concept of Mentoring and use of the Toolkit has been very encouraging, with more mentors trained to support their peers than originally envisaged
  • A successful ten-week visit by a volunteer Scottish recently retired gynaecologist
Future and ideas for partnership development
  • Building on learning in MALSCOT, together with Malawian screening and academic colleagues we are pursuing collaborative research opportunities in similar screening contexts in other LMICs
  • With national and international colleagues we are developing implementation research to support learning and strengthen the evidence-base for local delivery
  • A key objective over the remainder of MALSCOT is to work with in-country partners to strengthen the complete pathway of care for women diagnosed with cervical cancer, hence there will be opportunities for volunteering in relevant disciplines; we anticipate close working with the Scottish Global Health Collaborative

Project 10: Generation Malawi

Using microbiome studies to understand the pathophysiology and improve diagnosis, treatment and prevention of respiratory and childhood infections

University of Edinburgh 5

Area of work: Childhood health
Location of work:
Lilongwe, Chilumba

Project lead:
Prof. Andrew McIntosh
Contact details:
Andrew.mcintosh@ed.ac.uk

Partner organisation: MEIRU, Ministry for Health
Partner contact:
Professor Mia Crampin
Contact details:
mia.crampin@glasgow.ac.uk

Funding:
MRC, Wellcome

Project 11: Analysis of lung macrophage phenotype in chronic infections

Area of work: Infectious Diseases, Immunology
Location of work:
Blantyre

Project lead:
David Mhango, Henry Mwamba

Funding:
Training fellowship to David Mhango

Description of project

Analysis of lung penotype in healthy Malawian patients and people living with HIV, with or without concomitant tuberculosis. Analysis of bronchoalveolar macrophages by flow cytometry and by single nuclear RNA sequencing. Relation of transcriptomics profiles to protein expression and analysis of phenotype. Examination of change in phenotype with effective control of viral infection or bacterial load.

Human lung macrophages show multiple phenotypes reflecting different ontogeny and environments in which they mature. Infections such as HIV and TB cause a variety of stressors impacting cell death paradigms . These impact cell phenotype and response to infection as well as susceptibility to other diseases. The changes occurring with each disease and its treatment are being analysed at transcriptome, protein and functional level.

Key successes and outcomes so far

Collaboration sharing skills in single cell transcriptomics and bioinformatics.

Future and ideas for partnership development

Continued development with MLW and UoE CIR/IRR.

Project 12: Socio-Ecological Observatory for Studying African Woodlands (SEOSAW)

SEOSAW is a network of people who research and manage vegetation plots to understand the response of African woodlands to global change.

Area of work: Ecology, Forestry, Natural resource management, Sustainable use, Climate change
Location of work:
Dedza, Dowa, Lilongwe, Mchinji, Ntchisi, Salima, Balaka, Blantyre

Project lead:
Casey Ryan
Contact details:
casey.ryan@ed.ac.u

Partner organisation: Centre for Independent Evaluations
Partner contact:
Professor Charles Jumbe
Contact details:
cjumbe@ciemalawi.com

Funding:
Natural Environment Research Council
More information:
https://seosaw.github.io/index...

Description of project

SEOSAW comprises a network of scientists and a network of woodland survey plots in Africa. The long-term goal of SEOSAW is to understand the response of African woodlands to global change. Members of SEOSAW conduct diverse research which is unified by a shared interest in the ecology of woodlands and savannas.

SEOSAW is managed communally, and the scope of SEOSAW's activities is open to change as the network and its members' research interests develop. SEOSAW's main purpose is to connect researchers and their data, and to facilitate collaborative research. Anybody is welcome to become part of SEOSAW, by contributing data or expertise, or by using the SEOSAW dataset for their research.

Rationale: Shifts in vegetation structure and ecosystem service provision in African woodlands have been hypothesised to result from altered fire regimes, an increasing frequency of extreme weather events, rising CO2 concentrations, and increasing human use. These changes could threaten future provision of ecosystem services to rural and urban people who depend directly upon these woodlands for fuel, food, medicines and other materials, and indirectly via their role in nutrient cycling which supports the region's agriculture (Ryan et al. 2016). Global change is also predicted to increase the carbon stored in African woodlands from 14 to 34 Pg by 2100, a change comparable to the mass of carbon currently stored in the Congo basin forests (Scheiter et al. 2009). Until recently however, there was no regional network of observations to evaluate if such changes are underway, and little testing or validation of model predictions against relevant data. Indeed, such models are generally based only on understanding and validation from African national parks, or other continents, neither of which represent the woodland's functional ecology or social context (Lehmann et al. 2014).

SEOSAW addresses these issues by synthesising data from across the region, and making it easily accessible for regional analyses and modelling efforts. SEOSAW has also developed a set of standardised methodologies and new collaborations to improve future observations. SEOSAW has created a novel partnership of research groups, and is continuing to develop the intellectual infrastructure to support collaborative research for the long term.

Key successes and outcomes so far

Novel analyses of the determinants of ecosystem structure and function for Africa, based on a synthesis of plot data—SEOSAW has a number of on-going projects to examine different aspects of savanna socioecology, several of which have already resulted in publications

Standardised methods for plot design and measurement, tailored to the socio-ecology of African woodlands-- SEOSAW has developed a set of linked protocols to study the complex socio-ecology of African woodlands. These protocols were designed to allow for data collected across the region to be compared, whilst retaining flexibility to suit many different objectives. Six protocols are currently available, and more are in development.

A long-term plan for plot remeasurement within Africa—SEOSAW established permanent sample plots at more than a dozen sites across the region to monitor change.

Future and ideas for partnership development

SEOSAW plans to expand the number of members from Malawi and incorporate Malawi into SEOSAW’s regional studies through Steering Committee Member, Professor Charles Jumbe. SEOSAW would like to expand its activities in Malawi. At the moment, SEOSAW has single census plot data from Malawi. Ideally, SEOSAW will set permanent sample plots in Malawi to monitor vegetation change over time and form a study site which can be the foundation of related research on the socioecology of the area. This will lead to a better understanding of use of forests and savanna woodlands in Malawi, and also contribute to regional analyses on carbon, sustainable use, and climate change.

Watch a video from SEOSAW here: https://seosaw.github.io/image...

Project 13: ANTHUSIA - Governance and Human Security: The state and everyday practices of governing in Malawi.

As part of the EU-funded multi-disciplinary research project in the Anthropology of Human Security in Africa (ANTHUSIA), this PhD project focused on disaster governance in Malawi from the perspective of district-based civil servants.

Area of work: Disaster, governance, humanitarianism, floods.

Project lead:
Tanja Hendriks
Contact details:
t.d.hendriks@sms.ed.ac.uk

Partner organisation: Faculty of Law, Chancellor College
Partner contact:
Prof. Fidelis Edge Kanyongolo

Funding:
The European Union's Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement no. 764546
More information:
https://anthusia.eu/early-stage-researchers/tanja-hendriks

Description of project

As part of the EU-funded multi-disciplinary research project in the Anthropology of Human Security in Africa (ANTHUSIA), this specific PhD project focused on disaster governance in Malawi from the perspective of district-based civil servants.

States are commonly considered responsible for protecting their citizens from harm and safeguarding their livelihoods. Yet this is no easy task for Malawi; a donor-dependent and disaster prone country with limited state capacity. When disaster strikes, the Malawi state thus engages in complex collaborations with donors, non-governmental organizations, global humanitarian aid institutions, volunteers and (affected) citizens to carry out relief interventions. By conducting ethnographic fieldwork in a disaster prone district in the south of the country, I explored these collaborations with a focus on the everyday practices of civil servants working in the Department of Disaster Management Affairs (DODMA). My fieldwork coincided with the occurrence of Cyclone Idai and Cyclone Kenneth.

Future and ideas for partnership development

Enduring academic connections.

Project 14: University of Edinburgh interactions with RARE Charity scholars

Series of online discussion panels between University of Edinburgh academic staff and students and RARE Charity scholars to explore and develop mutual learning opportunities.

Area of work: Agriculture, food systems.
Location of work:
Lilongwe, Ntcheu, Blantyre.

Project lead:
Darren Watt
Contact details:
darren.watt@ed.ac.uk

Partner organisation: RARE Charity
Partner contact:
Mrs Daisy Belfield Santos
Contact details:
daisy@rarecharity.com

Description of project

The University of Edinburgh works in partnership with RARE Charity to offer regular training opportunities and discussion panels to RARE Charity's tertiary scholars, primarily in the fields of Agriculture. RARE Charity funds transformational scholarships for individuals from Malawi's marginalised tea communities. The Global Academy of Agriculture and Food Systems in the University of Edinburgh is a leading interdisciplinary hub of researchers, teachers and students; developing new science, curating evidence and learning on the intersection and interdependence of the systems that underpin the health and wellbeing of people and our planet. The partnership aims to promote a two-way learning experience and eventually to prepare scholars for post-graduate work abroad, should they wish to pursue this.

Key successes and outcomes so far
  • One scholar has been nominated by LUANAR (Malawi) as a top-performing student, to attend an 11-month internship program at Kinneret College in Israel. The Global Academy of Agricultuyre and Food Systems panels and discussions certainly played a part in how this scholar presented for and secured this opportunity. The exposure the Global Academy offered him to international systems will surely help his confidence too as he embarks on this next step abroad.
  • An enormous and unquantifiable leap in the effective use of video calling technology, both on Teams and Zoom. Not just the tools themselves, but the etiquette surrounding video calling. The partnership necessitated a series of 'video training sessions' with the scholars, and they are now confident, Zoom-literate students, which will give them a competitive edge when they graduate!
  • Testimonials from scholars:

    "Those discussions opened up my mind a lot - no wonder I emerged as one of the best students in class!"
    "The webinars have opened my eyes as to how high can we go. The interaction with different professors has taught me that I must not look down on myself, for with passion and a hardworking spirit all my dreams are possible. The programme has also opened my eyes as to how I can apply for Masters scholarships with international universities. Some of the webinars uncovered some of the areas that the Malawi agriculture sector is failing. This helps me once we get into the field or once we get an opportunity to be heard by the top authorities."
    "I will be glad if this programme continues, so that I can learn things which will help me not only at College but also as world experience."
Future and ideas for partnership development

The partnership will evolve to allow the RARE scholars to present to the University of Edinburgh community as much as the University presents to them. This is made possible by the continually increased confidence the scholars display with their interactions.

Project 15: Ethics in Global Research

This project support researchers, practitioners and others who conduct or support research in complex, low income or fragile settings.

Area of work: Health, Social, Humanities, Ethics and other cross disciplinary research.
Location of work:
Lilongwe, Blantyre, Mangochi, Zomba.

Project lead:
Clara Calia
Contact details:
calia@ed.ac.uk

Partner organisation: Epilepsy Movers, Univesity of Malawi
Partner contact:
Action AMOS
Contact details:
amos_action@yahoo.co.uk

More Information:
https://www.ethical-global-res...

Description of project

Our Project goal is to assist researchers, policy makers and all stakeholders including the research participants to be ethically part of the research journey. The research journey is long and often arduous in global research contexts. Ethical challenges may emerge at any stage in this journey, from the design of the initial idea through data collection to the legacy that remains long after the project has been completed.

Key successes and outcomes so far

The project has managed to establish a network of over 400 researches interested in Research Ethics globally. The project has created a toolkit and case studies templates and has published in 4 journals its work. It has supported 1 postgraduate student in Malawi.

Future and ideas for partnership development

We intend to partner with like minded institutions to further the research ethics regionally and beyond working with Academia, NGOs and policymakers to shape research ethics together. We wan to ensure that the tools we create are aligned to the global research challenges and when used will enable research to impact society.

The Sustainable Development Goals (SDGs) can provide us with some clear direction about how to achieve this – both in the way we do this work as well as in the outcomes and transformation our research can enable.