LETTER FROM MALAWI

Homba picked her head up from her chest, and with as much power as she could force out of her weakened lungs, she whispered hoarsely, “I’m a chief.”

Then she wiped her mouth as daintily as she could with hands almost paralysed by a series of strokes and dropped her head back on to her chest. “Tired,” she said, almost inaudibly.

Homba will be 92 on her birthday, on July 4th, two days before Malawi celebrates its 55th year of independence from Britain. She is not Malawian, but was born in South Africa’s Eastern Cape and, as she used to proudly tell me, went to the same school as Mandela, “but he had left by the time I went there.”

Scotland and Malawi share a unique bond stretching back 160 years to Dr David Livingstone. Scotsman columnist Susan Dalgety has moved to Malawi for six months where she will write a book about the small African nation. The Spirit of Malawi will be published next year, 15 years after Scotland and Malawi signed a co-operation agreement. In her column she will share stories about daily life in Malawi as well those of the many Scots who are today making a positive impact in the country dubbed the Warm Heart of Africa.

She came to Malawi in 1954, with her long dead Malawian husband Roland, to help fight for her adopted country’s independence. Now she waits to die. “I am too tired,” she said.

She is one of a growing number of Malawians who suffer from hypertension and strokes. In the last 20 years, the number of people suffering a stroke caused by a bleed to the brain has gone up by a third. It is one of the biggest killers in Malawi, and a significant cause of disability.

High blood pressure is a growing epidemic, fuelled, like type 2 diabetes, another disease on the rise, by poor diet and lack of exercise, but also genetics. Africans, it seems, are more susceptible to hypertension.

Homba is lucky. She is the matriarch of a family that at the last count included ten grandchildren and 18 great-grandchildren. Her grand-daughters take turn to bathe her and massage her almost lifeless limbs. They tempt her appetite with beef and rice, spiced with chilli, and there is always someone there when night terrors wake her at three in the morning. “I think I am trapped in my coffin and can’t get out,” she told me once.

But for many Malawians, particularly the villagers who make up the bulk of the country’s population, a stroke is a life-destroying, if not life-ending, event. There are no disability payments from the Malawi government, no state pension, and the country’s first stroke unit is still a work in progress.

A group of British stroke experts from London and Liverpool have joined forces with Malawi medics to raise enough money to open the country’s first dedicated stroke unit, but they are still 8,176 bricks short. Meanwhile, an increasing number of people are struck down every day.

“Soon we will be able to research the causes of stroke and other inflammatory diseases such as cardiac disease and arthritis, thanks to support from Scotland,” says Dr Mwapata Mipando, principal of Malawi’s highly rated College of Medicine, as he showed me round the site for a new research lab.

So far so predictable. Rich country helps poor country with aid for basic health care. But this new partnership between the University of Glasgow and the College of Medicine, funded by the Scottish Government and the World Bank, is a world first.

The Blantyre-blantyre project, as it has been dubbed, will directly benefit both countries. Its findings will help improve healthcare in Malawi, at the same time informing research into the, as yet unexplained, causes of poor health and low life expectancy in Glasgow and the surrounding area. This so-called ‘Glasgow effect’ sees a quarter of men die before their 65th birthday.

As Alex, the administrator for Glasgow University’s Wellcome Centre for Integrative Parasitology, showed me the site for the new state of the art microscope she had carefully packed for its flight to Malawi, I thought of David Livingstone – 160 years after the young medic from Blantyre set foot in Malawi, the two countries are collaborating on medical research that could saves countless lives in both countries. I think he would have approved.

He would most definitely have given Professor Jeremy Bagg the thumbs up. The cheerful dentist is on a mission to improve the oral health of Malawi children and train a new generation of Malawi dentists.

The Maldent project, also funded by the Scottish Government, is nothing sort of an oral revolution.

Over a (sugar-free) coke, Professor Bagg, who is head of Glasgow University’s Dental School, told me about the team’s plans.

“There are 39 dentists in this