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Reports

Annual report 2009
The malawi.kom Foundation, founded in 2004, aims to improve health care in Malawi with a specific focus on surgical care in the Central and District / Mission Hospitals.  
In 2009 the foundation has been very active.
The programme tools & skills has been officially assigned to CHAM, the Christian Health Association of Malawi. To this end  a formal contract is signed in February 2009.
As part of the tools & skills Project 3 series of workshops in hospitals in Southern Malawi and the first series in central Malawi have been organised.
Extensive surveys, studies on people and resources, have been carried out in the District and Mission hospitals in Central and Northern Malawi, as has been done in 2007 in Southern Malawi. On the basis of the results of those surveys a useful programme of workshops in the Northern parts of Malawi can be made. There is now a start with an assessment study of all hospitals in Southern Malawi where malawi.kom over the past two years has been active. The results of this evaluation will be of influence for the programme of workshops in Central and Northern Malawi.
Facilitated by malawi.kom,  in 2009 four Dutch Surgical Consultants on a rotational schedule (rotating surgeons) joined the staff of the queen elizabeth central hospital in Blantyre and appear to be indispensable for the surgical basis training of Malawian registrars, interns and 5th year medical students.
In other ways malawi.kom contributes to the formation of more African doctors by financing the first study year of a medical student from Sierra Leone.
Again in 2009 much of medical materials has been sent to Malawi and distributed. The bad experiences with sending all offered supplies have led to a rigorous selection of what is being considered useful, which is why the consignments are now more limited.
The board of malawi.kom this year has expanded to include an Advisory Board.

tools & skills
The basic principle of Tools & Skills is to teach and train basic surgical skills at district level, at the same time making available the necessary tools to be able to put the skills into practice. In 2008 in Southern Malawi workshops based on this formula have been organised on skeletal traction, sutures & suturing and skingrafting.
In 2009 the following topics are dealt with.
POP (plaster of Paris) and bandaging:  February 2009, in 13 hospitals in Southern Malawi.
Purpose: to avoid the many complications of not correctly applied plaster casts and the learning of a good bandage technique. A very practical workshop clearly providing in a need.
Suitable cast instruments, lacking in many hospitals, could be supplied thanks to the contribution of a number of Dutch hospitals.
Basic trauma life support (BTLS). April - May 2009, in 12 hospitals in Southern Malawi.
The purpose of this short course was for the participants to be able to recognize and treat the potential lethal complications in major trauma by strict following a simple protocol. It was a training with a number of near-to-life practical cases. Each hospital was provided with basic and very welcome tools: blood pressure machines, neck collars, mobile mini pulseoximeters, Guedel airways and oxygen masks and - tubes.
Local anesthesia in surgery. October 2009, in 13 hospitals in Southern Malawi.
Purpose: to familiarize participants with the use of local anaesthesia, which actually in surgery is seldom applied. Whereas if local anesthesia is possible, it is preferred to general anesthesia which carries more risks, more costs and asks for an anesthetist.
Sutures and suturing. November 2009, in 11 hospitals in Central Malawi.
Purpose: to communicate necessary knowledge about suture material and learn basic techniques of suturing in order to prevent wound complications such as poor healing (fascia disruption) and wound infections.

Education
 
On average 33 trainees per hospital attended the workshops, 1563 in total, who all got a highly appreciated Certificate of Attendance. It is noteworthy that both the theoretical and practical training for the vast majority have been given by Malawian doctors and Clinical Officers.
To all the aforementioned workshops, the Kennemer Gasthuis (hospital), Haarlem, Netherlands contributed in a generous way by providing manpower, knowledge and materials.

accident
On November  11th 2009 Charles Boissevain, co founder of malawi.kom with an unbridled commitment towards the Foundation, got seriously injured in a car crash in southern Argentina. He has survived the accident, albeit with severe brain damage.
We are missing his enormous input, his broad vision and leadership.
Previously Charles had recruited Malawian staff for malawi.kom. They will ultimately take over the responsibility of the activities of malawi.kom, for a part (Tools & skills) together with CHAM.

Program 2010 / 2011
Date Workshop Hospitals
March ‘10 woundcare, skingrafting, fysiotherapy Central Region
April '10 woundcare, skingrafting, fysiotherapy Northern Region
September ‘10 LAS (Local Anesthesia in Surgery) Central Region
October '10 LAS (Local Anesthesia in Surgery) Northern Region
Februari '11 BLS (Basic Life Support) Central + Northern Region
May '11 Evaluation + handover Central + Northern Region