Dr Ramy Daoud, Consultant Psychiatrist
After eleven years in the NHS, I gave in to an ever-growing desire to volunteer in a country of need. It was the same desire that motivated me to become a doctor in the first place. From time to time, that desire had faded in the daily battles of minor differences, the dust storms of policy change after policy change, the confusion of targets and outcomes, and just sheer exhaustion. That desire had not quite been lost, but it was weakening.
I had trained and worked in developing countries in the past, so I suspected I could regain that desire to be a doctor by working in such countries again and I took the plunge.
Malawi is one of the poorest countries on earth, but it is peaceful. When I arrived, I discovered there were barely any psychiatrists in the country - an enormous weight, but a terrific opportunity to effect change. SMMHEP’s programme in Malawi is fantastically well-run, providing clear goals and structure to volunteers, maximising the use of time and resource. I spent roughly a third of my time volunteering in outpatient clinics and two-thirds teaching medical students.
The clinic was a learning experience and an opportunity to teach. Not understanding the language of your patients in psychiatry is an uncomfortable experience, but the students did an excellent job of both linguistic and cultural interpretation. We all learned to appreciate a little better the "otherness" of lived experience of mental illness. A big surprise was the prevalence of HIV in Malawi. One in ten Malawians have HIV and I would see at least 1:5 patients in clinic with AIDS-related dementia and other mental health issues. The entire experience was deeply rewarding and rejuvenating, and one that I will certainly repeat.
Dr Anna Stout, Consultant Psychiatrist
I cannot recommend volunteering with SMMHEP highly enough! This was an invaluable experience for me, professionally and personally. Malawi is a magnificent country and volunteering is a wonderful way to explore this amazing place in depth, geographically and culturally, while contributing to the vital expansion and development of mental health provision there.
Teaching with SMMHEP is one of the best things I have done. Working in the outpatient clinic at Queen Elizabeth Hospital and Zomba Mental Hospital with the medical students was refreshingly rewarding – experiencing with the students the joy of helping people recover from serious mental illness and watching their lives improve, learning alongside the students as they discovered psychiatry and I discovered how mental illness manifests itself and is explained in a culture different to my own, learning from the indigenous ways of coping and inclusion.
Non-clinical teaching at the College of Medicine is a lively experience - the team are highly dedicated and there is so much to get involved in: lectures and seminars, exam setting and marking, problem-based learning, and the opportunity to visit organisations around Blantyre during the Child and Adolescent block. The medical students are creative and enthusiastic and it was a wonder to watch them move from a position of polite interest to real passion for mental health and serious consideration of psychiatry as a future career. I feel very proud to have been part of SMMHEP, and have developed a wealth of skills and knowledge wholly applicable in a universal sense to my ability as a psychiatrist.
Dr Heather Gardiner, Retired Child and Adolescent Psychiatrist & Medical Manager
When I retired in 2015, I volunteered with SMMHEP; it was so wonderful that I came back this year. I have had a very fulfilled career, but going to Malawi has given me a whole new perspective. The students are a delight - they are enthusiastic, hard working, interested, competitive and imaginative. They are also very appreciative. Their thirst for learning is evident from the first moment. They are unafraid to challenge (always courteously) and insist on explanations if things are unclear. They have often read up in preparation for the teaching. The standard is incredibly high and British Medical Students could learn a thing or two! An assignment given on a Friday afternoon is ready on Monday!
Clinically, the unmet need is truly shocking – it seem to me that the professionals who work there have been give a enormous mound of sand to move – with a teaspoon as their only tool. People can queue for hours for their psychotic relative to be seen – they may have brought them on 2 or more minibuses and have been up all night worried about aggression or wandering. Things are very raw, often distressing and very often surprising – but spending time in clinic is hugely rewarding. Malawians are very welcoming, warm, and friendly. There is laughter, hope, generosity and compassion. Health Warning - teaching for SMMHEP could become addictive.
Dr Gaynor Jones, Consultant in Forensic Psychiatry
Twenty-seven years ago I visited Malawi for a student elective. It was a wonderful experience and I had always wanted to repay that debt. Through the support and structure of SMMHEP I felt confident that I could return to Malawi and contribute to something important, the training of medical students, Malawi's doctors of the future. It was hard but enjoyable work, seeing the medial students grow in their theory and practice of psychiatry. The medical students were enthusiastic, bright, and resourceful - which would give anyone a boost to be around. I returned to the UK a revitalized, more positive doctor, much the better for my experience.
Dr Jan Klimach, Higher Trainee
During a year out between core and higher training, I decide to broaden my clinical and teaching skills in the developing world. The medical student psychiatry rotation in Blantyre is high quality thanks to its neat design and effective use of the clinical environments for teaching.
I have found my involvement with two rotations very rewarding. I have tutored PBL sessions, given presentations on a range of topics, run sessions I have not been involved with in the UK, such as sessions on mindfulness and stigma, as well as provided clinical teaching at the psychiatry clinic at Queen’s hospital.
The clinic is a challenging place in which to work but one where assessment skills can be improved very rapidly due to the sheer volume of very unwell patients. The effects of culture on how psychopathology presents is fascinating and there is ample opportunity to consider the interaction of the disease processes with the social and psychological environment. I have greatly enjoyed volunteering in Blantyre and my clinical and teaching skills have developed rapidly in the short time I have been here.