Research Capacity: Building for the Future

The University of Malawi College of Medicine recently announced that it's 13th annual Research Dissemination Day would be held on Saturday October 17th, 2009 on the main campus in Blantyre. The focus of this years conference is "Capacity Building for Research in Malawi."

Capacity building in any setting is a required but often expensive endeavor when the ultimate goal is increased productivity, expanded opportunities, and institutional advancement. Capacity building in "remote" parts of the world (i.e., any location for which shipping/transport and/or local manufacturing is not established to the point of feasible economy) faces several challenges which may not be anticipated by "outsiders" wishing to help. For example, the donation of a chemistry analyzer to a hospital, clinic, or even research laboratory within a school of medicine by a foreign donor is of little to no value to the receipient unless it is provided with several years of reagents and a service contract for machine maintenance. In addition, careful shipping of such peices of equipment can add significant cost for simply getting the machine to the right spot. Technical expertise with the operation of a such a piece of equipment is easily achieved by training local bright enthusiastic minds (which are readily available) but still requires getting a technical expert to the country for an extended period to perform the training. Despite these challenges, if a piece of equipment can be delivered, service and reagents provided, and technical training completed, the functioning device can have immediate benefits including providing research data for analysis, providing laboratory data for economically depresses populations, and generating revenue by providing laboratory data for paying populations. An example of such a successful process includes the Magnetic Resonance Imaging Center at the Queen Elizabeth Central Hospital in Blantyre which was donated by General Electric (including transport and set up of the machine to Malawi) and is supported for performance and maintenance by research grants as well as revenue generation from private pay patients. One of the most successful aspects of this particular event, however, was the presence of a Malawian radiologist who was already an expert in his field who provides the day to day productivity of the machine.

This example illustrates one of the MOST important aspects of capacity building: people. The Research Dissemination Day at UOMCOM is an excellent opportunity for faculty of the college (both foreign and domestic) to highlight the range of fascinating and important projects happening within the College. In recent years, 4th year medical students at the College are now required to perform a research project during that year. With ~60 students per year, this requirement allows exploration of the breadth of research possible within Malawi and allows students who may be interested to have a concrete experience. It is these very students who must be nurtured in the 5th and 6th year with more exposure to research and it's uses if there is any hope of retaining them as "research scientists". Can every student be a "research scientist?" The answer is, of course, no. Primary care, surgery, obstetrics, pediatrics, nutritional support, and infectious diseases training for the care and treatment of the population of Malawi is still the highest priority as the College tries to fill the void of physicians which is common in much of Africa. However, it is not too early to recruit handfuls of students per year who may wish to pursue research careers.

Retention of highly skilled and well trained people is ALWAYS a problem for any business. "Brain drain," as it is called, is NOT a unique problem of Africa. Africans who choose to pursue careers out of their home country for increased salaries and benefits for their children can not be blamed for this behavior. Just like any major academic center, the people who work within these institutions spend much of their time teaching, providing clinical service, and possibly devoting a little or most of their time to research--often at salaries much less than they could expect in private practice or within commerical biotechnical companies.

Michele Barry, in her Presidential Speech to the American Society of Tropical Medicine and Hygiene "urge(d)...members to host...overseas scientists and create collaborative field sites to enhance research capacity around the world" with an emphasis on "fund(ing) young scientists from developing countries to return to their indigenous countries with financial and institutional support". This concept, although simple in principal, is extremely important, perhaps the most important aspect of establishing feasibility for a young Malawian scientist to make his/her way. They must be provided support which includes a living wage and enough initial support to establish themselves as scientists and seek out grant and other funding to move forward in their career.

Seeing this as paramount, the UOMCOM has made strong efforts to recruit young enthusiastic scientists to its fold. The results of these efforts will be easily surmised by attendees of the upcoming Research Dissemination Day. More is still needed to dramatically change the environment in Malawi including post-graduate advance medical training IN COUNTRY; however, the progress that has been made is not only impressive but should be equally encouraging to young Malawians as evidence of the feasibility of a career as a research scientist in their home country.

Welcome Dr. Milner!

We would like to warmly welcome our first blogger, Dr. Danny Milner!  

Dr. Milner is an Associate pathologist and assistant medical director of microbiology at the Brigham and Women's Hospital. He is an instructor and an adjunct lecturer at Harvard Medical School and Harvard School of Public Health, as well as a honorary visiting lecturer at University of Malawi College of Medicine in Blantyre, Malawi. He has been collaborating with the University of Malawi's pathology department in the past nine years to help develop capacity and transfer technology. 

He is an exceptional researcher, teacher, mentor, and an extraordinary human being, and it is a privilege to have him write for our blog!