Outreach exhibitions are an effective tool for communicating science or research information to rural communities in Malawi
This story is based on my encounter with Mrs Buleya during an outreach exhibition.
BY Rodrick Emmanuel Sabakunsi
“Beep” - I ignore it. Then a second one: “Beep”. I peep through the window, and there stands Kestern, the exhibition officer. He beckons me, saying: “Boss, we are ready, everything has been packed, we can start off now”. I look at my watch: exactly 7:30 AM. I switch off my laptop, put it in the drawer, take my bag and walk towards the car.
This is the journey that I have performed for the past two years. This day, Friday, like all other Fridays is the day when we conduct our outreach exhibition, a crucial part of our science communication and public engagement initiatives. Malawi Liverpool Wellcome Trust, the organization that I work for, is a Clinical Research organization conducting its research in both urban and rural Malawi. These weekly outreach exhibitions are implemented as part of the organization’s obligation to engage research communities with Science and research information.
The mobile exhibition has several exhibits with public health information aimed at facilitating behavioural change as far as accessing health services is concerned, as a matter of fact, most rural communities in Malawi find several difficulties in trying to access healthcare services.
Among the many notable exhibits present today are common hospital equipment, tools used in the conduct of different research projects, health information leaflets, banners, short videos of research findings and of course traditional dances to spice up the outreach.
Vaccine information, mainly vaccine schedules, is another important public health information worth sharing especially with rural communities. For instance, the Malawi immunization programme considers a child to be fully vaccinated if the child has received all basic vaccinations, some of which including BCG at birth, Rota 1 at 6 weeks, Rota 2 at 10 weeks, Hep B at 14 weeks and Measles 2 at 15 months, just to mention a few.
On this particularly hot summer day, our outreach activity is going to take place at Nalanda, a village 35 KM away from Blantyre city. The loud music from the Public Address system mounted on the vehicle announces our arrival. This is usually the strategy that we use to encourage people to come to our outreach activities.
On arrival, without wasting much time, I go to the village chief’s house to formally register our arrival, right on time as pre-arranged. Upon arrival at the chief’s house, we find quite a good number of village elders waiting for us: it is clear that the people are ready for us.
As I attend to the village chief, my colleagues arrange the tables for the exhibits in a form of a circle: this allows smooth viewing of exhibits by the community. “What a beautiful day!” I say to myself as I stand next to the hospital equipment table that got allocated to me for today. Kestern blows his whistle, signifying the start of exhibition visits.
“Please don’t push each other, make sure you draw back a bit to ensure that everyone can see what is on the table” - I try to
control the crowd that collects in front of my table, eager to view, touch and
test the different hospital equipment on display.
One by one I lift the tools and ask: “Does anybody know what this is and what it is used for?”. “Yes! That is a mask, it is used by doctors when attending to a patient.” - said this middle-aged man. “Good” - I said - “this is worn to prevent spreading infections between doctors and patients. Does anybody want to try it?”.
Nervous laughter erupts from the crowd, and a woman says: “It makes you feel difficult to breathe!”. I try to reassure the woman, but she doesn't budge. I'm in an awkward position, but thankfully a boy of about 15 years old comes to the rescue! He puts it on, and the whole group starts laughing with delight. “Phew” - I think.
This goes on in the same way for several instruments until I get to one called sphygmomanometer - a Blood Pressure (BP) machine, for the laypeople. This is one of the most important tools commonly used in hospitals. It is advisable that everyone, but especially the elderly, take their BP test regularly. The importance of maintaining a normal BP cannot be over-emphasized. High blood pressure dramatically increases the risk of heart attack, stroke and heart failure. Normal blood pressure is less than 120/80 mmHg (blood is measured in units of millimetres of mercury, a relic of Torricelli's experiment!).
As I continue my presentation, I notice a charming old woman. “What’s your name, ‘Anganga ’?” - I asked, pointing at her. “My name is ‘Mayi Buleya.”- “Perfect, Mrs Buleya, can you tell me what this is and what it is used for?”. Without hesitation, she replies with a soft smile: “That is a BP machine, at the hospital they use it to find out how fast your blood is flowing, they test me every time I visit the clinic.”. I smile and try to congratulate her, but she continues: “Please test my BP, I am not feeling well these days. I guess it’s my old age”.
I hesitate, but seeing that Mrs Buleya had already stretched her arm towards the machine, I know that I have no options but to give in and test her. Some of you may be wondering the reason for my hesitation: the truth is, according to her sentiments she shared earlier regarding her age and how she is feeling, it's more likely that her BP is going to be high. And that’s where I think the problem will be.
Confirming my fears, Mrs Buleya’s BP reading comes out as 145/96, translating into High Blood Pressure, almost Hypertension stage 2. My attempts at explaining the reading to her end up souring her mood. A moment of perfect silence hangs in the air. Everyone looks at me as if asking me: “So what are you going to do about it?”. Indeed, Mrs Buleya herself asks me the same question. I start explaining to Mrs Buleya our protocol on how to conduct these outreach activities, mainly that we do not offer any clinical services during these outreach exhibitions, but I know that this won't cut it. She needs treatment.
However, there is no single clinician among our group. We are merely science communication and public engagement experts. We cannot offer Mrs Buleya any medical help, and time is of the essence. The crowd can see that I am at a loss and begins to complain. I am in a predicament.
While the village elder maintains the calm among the agitated people, one of my colleagues gestures towards the car we came in with. “Of course” I think. We take Mrs Buleya and drive her to a nearby clinic, the next village over. Since that incident, we have now brought some changes in the way we conduct our outreach exhibitions: we have co-opted a clinician and a nurse to be part of the team so that they are now responsible for the hospital table.
We have also added some essential drugs to the hospital table, to support those that may be in critical condition. The drugs are mainly for Malaria, BP and pain. Everybody is happy now because we are able to assist those in need while at the same time engage communities.