Dr. Gerald Msukwa
Ophthalmologist Dr Gerald Msukwa works at the Queen Elizabeth Central Hospital, which serves nearly five million people in Southern Malawi. He performed Winesi’s live cataract surgery on 8 October 2014.
“I come from a very humble background; my dad was a teacher and my mum was a housewife (I call her a house manager). My dad wanted to hear nothing from his children but distinctions. I wasn’t always distinction material though! I initially wanted to be a scientist, and then I ended up enrolling for a science degree at The University of Malawi. It was there my interest in medicine developed.
After two years I applied to St Andrews University in Scotland under a British Council sponsorship – at that time the government had a partnership with the Council to help train Malawian doctors. I got picked and after three years I moved to St Mary’s Hospital for clinical work. By the end of the training I was back in Malawi, and it was during this time that my interest in ophthalmology was strengthened. I met Prof Moses Chirambo who was the only eye surgeon in Malawi at that time. He was one of the most dedicated surgeons – I worked with him for a couple of weeks and I couldn’t believe how one person could change so many lives. That was it: I never looked back. I was gone.
I set up the eye unit at Queens [Queen Elizabeth Central Hospital] and at the moment I’m the only paediatric surgeon in Malawi. I was involved in a survey in the schools for blind children and we found that 85% of these children should never have been blind at all, because they should have been operated on. That changed my life overnight and I really became an advocate for kids. I chose to specialise in paediatrics and luckily, the Ministry of Health and Sightsavers were keen to support this and we put everything together. In the past five years we’ve moved from operating on almost no children to operating on more than 400 children every year. This has become a passion.
The challenges are enormous. At the moment in Malawi there are only eight surgeons [for a population of more than 14 million people], so one issue is the number of doctors versus the patient need. Another is that in a poorly-resourced country people don’t seek help. They are stuck somewhere and the doctor is somewhere else – until you link the two: that is when you start to make an impact. Most patients in Malawi don’t go looking for help, so first of all somebody has to go and look for them in their own villages. Once you find them you can’t ship them all to one centre as it would be impossible, it’s easiest to move the team as close as possible to where they are. So you find the patient and move them to their local hospital. Then you find the medical team and move them to the same local hospital – not just the team but all the [medical] necessities, which is a huge logistical problem. All of these logistical movements are funded by Sightsavers, including the procurement of most the essential medical equipment.
There are no tarmacked roads – if you need to visit a patient they are mostly off the road. This is easier in the dry season because sometimes in the rainy season, even in a 4×4 you could get stuck. One time my team crossed the river, then while they were working it started raining, the river filled up and they got stuck. The locals had to pull them out! It’s not the everyday fancy commute to work.
“I believe Africa is a half-written book”
I have one simple philosophy. I believe Africa is a half-written book with the other half blank. You either read it and feel inspired to leave a line of your own – or read it, drop it and run. I chose the former.
At 45 years old, I don’t live in a fool’s paradise. I know the limit of what a single individual can achieve, and in the last chapter of my life my attention is turning to motivating as many doctors [as possible]. I’m trying to work with like-minded friends to come up with ways of making them stick around once they specialise. Once that is achieved, my chapter is closed.”