Summer of 2025 (Needs Assessment)

This needs assessment was conducted during the summer of 2025 by two medical students from the Royal College of Surgeons in Ireland (RCSI), working under the guidance and supervision of a Native Malawian professional currently contributing to Ireland’s health sector. The primary aim of this assessment was to inform the priorities and project direction of RCSI’s Global Health Initiative (GHI) for the subsequent summer programme in 2026.

Over the course of several weeks in Malawi, the team engaged extensively with community leaders, health professionals, and local stakeholders to ensure that the findings accurately reflected the region’s realities and needs. Throughout this process, the project received support and encouragement from key national and international partners, including Malawi’s Ministry of Health, the Bishop of Mangochi, and the Irish Ambassador to Malawi. Their collaboration not only strengthened the quality of the assessment but also underscored the shared commitment to advancing sustainable, community-driven healthcare initiatives.

📅 Week 1:

Malawi College of Health Sciences

When we arrived at the Malawi College of Health Sciences, the first thing that struck us was how much the students were achieving with so little. With fewer than five computers for 1,500 students and tuition costing only €200 a year, resources were stretched thin in every direction.

During a meeting with its administration, we learned about classmates struggling with depression, gambling addiction, and the hopelessness of a weak job market. Several recent suicides had shaken the college, and it was clear they wanted practical tools to support each other. Mental Health First Aid training was something that seemed like it could be very beneficial.

In addition to their desire to learn about Mental Health First Aid, their enthusiasm for research was just as strong. Lecturers explained that they wanted to conduct studies but lacked mentorship and experience. Even a small partnership with RCSI, providing laptops, PPE, simulation equipment, and guidance with mental health first aid and research could make a major difference. Leaving campus, it was clear their needs were simple, but their motivation was great.

📅 Week 2

University of Malawi

The University of Malawi buzzed with activity. Students crowded the pathways, studying everything from psychology and sociology to nutrition and science communication. But beneath the lively atmosphere was a clear undercurrent of worry. Three students had died by suicide this year alone.

When we discussed Mental Health First Aid for student ambassadors, faculty immediately recognized its value. They already had peer leaders, but what they lacked was training in mental health. Professor Asanti, who invited us for tea, spoke passionately about improving support systems. We left feeling that RCSI could meaningfully contribute here.

Safari

During a short safari stop, we learned something unexpected: local fishers use sap from the naboom tree to stun fish, which float to the surface. They remove the fish’s stomach immediately to avoid poisoning themselves. It was a small moment, but it reminded us how deeply traditional knowledge is woven into everyday life here.

Mulibwanji Hospital

At Mulibwanji Hospital, the scale of their need became immediately clear. The hospital had 130 beds and a catchment area of more than 150,000 people, including some who crossed over from Mozambique. Yet ratios like one provider for 60 mothers or 30 children were common.

Despite these challenges, the staff welcomed us warmly. They explained how students could help, charting, writing SOAP notes, supporting pharmacy or dental work, and joining community outreach. We were surprised by how welcoming and community-oriented the area felt; everyone seemed to know each other.

We spent time learning about the local disease burden: severe anaemia due to malnutrition, emergencies from delayed transport, and over 1,300 patients on ART whose viral loads weren’t improving. The hospital had one ambulance, so many mothers arrived on bicycles or on foot, sometimes too late.

Their needs were practical and urgent: medications like magnesium sulfate and hydralazine, asthma inhalers, uniforms, lab tests, and a way to transfer digital X-rays without relying on patients’ phones. They also hoped for wells and improved sanitation in villages like Kana, where the community walked miles for water.

Walking through each ward, we were struck by how hard the team worked and how much difference even small interventions could make.

Kana Village

Kana Village gave us a clearer picture of the everyday realities behind the hospital statistics. Families described how they grew bullrush millet to survive drought seasons. Fish spoils quickly here, so they dry or smoke it immediately, sometimes losing entire batches if flies infest it.

We joined the hospital’s community health workers as they checked on children with malnutrition. Those who were severely underweight received RUTF; others were monitored closely. It was a simple but effective system, and it showed us how connected the hospital was to the communities it served.

Billy Clinic

Billy Clinic, serving 20,000 people, felt like a lifeline for the surrounding villages. The staff performed primary care that kept patients from traveling long distances to Monkey Bay Hospital.

There was no X-ray machine, but an ophthalmologist flew in occasionally to provide free care to locals.

The most striking issue we saw was schistosomiasis. Many patients, especially children, came in “peeing blood,” and the clinic struggled to keep enough praziquantel in stock. There were no warning signs at Lake Malawi, even though it was a major source of infection.

The clinic was fundraising to build and equip a maternity ward and hoped to eventually reach community health centre status. Despite limited resources, their impact was clear and deeply felt.

Meeting with the Bishop and the Diocese of Mangochi

Meeting the Bishop was surreal. Appointed by the Pope, he spoke calmly about his work across the Diocese of Mangochi. He told us that the Bishop’s House was property of the Vatican, the same way embassies are part of the country they serve.

He shared stories about walking from Blantyre to Zomba as a young priest to fundraise, and about bishops’ mandatory retirement age of 75. The visit offered a rare glimpse into the Church’s influence on healthcare and community life in Malawi.

Dedza

Dedza was a welcome breath of fresh air, quiet, scenic, and full of pottery. It was one of the few moments where the heaviness of the needs assessment lifted, and we enjoyed seeing local artistry firsthand.

Curios

Throughout Malawi, we saw stalls selling wooden curios, beautiful hand-carved works, often from mahogany. What stunned us was the pricing. Items that would sell for €100 in Europe cost the equivalent of about $8.75 locally. It was a simple but sobering reminder of the economic gap we’d been witnessing all week.

We brought some home for fundraising events, knowing they’d tell a story far beyond their artistic value.

📅 Week 3:

The Catholic University of Malawi

At The Catholic University of Malawi, we met lecturers and students from its nursing program. With more than 6,800 students, and 335 in nursing, the campus was busy and full of life.

Their nursing curriculum covered everything from community health and trauma to mental health and surgery. They had partnerships with ten clinical sites but wanted deeper collaboration: curriculum review, capacity building, grant writing training, mentoring, and more research opportunities.

The simulation centre had a good foundation but lacked key items like CPR manikins, stethoscopes, anatomy bones, and ECG leads. Even small investments here would go a long way.

A visit to Ntauchira Village, displaced by Cyclone Freddy, showed us what their community health work looked like in practice. Students led songs on family planning and essential health behaviours, while villagers shared concerns about water safety and rebuilding their livelihoods.

Meeting the Irish Ambassador — Kate Brady

One of the most memorable moments of our trip was being invited to tea at the Irish Ambassador’s residence. Ambassador Kate Brady welcomed us, along with a group of students from the University of Galway, with genuine warmth and openness. The atmosphere felt familiar and comforting, almost like stepping into a little piece of home in the middle of Malawi.

As we spoke over tea, the Ambassador shared her concerns about Malawi’s financial situation, especially the recent defunding of USAID, which has long been one of the country’s most important development partners. She explained how deeply USAID’s support has shaped healthcare, education, and community programs across Malawi, and how worrying it is to imagine those resources disappearing. Her honesty underscored the uncertainty many Malawians are facing.

It was also terrific to meet the students from Galway. Hearing about their experiences in Malawi helped us reflect on our own, and it reminded us that Irish institutions can accomplish far more here together than alone. By the end of the afternoon, we found ourselves thinking about future collaborations, shared projects, and the potential of building a broader Irish student network in Malawi.

Leaving the Ambassador’s residence, we felt not only welcomed but connected, to each other, to home, and to the work ahead.