Madeleine: So the time has come, even though our whole lives have recently changed, it is hard to believe the project is really happening. Meeting with the Kenyan team is something we have all been waiting for. I am with the youngest team member, Lucas 24/7 and I am getting to know every crevice of the eye department at the Nakuru District Hospital very well as Lucas goes exploring. We watch football games over the fence, run in the VERY heavy rain, toddle up steep slopes of stone hoping my flat shoes are not going to give way and teaching Lucas about the retina from a wall poster. In between being an eye hospital explorer we are part of the team meetings. The project’s office manager, Redempta, has been incredible, showing us the ropes since we arrived and lending us our car! We will introduce you to the team one by one as we work through the clusters! What excites me is this is a team with a lovely diversity of age, skill and clinical know-how. Andrew has begun training the team and will continue till the end of next week …here we go.
I asked Redempta what she though the team would like for a first bake, she said a cake so I thought I would stick with a tried and tested recipe…well I only changed it a bit to use millet flour instead of rice flour and I couldn’t find any ground almonds so I ground down ground nuts (fresh peanuts).
Before we left the UK, Andrew was invited to write a blog entry for the Medical Research Council. Here it is:
Serendipity in Science
Seven years ago as a very junior doctor attending an international health conference I found myself sitting in the wrong room at the wrong time. As we went around the room introducing ourselves, it dawned on me that I’d misread the programme and the session I thought was on healthcare in Africa was actually on making the most of medical school.
When it got to my turn, I explained apologetically that I was in the wrong session and introduced myself as a wannabe ophthalmologist (eye surgeon) with a dream of working in Africa. I contemplated daydreaming the rest of the session away, but as the introductions continued, I heard another man apologising for also having misread the programme. At least I wasn’t the only one.
This wise-looking man, it turned out, was Nick Astbury, the then president of the Royal College of Ophthalmologists. I listened in disbelief as he explained his plans to establish a programme linking eye hospitals in the UK and Africa. When the session was complete, he took the time to listen to me and later put me in touch with people establishing a link between the Leeds NHS Trust and Madagascar, in which I became involved.
Since my time in Madagascar I have completed the majority of my ophthalmology training and am now doing a PhD at the International Centre for Eye Health (ICEH) in the London School of Hygiene and Tropical Medicine (LSHTM).
I’ve also been combining my geeky fascination with technology with my passion for eye health. Branching out into smartphone apps and hardware was unfamiliar territory and I thought that finding an affordable app designer with the right combination of experience, coding ability and understanding of international health would be almost impossible.
Yet I returned home one evening in March to find my wife beaming — her friend who’d just returned from working in Cambodia had this “app designer friend” looking for an international health project. He has now worked tirelessly for months for nothing.
Equally incredible, my search for a precision engineer to build the hardware lasted less than 24 hours. The man behind a microscope attachment for a smartphone that I’d read about turned out to be a good friend of my new next-door neighbour, and he has also generously given his time and skill free of charge to make this project work.
We now have a working prototype of the smartphone ‘eye clinic’ (The Eye Phone) ready for testing.
Nick Astbury is now a colleague at the International Centre for Eye Health and the UK-Africa network is thriving, with more than 20 partnerships established.
I have been an ophthalmologist for six years and I love it.
And next week I’m moving with my beautiful wife and toddler to live and work in Kenya.
Funny how things work out…
For the full article as it appeared on the Medical Research Council website follow the link: http://www.insight.mrc.ac.uk/2012/10/11/serendipity-in-science/
Andrew: In our first trip in January, 8 months ago, we recruited the majority of the study team, many of whom are based in the eye department of the public hospital in Nakuru. It was great to see some familiar faces again. We will spend many hours and days over the coming months travelling and working together and I hope getting to know one another as friends. After a short presentation on the study and establishing the various roles that would be needed, it became apparent that I was surrounded by good people. Initially everyone was very quiet and slow to share ideas or opinions and gave very little away. After a while some enthusiasm became evident which reached it’s peak when Madeleine explained the baking challenge (https://toddleradventure.wordpress.com/about/) and shared Butternut squash and orange muffins with everyone!
Andrew: We retuned the next day to begin training. Having gone to great lengths to get this camera and transport it from the UK to Kenya, we were on the final leg of the journey for it to be unveiled. Lugging the retinal camera and equipment down 3 flights of steps from our flat and then driving on the non-tarmac road to the hospital was not good for my back or the car. We arrived safely, as did the precious (still working) equipment. Halfway through the camera (v expensive!) demo it started to down pour. We had several power cuts meaning the camera shut down and would require restarting, only to happen again and again. One of the the many challenges that lays ahead. The sound of the rain pounding away on the corrugated iron roof was deafening and near impossible to hear or be heard. Droplets of rain seeped through the roof on to the table and with a mad dash we covered up the camera to protect it. The rest of the afternoon was spent shouting over the rain teaching the protocols for measures such as blood pressure, weight and hip circumference. Tomorrow the training continues and we are hoping to kit out the office in preparation for starting field-work in 2 weeks time. We feel privileged to be here and can’t wait to get started.
Ingredients for muffin:
2 medium eggs
80g brown sugar
80g castor sugar (Castor sugar here is finer than our castor sugar but not as fine as icing sugar)
200g grated butternut squash
Finely grated zest and juice of one orange
50g millet flour (or rice or plain)
50g plain flour
100g ground groundnuts (raw peanuts) or ground almonds
2 level tsp baking powder
pinch of salt
Ingredients for Orange butter icing:
6 tablespoons of softened butter
250g icing sugar
Finely grated rind of one orange
Method for muffin:
1. Preheat oven to 180°C and place 12 muffin/large cupcake cases in a muffin tray.
2. Whisk eggs and sugar into a large mixing bowl for 5 minutes until pale and quadrupled in volume. Add the grated butternut and whisk again. Mix in the flours, ground groundnuts, baking powder, salt and orange juice until all are well introduced.
3. Spoon the mixture into the cake cases until evenly distributed. Put in the oven for 20mins. They will be flat when you take them out…thats fine! Leave them to cool in the tin before placing on a wire rack to cool.
Method for icing:
Beat the butter and icing sugar for 7 minutes in a mixer until pale, fluffy and smoother, beat in the grated orange rind and a 0-2 tsp of orange juice depending on consistency and what you prefer to pipe.
Using an icing bag and nozzle make swirl patterns on the cakes as in picture. I actually find this far too much icing and if I am making them for me I just do a pretty piped small blob in the middle of the cake for a little taster. You may also find you prefer more icing.