Malawi earns first adult neurologist in Dr. Tiwonge Phiri

Dr Tiwonge Elisa Khonje Phiri has just earned the speciality as an Adult Neurologist in Malawi obtained at Fellowship in Neurology at the University of Stellenbosch, South Africa.

She was trained at Tygeberg Hospital in Cape Town and she joins Dr Macpherson Mallewa, who is the vice-principal at the College of Medicine in Blantyre as a Paediatric Neurologist.

The doctor, who did her undergraduate medical training at College of Medicine where she obtained her Bachelor of Medicine, Bachelor of Surgery (MBBS) degree in 2008, says she was prompted to pursue this speciality is that she has always been fascinated with neuroscience.

After graduating from the College of Medicine, she then did internship at Kamuzu Central Hospital for 18 months and thereafter, she was posted to Blantyre District Health Office as a Medical Officer.

“In 2011, I joined Johns Hopkins Research Project where I worked as a medical officer and later as a study coordinator.

“While working at Johns Hopkins, I had the opportunity of participating in a protocol which involved Paediatric Neurology. It was then, when I realised that there was a gap in Adult Neurology.

“I then immediately applied for enrollment at Fellowship in Neurology at the University of Stellenbosch for the training in 2014 and trained at Tygeberg Hospital in Cape Town, South Africa,” said Phiri.

She described Neurology as a branch of medicine which deals with disorders of the nervous system.

“This consists of the brain, spinal cord, peripheral nerves and muscles. A neurologist is a physician who specializes in diagnosis and medical management of disorders affecting this system.

“On the other hand, a neurosurgeon specialises in diagnosis and surgical management of disorders of also the same system.The list of conditions requiring the services of a Neurologist is long. Some of the conditions commonly seen in our clinics include strokes, headaches, Epilepsy, spinal cord, neuromuscular and movement disorders,” said Phiri.

She continued: “We also see patients with sleep disorders, infections and inflammatory conditions involving of the nervous system. We do also work closely with Psychiatrists and Psychologists in the management of some cognitive or behavioural disorders.”

Phiri says like in all fields of medicine, good history taking from the patient is a prerequisite for proper management of patients as most neurological conditions require extensive investigations which might be quite expensive and may not be readily available in Malawian setting.

“However, conditions like epilepsy, strokes, movement disorders and some neuromuscular conditions can be easily diagnosed with good history.

“In terms of investigations of these conditions, most of them are investigated with the regular laboratory studies with exception of a few conditions where specific tests may be requested.

“Neuro imaging with CT, MRI, PET, dopa PET scans also plays a critical role in diagnosis of neurological conditions.”

She added that management of neurological conditions depends on their cause, saying medical treatment is mostly used in management of these conditions and if surgical intervention is required, the patients are referred to the neurosurgeons.

“In a resource limited setting like Malawi, there is still a lot more that a neurologist can do. As previously said, some of the neurological conditions can be easily diagnosed with minimal investigations.

“Involvement in research is also another avenue; we need to know the common neurological conditions in our setting and develop cost effective management plans.”

What are the highlights of your career apart from this new achievement?: “The highlights have been the wonderful people I have met throughout my training.

“I have interacted with great minds in the various fields of Neurology within South Africa and abroad through the various congresses I was given the opportunity to attend.

“The knowledge I have acquired is immense and it is my prayer that God will be able to use my expertise to assist many people requiring my services.

Asked if she will go for further training  if opportunity arises, Phiri said: “Life is a journey; it never stops teaching us. Neurology like everything around us, keeps evolving.

“To ensure that quality neurological services are provided in Malawi, training of some sort may be inevitable at some stage. I would not say that this is it,” said the doctor, who is still in South Africa completing her MMED project with the University of Stellenbosch.

“I will be returning to Malawi at the end of this year when this is done,” she said.

To the youths aspiring to do medicine, Phiri says: “My advice is that their dream is possible. With hard work and determination, they can achieve this.

“Those who have attempted and not succeeded; don’t give up your dream. Keep pressing on, you will get there.

“And to the youths already in medical school, my advice is keep working hard and persevere. No matter how tough the going gets, hold on, everything will actually come to an end,” said the good doctor.

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