In May 2001 members of the Harrogate Health NHS Trust visited the Zomba Mental Health hospital in Malawi. The focus of the visit was to familiarise the team with the psychiatric services available in Zomba and look at the medical input provided. The situation within the hospital and in the community is very poor. There is no consultant psychiatrist attached to the hospital and medical input is provided by a clinical medical officer whose level of training is lower than that of a UK medical practitioner. In the whole country there are five qualified psychiatric nurses and no plans have been made for after their retirement, which is imminent. Medication is haphazard and supplies limited. The patients are accommodated in poorly maintained wards.

While much of what was seen during the visit was disheartening, there was a great desire by all the staff to change things for the better. A visit to Harrogate by staff from the Zomba Mental Health hospital is planned for late 2001, with a view to exploring links with York University and the possibility of further training for nursing staff from Malawi. The need for medical input is clear, but the Ministry of Health in Malawi has been unsuccessful in recruiting psychiatrists to take up the post. However, they are very keen to discuss the possibility of recently retired consultants from the UK taking an interest in the development of their service and perhaps assisting them in this. Those who would like to explore this option or obtain additional information regarding the establishment of a further link should contact Dr Dympna Ryan, Consultant Psychiatrist, Briary Wing, Harrogate District Hospital, Lancaster Park Road, Harrogate HG2 7SX (tel: 01423 553 683).