Miriam Nandi

Miriam Nandi

Norwegian living in Malawi.
Profession: Radiographer, MSc Imaging (UoE) and MSc Public Health (LSHTM).
Work interests: Imaging, Public Health, Conflict Zones, working with children.
Open for project-work

Location Malawi



  • Miriam Nandi made a comment

    It was interesting to hear the change in their attitude towards AI. Change is difficult due to many factors (uncertainty is one), and seeing the advantage and possibilities of AI together with one's role in the change is positive.

  • Miriam Nandi made a comment

    AI has evolved tremendously in the industries as we have just seen.

    I have a background in radiology, where CAD (computer aided detection) have been used for several years already especially within breast cancer screening. It is also evolving to broader areas and there are discussions on how to implement AI in different cancer programs to optimise and...

  • The test was a good recap of week 1. There's nothing specific I'm unsure about but I'm looking forward to gain more in-depth knowledge and understanding during the next weeks. No answers surprised me and I was happy with the thorough explanations that came with them.

  • Miriam Nandi made a comment

    There are many good thoughts in the previous comments. One point I want to raise is that it is crucial that the learning that AI acquires is correct, as it constantly evolves based on this.

  • Miriam Nandi made a comment

    I'm not sure when I first heard about AI, but have seen several movies with robots acting like humans. We have alexa in our home, and siri on the phone.
    I think it's an interesting phenomenon and look forward to explore it more in this course.

  • Miriam Nandi made a comment

    I answered very unsure, like only 2% of the rest. Think I have a lot to learn from my peers as well as the tutors/mentors!
    The reason I chose this option is that AI is very new to me, especially in my workplace.

  • As my knowledge about AI is very limited, I am exited about all the learning outcomes for this week!

  • Hi, I live in Malawi. My motivation for joining this course is that I want to learn more about AI, especially within health care and radiography.

  • As several has mentioned previously, I think resources are a major obstacle to developing and maintaining an emergency plan. There are several different scenarios of different magnitude which could be embedded in a plan, and it might be time consuming and costly. Then there is the need to train for each scenario. Some scenarios might have overlapping parts but...

  • For an organisation to be properly prepared, they need to have ownership of the plan. Everyone that has essential roles in the plan needs to be aware of their role and what their duty is in the case of an emergency. A plan can be really good, but if the people carrying it out don't know the details and their role it will not be an efficient response.

  • Hi, I live in Malawi, have a background in Public Health and I'm a part of the Norwegian Red Cross Emergency Response Unit. I joined this course as I find emergency planning preparedness interesting and want to learn more about it, especially how to make new plans and how to improve existing plans.

  • In theory I prefer making decisions based on logic, but in real life I make them more based on emotions.

  • Hi, my name is Miriam and I live in Lilongwe, Malawi. I newly graduated from LSHTM with an MPH (distance learning), and I'm working at a local agency doing research and training. It is special times now and I think Malawi is one of the few countries where the virus hasn't spread officially. Even so, schools are closed and there are major travel restrictions,...

  • I was attracted to the course as I want to expand my knowledge about EI. I expect to achieve more in-depth knowledge about EI, and how to better handle emotions (my own as well as others). Knowledge of EI and how to manage emotions is always helpful both personal and professional.

  • Hi, my name is Miriam. I live in Malawi, and work for an agency doing research and training. At the agency we also provide some courses which touch on emotional intelligence so I want to learn even more. Personally I am better at managing emotions at work now than previously, but I can also gain at learning more. I sometimes get very worked up during arguments...

  • It was gripping to read through all the previous comments.
    Unfortunately I cannot make my mind up on what to focus on. There is so much I would like to change and I find it difficult to focus on one area.

  • @NicoleGrissom Great focus for change! Hope you share some thoughts you have on how to do this later in the course.

  • @cilaUamusse Very interesting topic. Look forward to hopefully read more about your project later.

  • @ChrisHolly Would it be possible to also focus on what people can do to reduce the amount of litter, on both personal and community level?

  • @NatalieKeffler This is a very important focus. It is difficult to understand some governments handling of refugees.

  • The change analysis tool help you analyse the circumstances regarding the change situation. You analyse different perspectives on multiple levels making you understand the context and factors of change. Some of these factors can sometimes be transferred to other situations where you want to make change happen.

  • I can't choose one thing. As already mentioned, there is so much injustice in the world. I come from Norway and live in Malawi. Most people cannot comprehend the huge differences between these two countries; one of the richest and one of the poorest. These differences can be found at all levels. I would like privileged people to actually understand how the...

  • A good understanding of self makes you understand the different power relationships you have in your relationships, and how you should proceed in your role as changemaker.

  • A very good start point for the change process. I would say it’s equally important to think of these factors in light of the environment in which you want to implement the change.

  • Thanks again for an interesting course with engaging discussions. I appreciate both the content and the way you interact with us learners. Will definitely look into your website and make use of the materials you have there in the future.

  • If a colleague works in a different way than what I expect, I would approach my colleague and ask what he/she does in those cases, and why. This should be done in a friendly manner. This way you get some information on the reason behind the behaviour, and you can take it from there.

  • Miriam Nandi replied to [Learner left FutureLearn]

    @BenjaminOsaka I'm glad you are bringing up this point. As @ElisabethMStrømme and @NicolaJames points out, violations of treaties can be brought to a court. However, as discussed in a previous course, this rarely happens (as to my knowledge). In many cases I find that there are so many documents/treaties/laws and so much focus on violations on the paper, but...

  • Miriam Nandi made a comment

    Disclosing this information will make Peace re-live what happened. This will open a door to many feelings, and it is difficult to predict which ones she will feels the most. As mentioned below it is crucial to make an assessment on how you think they will feel after this, and that they have someone to take care of them. If they don't have anyone they should be...

  • Maybe the doctor could have mentioned support groups, and given Peace the feeling that she was not alone.

  • Working in a refugee camp in Bangladesh, I have met many patients with several of the symptoms on this list. I do not know how many of them had been tortured or whether their behaviour were due to other things. Nevertheless I am sure that they all had been through a lot. Many of my patients just stared blankly at me even though I know they were in a lot of...

  • Dr Talbot probably thinks that Peace's symptoms is due to TB, and maybe he expects the symptoms to go away after she starts the treatment. Or he might be too busy to deal with more than one problem per consultation.
    I do not like his approach, which is very straight forward. It lacks communication, as he has not explained or discussed the situation with...

  • Miriam Nandi made a comment

    From my experience, you do not need to show proof of identity, immigration status or proof of address in order to access medical care here in Malawi.

  • I do not know which definition is used where I live (Malawi), but I find it strange that the UNCAT definition is so narrow as to only apply in cases where the abuse is performed by public officials.
    In my opinion, the ECHR definition makes more sense. Which of the definitions are most widely used?

  • Here in Malawi everyone has the same access to government hospitals and health clinics. However, they are many times understaffed and you might have to wait for a long time. There are many private clinics. Some offer treatment for free if you don't have money, but most has to pay. For poor people also transportation is a problem.
    Private health insurance is...

  • Here it is not common to use professional interpreters. We use colleagues, families, or sign language. I think costs is the biggest barrier, and then it is availability.

  • I worked in a refugee camp in Bangladesh last year. We had translators, but there were not always enough. In my case, working as an X-ray technologist, I used body language to explain the procedures.
    Here in Malawi, the patients' stories does not always comply with the disease presentation. It is important to be aware of cultural differences. This can be how...

  • I haven't thought about the difference in psychotherapy methods for people with different cultural backgrounds. In the western world it is so usual with one-to-one, but it makes sense that another approach might be better for people who are used to the healing power of the community.

  • As said below, the incubation period is crucial. If there is any well grounded suspicion of a contagious and devastating disease as Ebola, protection measures should be taken (which of course should include communication to the patient as why this is happening, and that it is also in the patients' best interest).
    As in the leprosy case above, I do not...

  • Living in Malawi, the views of patients from rural villages on medicine and disease often differs quite a lot from that of western medicine. Many patients believes they get a disease due to something bad they did, and that it has come with bad spirits. They go to the local medicine man before coming to the hospital, which often leads to the disease having...

  • In the central hospital where I worked in Lilongwe, everyone had the right to treatment. We actually had people crossing boarders to access the treatment as they did not have the same opportunity in the neighbouring country.
    However, there are people in a refugee camp quite close to Lilongwe that suffers due to neglected health care. The free care at the...

  • Everyone has the right to proper health care treatment, whether you are a refugee or not. If there is a big influx of refugees, the government can seek assistance from medical NGOs like MSF, or the Red Cross movement, to handle the situation in a proper manner form the beginning. These organisations have good experience with such situations and can help build...

  • An outbreak has other consequences than deaths, as it affects many of the socioeconomic factors. The more prepared we are for an outbreak, the less impact it will have. That being said, the priorities of outbreak preparedness must be weighed against other public health issues of the country, and the country's budget. Outbreak preparedness should have a...

  • Hi, I am a radiographer living in Malawi. I have an MPH and work in the Red Cross emergency response unit. All this makes disease outbreak relevant both professional and personal, and I joined this course hoping to learn something new and to interact with other learners.

  • I think that there are few, if any, in Malawi. There might be some by the government or NGOs, but I am not aware of any.

  • In the country I come from, Norway, we have an obligation to report.
    Where I live now, in Malawi, I am actually not sure what the law says. I do not think the system is in place for reporting. But, I will find out from my colleagues.

  • Miriam Nandi made a comment

    I have had positive replies when using a method similar to the last point. You kind of tell them that this and this sometime happens, and wonder if they are in the same position (but by no means justify what happened). It makes them feel that they are not alone.

  • Case finding requires less resources than screening, but the staff needs to have the knowledge and experience to find the right cases. It's difficult to say which method has the best sensitivity and specificity, as this subject is also quite dependent on the health care workers' skills. You can screen as much as you want, but many people will not open up...

  • As mentioned below, the death rate is only the top of the iceberg. It does not say anything about all the victims that survived, and are living with the traumas from DV. These victims are suffering and needs support form the health care systems.

  • @FrancesW You have many interesting thoughts. I think our stereotype image of a DV perpetrator is male. I suspect there are many dark figures in this area, and maybe especially when it comes to female perpetrators. As female perpetrators don't fit into our typical stereotype it might be difficult to recognise the situation for health care workers and others,...

  • Hi everyone, I am from Norway, living in Malawi. I just finished another course here on Futurelearn which was based on medical peace work and found it very interesting. I am a radiographer with a background in public health. I think I will find this course relevant to my position as an X-ray technician in the Red Cross emergency response unit.

  • I had high expectations for this course, and you managed to exceed them with sobering videos, simulations, interesting articles and good discussions. Thank you.

  • I think the basis of our capitalistic society needs to change. People want to do what they want, buy whatever they want, go wherever they want without looking at the wider consequences. If you get sick, you get all the diagnostic tools available, you get the medication/treatment needed and then you can continue living your life. This picture is very...

  • Miriam Nandi replied to [Learner left FutureLearn]

    It is an interesting discussion about the 80% reduction target. At the hospital I worked at in Norway, a lot of the instruments and supplies were wrapped up in plastic and only used once. I am sure they can do an 80% reduction quite easily. At the hospital in Malawi, a lot of the instruments are wrapped in cloths and very few in plastics (mostly one time uses...

  • The poor, elderly, pregnant women and small kids are the most vulnerable to climate change due to their economic and health situation. Farmers are also vulnerable to climate change as they are in risk of loosing their livelihood.
    The price of maize has already increased with 20-40% since June, and it is going to increase even more the coming months. Since...

  • We have a high incidence of malaria in Malawi. I do not know the statistics, but antimalarial drugs are easily available and in many cases people start with antimalarial drugs when they present with fever (without testing). I think that this, combined with climate change, will increase the incidence of multi-drug resistant malaria. Unfortunately, I do not...

  • Earlier this year heavy rain and cyclones hit our region with devastating consequences. Mozambique was more affected, but in Malawi at least 14 districts were impacted affecting more than 450,000 people. More than 31,700 people were displaced and at least 30 people killed (Source: https://reliefweb.int/report/malawi/malawi-floods-briefing-note-12-march-2019)....

  • I think everyone has a responsibility to engage in the debate on nuclear disarmament and nuclear safety, be it health professionals or others. As someone stated earlier in this course, I don't think people in general are aware of the huge health impacts it can lead to.

  • It is best to work for prevention of violence. However, where violence has broken out, health workers are needed. All people are human beings and should be treated humane from a health workers perspective.
    I have not been involved in armed conflict or war, but have been trained to work in those environments through the Red Cross.

  • The role as a healthcare professional in all kinds of crisis is to be professional and do the best he/she can. I think the simulation taught us a lot of what we should do in case of a nuclear confrontation.
    In Norway it is recommended for people between 18 and 40 years to have iodine tablets at home in case of a nuclear attack. This will not help if you are...

  • My biggest problem is that I would have died immediately, going into Berlin. After that I made some decisions which were too harsh (I thought 85% burns was too much and did not want to use helicopter resources for that).
    I have learned that when something happens you should take a moment and think properly to find the best solution and not just jump to...

  • Interesting simulation exercise. I learned a lot.

  • A powerful introduction to week 2, introducing why nuclear weapon is a part of this course. As with the previous week, I think the simulation and the following discussions will be both educational and interesting.
    This might be a subject that more people fear as it feels more threatening and devastating to our world.

  • Very interesting video.
    I also still agree with nurse Aisha, and think that she is a good connector to the specific community. The colonel and the military can be seen as dividers.
    Maybe it would be helpful for Dr Samoe and the vaccination program if they made a plan to visit several communities with different cultural background in the future, so that the...

  • The Do No Harm framework seems like a good approach when you work in violent conflict settings. It requires you to think through all the important aspects of the situation seen in the context of the conflict.

  • I agree here, it's a no from me as well. To coordinate with the local leader is much wiser in a situation like this. This will also increase the acceptance among the people in the area.
    To use a military escort for delivering health care should be avoided whenever possible.

  • I agree with you Anne. As I understand, it takes a long time to investigate and prosecute violations of the IHL, and the sentences are not in line with the violations.

  • With the military already in place, the humanitarian principle of independence is already threatened, together with impartiality and neutrality. Impartiality since some people might not access treatment due to the presence of military, and neutrality since people might perceive the hospital to be collaborating with the military.
    In Dr Samoe's position, I hope...

  • This is my interpretation of the four humanitarian principles:
    Humanity is the basis for humanitarian work; protect life and health, and ensure respect for people. Neutrality is that you should not take sides. Impartiality is that humanitarian work should be based on needs alone, and there should be no discrimination (both positive and negative...

  • As many has mentioned before, the immediate priority will be the safety of the patients and the staff. The best would be if it does not affect access to treatment for the patients. For some it might feel safer with the military surrounding the hospital, but this is thought to restrict access for some patient groups. For others the military might feel as a...

  • Miriam Nandi made a comment

    My immediate reaction is that the Governor and politicians were quick to blame insurgents for the attack. No one has claimed responsibility.
    There are always several sides to a story. Here the attack was aimed at the kitchen, leaving a relatively small number of kitchen staff with minor injuries. No in-patients were reported injured, and there is no reports...

  • There are many situations where health facilities and health care workers have been targeted by violence. I think the MSF campaign #notatarget started as a reaction to this.
    Albeit there are many others, here are some MSF facilities that has been targeted in the past (and more information about the campaign): http://notatarget.msf.org/

  • Last year I worked as an X-ray technician in an IFRC field hospital in Kutupalong, outside Cox's Bazaar in Bangladesh. Most of our patients were people who had fled from Myanmar and who were living in the refugee camp. Some of my patients were victims of violence, both domestic and external. As we didn't speak the same language I mostly used body language....

  • Several forms of violence other than direct violence has already been described. I would like to emphasise lack of education and to loose your identity, the latter may be a result of being forced to hide who you really are (e.g LGBTIQ). In addition, in some places there is a lack of access to proper healthcare, which may affect both the need of well-being and...

  • Miriam Nandi made a comment

    Hi, I am a radiographer from Norway, living in Malawi. My interests in this field overlaps with my work in the Red Cross Emergency Response Unit and my master in public health from LSHTM. I am looking forward to gain more knowledge about medical peace work, and to interact with both tutors and peers.

  • Working in radiology, we are often involved in the process of making a diagnosis. We are however not the persons who takes the final steps and talks to the family about it. In our setting we treat these kids as we do all kids; based on their individual needs and give them the support needed to get through the examination, while trying to make it a positive...

  • I wonder how much of the increase in prevalence of developmental disability in sub-Saharan Africa from 1990 to 2016 (70%) is due to differences in data reporting, data collection method, region captured etc, or if there actually was a high increase like the data suggests.
    Having worked both in HIC and LIC, I see a huge difference in children being born with...

  • Hi, I am a radiographer working in Malawi. I have hopefully finished an MPH at LSHTM this year (distance learning). I joined this course because I think it is useful both professional and personal to have more knowledge about children with developmental disabilities.

  • In general it has worked fine. The only thing I can comment on would be to shorten down videos or have alternative versions for people who have bad internet access.

  • No worries, internet much better now so managed to watch it.

  • Miriam Nandi made a comment

    Thank you for putting together a video answering questions.
    However, I cannot watch the video due to bad internet connection here in Malawi. Do you have an English transcript?

  • I do not work in this area, but when I worked at a field hospital in Bangladesh last year I met some children who were travelling alone. One of them disappeared from the field hospital the same night he came even though he was scheduled for an operation. He seemed very afraid, and he probably did not understand the situation. Maybe he was told by someone to...

  • I live in Malawi, and unfortunately I am not sure whether there is family-based alternative care offered to unaccompanied and separated children in your country? I imagine that some challenges with alternative care in this country is the economic situation for the country and many of its residents. I think informal family-based care at relatives' home is the...

  • When people work together, the system can become stronger and more resilient, given that everyone can collaborate and the efforts are put into a meaningful manner.
    Two challenges when working within a national child protection system can be lack of resources and too many organizations trying to push through their agenda with no or little consideration of the...

  • I do not work in this field, but in the media there are cases about kids and adults that are being sent back to their country of origin against their will; they say they are in danger there. If this is true, it violates the principle of non-refoulement.

  • Hi Chrissie, I do not think it is a reliable measurement. The standards are mostly based on older research on Caucasians (which might not be transferable to non-Caucasians) , and in addition to this skeleton growth varies quite a lot. The skeleton growth plates usually close when you are between 16-20 years - which is a big gap!

  • Miriam Nandi made a comment

    I do not have any experience directly related to the work of unaccompanied and separated children yet, but I found it interesting to learn about methods used.

  • I think there are multiple barriers to children’s participation, and that many of them vary depending on the context. Culturally it can be seen as unacceptable that children participate in decision making as it is an adults' responsibility. It is an old saying that children shall not be seen nor heard.. Other examples of barriers can be the mental state of the...

  • As a case worker you need all the skills mentioned here, but to see each child would be on top of my list. This is important to build trust, make them feel valued and to work together. You try to meet each child at their level psychologically and work from there.

  • I have not worked directly with this, but when working in a radiology department in Norway we sometimes got children for X-ray to determine the age of the child based on the skeleton growth of their right hand. This is usually done as a last resort to determine whether they are kids or not based on the growth plates.

  • Miriam Nandi made a comment

    What surprised me the most this week was the amount of guidelines and reports available on the same subject. I do understand that it is necessary to have guidelines, research and reports on the situation, but somehow I feel like this drains resources from the front line, from where people actually do the hands on work with the unaccompanied minors.

  • This is a complex situation which shows us that the world is not black and white, there are many nuances in between and people sometimes have to make hard choices based on what they think is right. It looks like they have a good family relation, but with the uncertain future and possible violence it is not hard to understand that Aden's parents wants to give...

  • Hi everyone, I am really sorry for joining late but hope to catch up within the next week. I am in the middle of the exams for an MPH at LSHTM, distance learning from Malawi. I work as a radiographer at the central hospital in Lilongwe, and I am also a part of the Norwegian Red Cross ERU team.
    I met a young boy who traveled alone in a refugee camp outside...

  • To not provide health care for the local community is not ethical nor impartial. All people should be treated the same and health care should be provided based on needs and principle of equity. This being said, the resources in the camp is constrained and we need to have a dialogue with the government to try to re-open the local health facility or approach...

  • To treat patients based on need assessment is important no matter what kind of crisis there is. Staff security is also important in natural disaster and disease outbreaks.

  • This video was informative, but I miss research on the vulnerable groups. As we have seen previously in the course these groups are important and we should have interventions that are evidence-based hence we need research focused on vulnerable groups.

  • There are many reasons why people do not seek help for sensitive health issues. Especially for mental health issues it might be difficult for the person to understand that they need help. If the condition develops slowly it is difficult to see it yourself. If the condition arise from a traumatic experience it might be too overwhelming to seek help. For all...

  • I agree with all the others here - the IHL is very important. Imagine a world without it.. However, as discussed previously and mentioned also here by others, the perpetrators of the IHL are rarely brought to justice. For the laws to still be meaningful in the future we should work for the perpetrators to be brought to justice for their violations.

  • In February this year I was in Bangladesh, working in a field hospital located next to the refugee camps for Rohingyas fleeing from Myanmar. My biggest challenge was the limitations we had, both for me and for the team. What we can do is limited in so many ways. The people we met had experienced so much and some of them were all alone, both kids and adults;...

  • The basic need assessment for the situation is already in place, and we know that the focus areas are sanitation-related diseased and trauma, both physical and mental, caused by the typhoon. As we in WHO is the health cluster lead, it is important that we collaborate with the government and local and international NGO’s that belongs in the health cluster. It...

  • Reading this I am curious about the accountability part. According to the text few Heads of State have ever been charged for violation of IHL. Please correct me if I am wrong, but it seems like it is the nations' responsibility to press charges. Nations where such gruesome acts have occurred are probably not in a good position to press those charges,...