Southern Ethiopia - Gwent Health Link

Venue: EDUCATION CENTRE NEVILL HALL HOSPITAL

Present

Alan Terry, Wendy Warren, Sally Venn, Carole Garrick, Grace Thomas, Robert Williams, Jill Curtis, Jane Herve

Minutes of the last meeting

Minutes of the last meeting were agreed as an accurate record

Matters Arising

Dave attended the ‘Wales for Africa Link’ group meeting in Biku’s absence. Biku was elected chair of the group.

Melrose will attend as representative from the Gwent link.

An advert will be placed in the January staff payslip encouraging them to give time and/or money to the link.

Biku has been in touch with David Higgs in Caerphilly Miners hospital and is following up the offer of equipment.

A DoH Circular (October 2006) was issued encouraging Trusts to support staff with professional leave whilst working in developing countries. All Trust staff who had recently travelled to Ethiopia with the link had received professional leave. Peter will contact Wendy Warren to ascertain if there are any problems supporting staff with professional leave.

Wales for Africa Health Link

This link is supported by the Chief Medical officer for Wales. The health link group was set up following the Wales for Africa Conference held in Cardiff earlier in the year and it is still in its early stages.

Members from the three main links in Wales, Southern Ethiopia Health Link, Dolen Cymru (Lesotho) and Pont/RCT LHB (Uganda) met in Cardiff on Saturday November 19th with the aim of putting together a ‘Memorandum of Understanding’ between the links which will be used to form the basis of further discussions with Dfid and others in order to capture a more sustainable method of funding. The aim is to spend ‘£1 per person per year’ across the target populations. The meeting was chaired by Jon Townley, WAG. The document will be emailed for comment.

Karen (THET) explained the funding available especially in Scotland and England.

Report of visit to Ethiopia Oct – Nov 2007

Biku reported on the success of the visit. 3 health centres will be supported with equipment and training. The health centre at Yirgalem will not be supported as it was close to the hospital and staff did not appear to be very motivated. The Regional Health Department were absent during the visit probably because they currently lack a head of dept.

Melrose explained that the midwifery skills course which ran the first week was attended by 48 nurses/midwives. It was noted that many had travelled several hundreds of kilometres to get to Hwassa. However the course was well received. In addition to the midwifery skills, the course participants were introduced to methods of teaching and learning which they also practiced in small groups. This was to enable them to teach colleagues at their health centres/hospitals the skills they had learnt on the course. This was ideally too large a group to teach skills effectively. The course was not taken out to the health centres as planned due to the reluctance of most of the course participants to travel further. Melrose visited two health centres – Wondogenet and Alaba. Both health centres appeared to be well run but lacked basic facilities. There were many student midwives at both health centres. There certainly appeared to be scope to work in both these health centres.

Lynn (student midwife) commented on the large number of student midwives at each of the health centres and the lack of support and teaching they received. She also noted that the women did not like to be seen by students at the health centre and this could be one reason why women did not always access the health centres.

Robyn commented on the help that she felt could be offered to the School of Midwifery at Hwassa. She noted the large cohorts of students being trained and questioned the methods of teaching and assessment. Robyn outlined the three sessions that she led on teaching and learning. Whilst initially it was difficult to assess levels of understanding, when they came to practice their teaching skills it was evident that they not only understood how to teach but also understood the midwifery skills they had been taught. This was borne out at the visit to Alaba health centre when the midwife there, having attended the course the previous week, helped in the teaching of midwifery skills to the staff and students.

Kyle explained how he led a group of 28 health officers in resuscitation skills during the first week in parallel to a group of Ethiopian doctors being taught emergencies which was supported by Jill and Paul. He used scenario based teaching and realised that without much in the way of equipment they had to utilise everyday things. The feedback was very positive. He wondered about some sort of formal testing as some of the health officers were very good and he felt that these should be identified and encouraged to be trained further. From the visit to the health centre it was apparent that there was little preparation and advanced planning for dealing with ill patients. Kyle set up an emergency area in the health centre.

Paul and Jill had visited Africa previously but not Ethiopia. He was particularly concerned with improving the skills of delivering anaesthetics to mothers in sub Saharan Africa. He noted that anaesthesia was entirely delivered by anaesthetic nurses. When visiting Hwassa, Yirgalem and Dilla hospitals he observed the practice of the anaesthetic nurses and was able to provide some informal teaching. He felt there was a potential to run CME courses for anaesthetic nurses and would be happy to facilitate this in the future. Paul was extremely impressed with the Gwent link, in particular with the quality of courses run and by the idea of the train the trainers course. He also liked the practical ways in which the link supported the health centres particularly when Biku physically took the cleaners to the town and purchased cleaning equipment and materials for them.

Peter and Pam gave a brief outline of their visit to Yirgacheffe with the Bryn y Cwm community link. Overall they had several meetings with various community groups who received the community link team very positively. Formal report will follow.

Biku concluded by commenting on the enormous support the link had received from Dr Yifru and Misganaw. Three or four health centres will be supported in the future. Considerations for the future include continuing the CME programme for midwives, teaching nurses/midwives in the health centres and preparing a course for anaesthetic nurses. As a Masters programme in Emergency surgery is being developed for the Health Officers, CME programme for them may not be as important in future. Our work in the health centres would include training issues, equipment and working with the community in particular women’s/mothers groups.

Sandy asked about the possibility of including ophthalmic training in the health centres. Biku had met with Dr Joseph, ophthalmologist he will be happy to look at this training. When the training commences equipment will follow. Sandy offered his support.

It is envisaged that a follow up visit will take place in March. A Continuing Professional Development workshop for the medical laboratory technicians working in SNNPR is expected to be arranged by the link with support from the Hwassa College. In order to provide continued support to the health centres a memeorandum of understanding need to be drawn up between the link, the individual health centres and the local community regarding responsibilities and expectations.

Karen informed the group about The International Child Health Group Annual meeting on Nov 27th ‘UK- Developing Country Links in Child Health: Why, What and How?’

Karen also explained that THET has launched its first e-bulletin. The e-bulletin will be circulated every month. Karen informed the group of two funding opportunities available from THET. £1,000 could be won in a links competition. This involves writing a story indicating how the work of your link has made a difference. Grants of up to £5,000 are available through a new funding programme launched by THET. A meeting of the Open University in Milton Keynes on Dec 4th will be looking at developing a training programme for nurses in particular in Ethiopia and Somaliland. Karen encouraged us to look at the THET website.

A photograph of the link members with the trophy and certificate given to the link during the recent visit by the Hwassa University College of Health Sciences in recognition of the link’s support since 2000 in development of the college.

AOB

Sandy explained that the Rotary has good links with schools in Africa in particular the Gondar region of Ethiopia. See website. Sandy offered to help.

Open University meeting Dec 4th – Robyn to attend.

NHS Wales Health Links, £50,000 available. Submissions to be in by early Dec. Biku, Carole and Robyn will put together a proposal.

THET story competition. Melrose to enter a story.

Next visit to Hwassa will probably take place during the first two weeks of March

Next meeting

January 9th 2008, 5.15pm, Education Centre, Nevill Hall Hospital