SMP - Catriona Connelly

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SMP - Catriona Connelly

  1. 1. Scotland Malawi Anaesthesia Dr Catriona Connolly, Consultant Anaesthetist Ninewells Hospital, Dundee
  2. 2. Outline of talk <ul><li>What we have done </li></ul><ul><li>Challenges </li></ul><ul><li>Future plans </li></ul><ul><li>Recommendations </li></ul>
  3. 3. Scotland Malawi Anaesthesia- summary <ul><li>Refresher courses in anaesthesia and resuscitation </li></ul><ul><li>Textbooks on each subject donated to every delegate </li></ul><ul><li>Equipment donations </li></ul><ul><li>Total attendees so far: </li></ul><ul><li>93 Anaesthetic Clinical Officers (ACOs) </li></ul><ul><li>12 midwives, 12 Intensive Care/HDU Nurses </li></ul><ul><li>2 paediatric and one surgical Registrar </li></ul><ul><li>1 obstetric clinical officer </li></ul><ul><li>7 Malawian ACOs trained as trainers </li></ul>
  4. 4. Training in Anaesthesia- UK/Malawi <ul><li>UK- Anaesthetists are doctors. Approx 8,000 in the UK </li></ul><ul><li>Post graduate training programme of at least 7 years </li></ul><ul><li>Malawi – 4 physician anaesthetists in the country </li></ul><ul><li>Clinical Officers: 3 year training programme as clinical officers </li></ul><ul><li>18 months training in anaesthesia </li></ul><ul><li>Independent practitioners- max 2/3 in a dept but usually 1-2 </li></ul><ul><li>NO POST GRADUATE EDUCATION PROGRAMME </li></ul>
  5. 5. Getting Started: July 05- Feb 06 <ul><li>Association of Anaesthetists of GB and Ireland </li></ul><ul><li>Obstetric Anaesthetists Association </li></ul><ul><li>World Federation of the Societies of Anaesthesiology </li></ul><ul><li>Paul Fenton </li></ul><ul><li>Cyril Goddia </li></ul><ul><li>Request from Malawi: </li></ul><ul><li>Refresher course </li></ul><ul><li>obstetric anaesthesia, paediatric anaesthesia, trauma management </li></ul><ul><li>Advanced life support courses in UK </li></ul>
  6. 6. Inaugural course: Planning Feb-Oct 2006 <ul><li>Course design and key topics </li></ul><ul><li>Textbooks and course materials </li></ul><ul><li>Donated out-of-date disposables/Hardware </li></ul><ul><li>All delegates invited by local co-ordinator </li></ul><ul><li>16 Clinical Officers from all over Malawi </li></ul><ul><li>3 midwives, 2 nurses </li></ul><ul><li>Pamela Johnston, Jo Thorp, Manchula Navaratnam </li></ul><ul><li>One week </li></ul><ul><li>Mixture of lectures, workshops, M&M, scenarios </li></ul>
  7. 10. Reflections on first course: <ul><li>Lessons learnt: </li></ul><ul><li>ACOs dedication, resilience, enthusiasm, resourcefulness </li></ul><ul><li>Local co-ordinator workload </li></ul><ul><li>Course Accommodation </li></ul><ul><li>Feedback </li></ul><ul><li>Training The Trainers one-day course for developing countries- </li></ul><ul><li>Royal College of Obstetrics and Gynaecology/ Liverpool School of Tropical Medicine </li></ul><ul><li>British Association for Immediate Care, Scotland (BASICs Scotland) </li></ul><ul><li>Refresher course structured to enable training and supervision of new trainers </li></ul>
  8. 11. Planning for sustainability <ul><li>Proposal: </li></ul><ul><li>3 separate 3-day courses running concurrently </li></ul><ul><li>-obstetric anaesthesia and trauma </li></ul><ul><li>-paediatric anaesthesia and trauma </li></ul><ul><li>-intensive care medicine </li></ul><ul><li>Run each set of courses three times </li></ul><ul><li>New Malawian instructors will attend one course then teach, under supervision, on two courses in the same subject </li></ul>
  9. 12. Plan for multiple crossover courses <ul><li>3 day course ( obs/paeds/ICU) </li></ul><ul><li>DAY OFF/ Train The Trainers (TOTT) </li></ul><ul><li>3 day course (obs/paeds/ICU) </li></ul><ul><li>DAY off </li></ul><ul><li>3 day course ( obs/paeds/ICU) </li></ul>
  10. 13. Challenges <ul><li>Books/Equipment </li></ul><ul><li>Shipment of course materials </li></ul><ul><li>Accommodation for delivery of the courses </li></ul><ul><li>Funding </li></ul><ul><li>Delegate expenses </li></ul><ul><li>Course Co-ordination </li></ul><ul><li>Faculty </li></ul>
  11. 19. Feedback <ul><li>Requests for repeat courses /slides and handouts </li></ul><ul><li>Specific points about the course content ( ECT, acute pain) </li></ul><ul><li>Two weeks is too long </li></ul><ul><li>Sunday work not popular </li></ul>
  12. 20. Autumn 2008 course <ul><li>Reorganised and delivered in 6 days </li></ul><ul><li>3 ACO instructors from 2007 on faculty </li></ul><ul><li>3 new ACO instructors attended TOTT and were supervised teaching on two courses </li></ul>
  13. 22. Key challenges raised by ACOs: <ul><li>Facilitation of CPD by Malawi Ministry of Health (medical council introduced CPD but await funding from ministry) </li></ul><ul><li>David Corner/Jean Kerr- Meeting October 2009 for all interested </li></ul><ul><li>Internet access </li></ul><ul><li>( lessons from the GP twinning project?) </li></ul><ul><li>Intergovernmental collaboration: </li></ul><ul><li>Support at Malawi Ministry of Health in procuring </li></ul><ul><li>essential drugs( including oxygen) and equipment </li></ul><ul><li>(??links with international health partners UK) </li></ul>
  14. 23. <ul><li>Supporting ACOs to run refresher courses themselves </li></ul><ul><li>Multi-disciplinary courses </li></ul><ul><li>Co-ordinate future courses (all specialties) </li></ul><ul><li>-Scottish Clinical Advisory Board </li></ul><ul><li>-Local Malawian co-ordinator </li></ul><ul><li>-Scottish co-ordinator </li></ul>Future Plans and Challenges
  15. 25. International Effort <ul><li>NGOs - Unifem / White Ribbon Alliance </li></ul><ul><li>Management of maternal and paed emergencies </li></ul><ul><li>Irish MOET </li></ul><ul><li>Norwegian Paediatric anaesthesia </li></ul><ul><li>ALSO Scotland </li></ul><ul><li>Child Health Advocacy International </li></ul><ul><li>Emergency Trauma And Triage </li></ul><ul><li>English Refresher course </li></ul><ul><li>Within Scotland </li></ul><ul><li>All medical specialties </li></ul><ul><li>Nursing-Bell College </li></ul><ul><li>Medical school collaborations </li></ul><ul><li>NHS Tayside </li></ul>
  16. 26. Recommendations <ul><li>Scottish Clinical Advisory Board (first mooted in 2006/7) </li></ul><ul><li>Scottish and Malawian Co-ordinators </li></ul><ul><li>Liaison at government level </li></ul><ul><li>Listen to the front line workers </li></ul>
  17. 27. Thank-you for your attention
  18. 28. Acknowledgements <ul><li>Cyril Goddia </li></ul><ul><li>Faculty members, their families and colleagues </li></ul><ul><li>Eric Borgstein </li></ul><ul><li>Dept of O&G QEH </li></ul><ul><li>Logima International, Fife </li></ul><ul><li>( Donation of 100 sets of theatre scrubs 2007 and 2008) </li></ul><ul><li>Avian graphics Dundee </li></ul><ul><li>( banners and stationery) </li></ul><ul><li>Synermed </li></ul><ul><li>Abbott Pharmaceuticals </li></ul><ul><li>Fresenius Kabi </li></ul><ul><li>Scottish Government Humanitarian Health Fund </li></ul><ul><li>Scottish Society of Anaesthetists </li></ul><ul><li>Royal College of Anaesthetists </li></ul><ul><li>Association of Anaesthetists of GB and Ireland </li></ul><ul><li>Scottish Intensive Care Society </li></ul><ul><li>Obstetric Anaesthetists Association </li></ul><ul><li>Advanced Life Support Group, Manchester </li></ul><ul><li>Local fundraisers- runs/cycles/ceilidh/charity ball </li></ul><ul><li>Forth Valley NHS Trust </li></ul><ul><li>NHS Tayside </li></ul>
  19. 29. Scottish Faculty <ul><li>Brian Carlin </li></ul><ul><li>Paul Currant </li></ul><ul><li>Colin Donald </li></ul><ul><li>Hilary Edgcombe </li></ul><ul><li>Chris Hawkesworth </li></ul><ul><li>Jacqui Howes </li></ul><ul><li>Drew Inglis </li></ul><ul><li>Pamela Johnston </li></ul><ul><li>Barry Klaassen </li></ul><ul><li>Richard Price </li></ul><ul><li>Caroline McQuillan </li></ul><ul><li>Rose McRobert </li></ul><ul><li>Sam Moultrie </li></ul><ul><li>Vince Price </li></ul><ul><li>Michaela Salvadore </li></ul><ul><li>Susan Somerville </li></ul><ul><li>Steve Stott </li></ul><ul><li>Jo Thorp </li></ul><ul><li>Lyn Walton </li></ul><ul><li>Nigel Webster </li></ul><ul><li>Wayne Wrathall </li></ul>

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