Through years of working overseas I know that partnership is the key to activity being of mutual benefit to healthcare and participating health professionals.
ellis prof judith web
Overseas governments and health professionals understand the needs, opportunities and limitations of their country and – however well meaning – education and practice development activity can only succeed if it is planned and delivered in true partnership.
The increasing in-country presence and employment of local staff by the Tropical Health and Education Trust (THET) supports this approach and better coordinates the plethora of well-meaning educational initiatives for health workers that are being undertaken in resource-limited countries. THET also has the trust of funders, which is vital in some developing countries. Schemes can be supported in the knowledge they will be of a high standard, with adequate financial and risk management.
It is thought difficult to quantify the impact of education delivered by UK health service staff beyond quantifying days of delivery and individual reach. But, in practice, there are observable specific differences: the use of intraosseous access in cholera outbreaks; fewer cases of inhalation pneumonia from teaching staff and carers; knowing how to ensure nasogastric tubes are in place; fewer cases of measles; increased uptake of breast feeding; and, hopefully, through medical technology training we will see less donated equipment broken and discarded to rot.
The benefit is definitely two way. Working in resource-limited environments boosts the adaptability of our UK health professionals and helps them see the importance of putting both countries’ resources to their best use – as an example, partner health professionals have used empty mayonnaise bottles to deliver continuous positive airways pressure while staff returning to the UK are challenging the use of ventilation for days following some cardiac surgery as outcomes have been shown to be no better than those in environments where no ventilation is available.
Learning gained overseas reinforces UK practice, and ensures we appreciate the resources we have available and use them correctly. Hearing high-pitched cries of pain in a hospital where there are few painkillers and death is the only outcome will affect practice for life.
The willingness of individual UK health professionals to not only share their expertise but also support and learn from international colleagues is undeniable, with many using their annual leave to do so. The NHS is also stepping up and, even in this time of austerity, some employers have grasped the importance and value of releasing staff to undertake such activity. Disease knows no boundaries, as highlighted by the 2015 ebola outbreak in West Africa and the rise of tuberculosis.
Health professionals must work together to prevent the spread of disease and develop a worldwide health workforce that can rise to whatever challenges lie ahead. In our multicultural country, it is vital that our health professionals have an appreciation of different cultures, beliefs and the health challenges we all face.
The world also shares the challenges of obesity, malnutrition and non-communicable diseases, such as diabetes, that are putting pressure on global resources. The world and the UK needs to develop and support knowledgeable health professional leaders, who can influence local, national and international policy makers.
Working in partnership at every level requires openness, trust, respect and honesty – and is endlessly rewarding. Our world is a small place when we truly do work together.
Judith Ellis is chair of THET and chief executive of the Royal College of Paediatrics and Child Health