Cambridge Yangon Trauma Intervention Partnership (CYTIP)
The second half of 2018 was very busy for the CYTIP. The partnership aims to improve provision of trauma care in Myanmar. Throughout October and November, a number of Cambridge teams were visiting Yangon and Mandalay working alongside Myanmar counterparts to co-deliver training and capacity building. The Cambridge Global Health Partnerships (CGHP) team also visited Yangon and Mandalay to carry out monitoring and evaluation work.
Whilst in Yangon, the Cambridge teams also attended and contributed to the THET Sharing and Learning event.
We have undertaken a systematic review of CYTIP and developed plans for the next phase 2019-2022.
Delivering Trauma Intensive Care (DelTICa)
In November, a team comprising of an Intensive Care Consultant, Specialist Trainees, Intensive Care Nurse and Operating Department Practitioner, visited Yangon and Mandalay to deliver courses over a 10-day period. The first course was a training of trainers for Myanmar Faculty who then co-delivered the 4
th DelTICa course in Yangon and 5
th DelTICa course in Mandalay. The course applies a systematic approach to the management of trauma patients in intensive care. Training took the form of simulation sessions, mentoring and workshops, delivered by the CGHP team and Myanmar faculty, including YGH ICU Nursing staff. The course is now increasingly being delivered in Burmese.
“It was very rewarding for everyone to see such enthusiasm for learning and for the DelTICa course from the students, and to see the faculty from Myanmar teaching more of the course in Burmese; today six out of the eight lectures were taught by them in Burmese.” – Cambridge Critical Care Nurse
Two Critical Care Nurses from Cambridge, remain in Yangon on 6 month placements to support the development of ICU nursing. They continue to document their time in Myanmar on their blog:
https://cambridgenursesinyangon.blogspot.com/.
Trauma and Orthopaedics
At the start of the visit, the Cambridge team were delighted to attend and present at the 50
th Myanmar Orthopaedic Annual Scientific Conference and 38th ASEAN Orthopaedic Congress.
This was a joint team from CGHP and the British Society for Surgery of the Hand, and British Foundation for International Reconstructive Surgery & Training. The team, made up of Trauma, Orthopaedic and Plastic and Reconstructive Surgeons, and Specialist Trainees, delivered the Advances in Orthopaedics Course, in addition to observations and faculty meetings. The team were also invited to attend the daily YGH Trauma Audit meetings and to join ward rounds, discussing with Myanmar partners and trainees, the most effective multidisciplinary approach to major trauma cases.
Physiotherapy
There were two visits from Cambridge Physiotherapists in the latter half of 2018.
NCCU Physiotherapist Caroline travelled to Yangon to deliver the first cardio-respiratory physiotherapy course. Caroline subsequently travelled to Mandalay General Hospital and the University of Medicine, to continue extending training in Myanmar. Physiotherapists, Faye Triggs and Toby Meek, made a follow-up visit to Yangon a few weeks later, to continue training with colleagues in Yangon.
Shortly after Faye and Toby’s return to the UK, we had the pleasure of hosting 4 staff from the Physiotherapy department at YGH. The team was made up of two Physiotherapists, a Physiatrist and the head of the Rehabilitation department at YGH. The had a successful and busy week observing at Cambridge University Hospitals.
Prosperity Fund Better Health Programme
The Global Better Health Programme, under the UK’s Prosperity Fund will operate in eight countries, including in Myanmar. The primary aim of the programme is to strengthen health systems which will alleviate poverty and contribute to economic growth. In Myanmar, the programme will focus on strengthening the healthcare around non-communicable diseases, developing medical professional training, supporting the development of nursing capability and strengthening continuous professional development. The impacts for this programme will be: strengthened national leadership and systems to deliver better healthcare and tackle NCD burden and health equalities; a skilled and quality assured healthcare workforce are able to address population health needs and reduce NCD burdens; and lastly, greater public health literacy to improve prevention, detection and management of NCDs. During the strategic development phase of the programme, the UK’ National Health Services (NHS) conducted a technical workshop; and submitted proposed interventions to support the Ministry of Health and Sports in working towards universal health coverage. Currently, BHP engages with counterparts in Ministry of Health and Sports (MoHS) and international health organizations including UK Myanmar Health Alliance in program structure and design. The programme is expected to begin during 2019.
World Child Cancer
Volunteers from Guy’s and St Thomas’ NHS Foundation Trust and Cambridge University Hospitals travelled to Yangon and Mandalay with World Child Cancer in November 2018 as part of the Health Partnership Scheme. The team was comprised of Dr Robert Carr (Consult Haematologist and Clinical Lead for Young Child Cancer), Dr Denise Williams (Consultant Paediatric Oncologist) and Shanice Brown (Paediatric Histopathology Biomedical Scientist). During their visit they worked closely with the clinical and laboratory teams at Yangon Children’s Hospital and Mandalay Children’s Hospital, providing mentorship and training on the diagnosis and treatment of childhood cancer.
RCGP/Myanmar GP Society Quality Improvement Project
In 2018 the Royal College of General Practitioners received a grant from DFID through THET to run a 12-month Quality Improvement and Sustainable GP Training project. The project was carried out in Mandalay Division and involved over 60 GP practices .
In 2018, working with the GP Society and IGH Fellows, RCGP volunteers, including members of the diaspora. have visited Mandalay and Meiktila districts in Myanmar on five occasions. Initial training in quality improvement was provided. Sustainability was ensured as Myanmar GPs went on to set up local quality circles to address resource issues and support peer learning.
RCGP supported practice visits and the writing of development plans. These development plans led to many successful improvements including improved GP surgery and hand hygiene, better sharps disposal, improved medical records, audits, and plans for personal development including taking the MRCGP[INT] examination.
Some quality circles have identified and addressed common learning needs such as the prevention and management of Hepatitis B.
In November 2018, Myanmar GPs who had attended RCGP training ran quality circles at a quality improvement workshop run as part of the GP Society Annual National Conference. Myanmar GPs used significant event analysis to discuss personal and practice development plans and to develop learning logs in preparation for the proposed introduction of Continuing Professional Development (CPD).
The project's final RCGP visit in December 2018 supported sustainable training of a new cohort of Myanmar GPs by the first cohort and the first phase of the project's extension to Taunggyi in the Shan States.
During this one year project, the RCGP Volunteers carried out 334 training days in Myanmar. The total number of training days for Myanmar GPs was 1321(GPs x days training). Six GPs from Myanmar, selected as Quality Champions, visited the UK in December to observe quality assurance and improvement in the UK, including meeting the GMC.
THET Sharing and Learning Event
On the 13th of November, with the end of 2018 approaching, THET Myanmar brought together all (both UK and Myanmar) stakeholders from three THET funded health partnership projects. The objectives of this “Sharing & Learning” event were to share the working experiences from different projects, to learn how thematic challenges across all projects were tackled and to explore the understanding and embedding of partnerships principles to strengthen future collaboration. It started off with presentations from each partnership, which included:
