News from the Poole Africa Link
October 2015 saw a change in direction for Poole Africa Link (PAL). Due to the political situation in South Sudan, the scheduled trip was diverted to Lira, Northern Uganda where there is a referral 500-bed hospital, and several schools of nursing. The one we used as our base was at a new University outside town, which currently has three intakes of midwifery students, (about 150 students in total). Funding is from the African World Bank and the Government is very supportive.
I and Peter McEwen met the Lira University team led by Professor Jasper Okwal-Okeng last year. We were hugely impressed by their enthusiasm and vision. In the past year they have finalised their plans for a new hospital, achieved a practising license for the soon-to-be-opened maternity hospital and forged very strong links with Lira Regional Referral Hospital.
This year we were warmly welcomed by both the hospital and university and spent many hours teaching at both places. We were a team of four, a midwife, surgeon, paediatrician and anaesthetist. We were impressed by the enthusiasm and knowledge base of the students. Many have worked in health care for some years and want to formalise their experiences and gain a good degree. The midwifery course is delivering a comprehensive curriculum which will include training in additional skills, so that the midwives will be able to run a small health centre and deal with many clinical situations when there is no nearby doctor. They are learning more pharmacology, more nursing skills, and some extended roles including diagnosis and minor surgery. It is hoped that they will be able to provide basic anaesthesia including spinals, will have the necessary resuscitation skills and be able to perform some emergency surgeries.
We now need to look to the future and see this new addition to our charity as an ideal opportunity to continue with our support for South Sudan from a safer base, and, in addition, provide support to the new university. The government of Uganda are committed to help South Sudan, and the university is keen for us to develop training for their students and for students from South Sudan. By bus the border is only 3 hours away and Juba 6 hours. The political situation is stable, the accommodation easily available and cheaper, and the area safer for teams to visit.
We believe that the university would be an excellent base for training South Sudanese and local nurses and doctors. We would like to send senior trainees from UK in all specialties to gain experience of working in sub-Sahara Africa. There are clinical and teaching opportunities, and Uganda has an excellent record of rolling out training to peripheral hospitals. The Safe Obstetrics course, Safe Paediatrics course, and Primary Trauma course have all been successfully rolled out with local doctors now providing much of the training. Short training courses are being delivered across Africa, including the surgical safety checklist, but these initiatives will be more successful if there are doctors on the ground to reinforce the messages. Lira has a huge need for people to help them to move forward. They have the infrastructure of wards, theatres, basic equipment but only 9 doctors when we were there (Figure 1).
Figure 1. Dr James Elima, Director General at Lira Referral Hospital (centre) receives a few items of equipment from the Poole Africa Link team. He is holding a book on Critical Care and hopes that we will be able to help him to develop the 16-bed Critical Care Area, which is built, but not staffed (credit Frankie Dormon).
The next step for us is to approach the colleges to see whether they would be able to support such a project, and to raise funds for trainees to visit for 3-6 months supported by a consultant who would stay for 2-3 weeks, and then provide the mentorship from UK for the remainder of their stay. In addition we propose to approach various organisations to try to secure funding for South Sudanese doctors and nurses to visit Lira for the short courses or the Midwifery 4-year course.
Lira University College is in early stages of development. The Faculty of Health Sciences has three intakes of midwifery students, with ambitious plans to develop training on-site, and clinical training at Lira Referral Hospital. The future sees a 200-bed hospital being developed on the site with further training and research opportunities. The University and the Referral Hospital have excellent links and a very good relationship. We see the two hospitals working well together into the future. The maternity facility is ready to open for outpatients and inpatients including a facility for Caesarean sections (Figure 2).
Figure 2. The team, from left to right, Pam Dumashie (midwife), Judy Mella (surgeon), Anna Agnes (midwifery tutor from Lira University), and Antoinette McAulay (paediatrician) are standing in the ward block of the maternity facility. Through the doors is a theatre, recovery unit, neonatal unit, and offices (credit Frankie Dormon).
If anyone wishes to contact me regarding taking this project forward send an email to [email protected] and copy in Hilary Fenton Harris [email protected], the Link main contact. You can see more of our work on our website and on Facebook.