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Trauma in Fragile States

By Dr Laura Hobbs, Anaesthetic Registrar (ST6) and Global Health Fellow

In this blog, Laura shares her experiences of working with the WHOthe Uganda SCALE partnership and supporting international medical graduates.


Laura is an Anaesthetics Registrar (ST6), who is currently taking part in the first East of England Global Health Fellowship Scheme.


The start of an exciting year

I have been developing an interest in global health during the later years of my training, and the Global Health Fellowship was an exciting opportunity for me to have some dedicated time to grow and focus my interest. What followed was a whirlwind opportunity – working with the World Health Organisation, as part of the Trauma and Operational Advisory Team (TOpAT). Alongside the local work with CGHP, this has been a new chance to understand global health from the  perspective of a large international body.

The World Health Organisation

I have been working with the TOpAT, looking at improving the care of trauma patients across the Eastern Mediterranean Region, focusing on the role of anaesthesia in trauma, and often in conflict zones. As part of my role, I have been involved in creating a pilot course in Somalia and Somaliland for doctors and healthcare professionals, titled the ‘Surgical Team Approach to Trauma – STAT’ course. I was unable to travel with the rest of the team to Somalia due to COVID restrictions, but I taught online discussions and assisted in group facilitation as well as simulation sessions, dialling in to Somalia each day.  As you can see (image), we had to be flexible with the equipment available, and at times I was very precariously balanced! The team working on the pilot was a multinational collaboration, and included anaesthetists, surgeons and emergency department doctors. The delegates were a mix of doctors, nurses and non-medical anaesthesia providers. Working in conflict zones has many diverse challenges – many NGOs are unable to work in these areas, and safety was a high priority when delivering the course.

Alongside this, I have been involved in producing a presentation for the WHO Regional Committee – an important forum where member states and decision makers throughout the region discuss the upcoming top priority health issues. Our work on trauma anaesthesia was selected for a presentation showcasing leading initiatives in the region. Currently we are working to produce a position paper on the role of anaesthesia in trauma in low- and middle-income countries – watch this space!

I have been involved in organising a joint meeting in February with CGHP and the NIHR Global Health Research Group on Neurotrauma– ‘Designing Trauma Systems in a Global Context’. This will be an evening of talks, including a keynote address from Dr Richard Brennan, Regional Director for WHO Eastern Mediterranean Region. You can find out more and register here. As well as being an opportunity for me to meet directly with other members of the TOpAT team, it will also be an excellent opportunity for us to showcase the work being done to a wider audience.

Uganda

I am also working with our partners in Uganda. The SCALE – Critical Care Uganda partnership is a government-to-government programme to develop critical care speciality training. Cambridge is the UK partner, and monthly grand rounds have already begun. These are joint between Uganda and the UK, with a case presentation from each centre, followed by discussion points, with shared learning objectives all centred around the key parts of the curriculum. They will be an opportunity for trainees to present cases at a high level and foster reciprocal teaching and learning. This has been an exciting project to work with, as there is the chance to help shape a new training programme as well as support incoming international graduates in the East of England.

International Medical Graduates

There is a lot of fantastic work taking place across the region to improve experiences for international medical graduates when they first enter training in the East of England region. As well as dedicated fellows, there are some brilliant examples of our colleagues in nursing working hard to improve the experiences of our new international colleagues. I am hoping to work specifically within the School of Anaesthesia to raise the profile and increase the support available for our international graduates.

Highlights of my first 6 months

  • Facilitating small group discussions with healthcare workers in Somalia and Somaliland
  • Working with the members of the STAT course team to create and develop a novel course
  • Creating a presentation that will be seen by international health ministers
  • Writing a position paper on the role of anaesthetists in trauma
  • Writing my first ever blog!

What’s next?

Whilst I have been very busy during the fellowship, I have been privileged to be involved in so many important projects, many of which I hope to be involved with in the long term, once my fellowship ends. It has given me a brilliant platform to work with so many passionate and experienced teams from around the world, and I hope that some of the work I do as part of this fellowship will help to increase the profile of the many opportunities available in global health.

I have exciting plans for the year ahead and hope I can continue with dedicated time for global health work once I finish my anaesthetic training.


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