Supporting the UK Office
Volunteering in the CGHP Office: My Experience
During the past three weeks, I have been volunteering at Cambridge Global Health Partnerships. Having studied a module on Global Health in my first year of Geography at Exeter University, I was inspired to learn more and spend some time volunteering in the Global Health sector. After researching which organisations are based in Cambridge, I contacted CGHP who were happy to welcome me as a volunteer over the summer.
Whilst in the office, I’ve been completing several really valuable and interesting tasks. From volunteer management, to writing posts for social media, work in the office has been varied and diverse. Seeing the range of experiences and significance of global health indicators between countries and regions has allowed me to better understand the link between what I learn in my degree and the shifts taking place in the real world. Compiling a document of information about other Global Health organisations offering voluntary experiences for medical professionals made me realise just how vast and dynamic the sector of Global Health is, and how the work of CGHP fits into the breadth of activities worldwide.
I have also learnt a great deal about the principles underlying health partnerships, particularly by reading around the work of THET and its relation to CGHP. It’s been really interesting to see how the partnerships bring about mutual benefits to CUH and the hospitals abroad, especially in terms of the renewed sense of vigour developed amongst NHS professionals. Meeting with staff from the neonatal unit who are involved with the Botswana partnership was a particular highlight of my time here, since I could put this idea into context and listen to discussion about what they hope to achieve when travelling there this summer. Hearing about treatments and understanding medical terminology has been fascinating, notably Rosinah’s maxillofacial surgery and the pioneering craniofacial surgery techniques of Dr Derick Mendonca.
I’m really excited to get started on my optional modules at university next year, which will be ‘Political Geographies’ and ‘Nature, Development and Justice’. Volunteering at CGHP has given me a real insight into how global issues interconnect with each other, so I’m looking forward to seeing how Global Health intersects with areas such as conflict, asylum, and the environment.
I have noted that current work in Global Health marks a pivotal moment in the future of healthcare management both at home and overseas, and hope that I will be able to engage with this after finishing university. I am incredibly grateful for CGHP welcoming me so that I could learn so much from this fantastic experience!
HEALTH PARTNERSHIPS: GLOBAL HEALTHCARE WORKFORCE UNITED WITH ONE GOAL
Chin Swain, a senior midwife, specialising in education and training, worked at CUH for over 10 years. She has volunteered with Cambridge Global Health Partnerships (formerly Addenbrooke’s Abroad) since 2012 and involved with two different health partnerships.
“I followed my mum’s footsteps, she was a nurse and has always been my inspiration. I went on to train as a nurse and then a midwife, this allowed me to work closely with mothers during their pregnancy and birth. My passion is safety for mothers and babies, this is the first step to ensuring each family has the best start in life and that is the most rewarding part of my job.”
I was first introduced to the idea of international work when I attended an evening presentation by Dr Hannah Missfelder-Lobos (Consultant Obstetrician) about the CGHP-El Salvador health partnership. Hannah was so passionate about the project; and what the programme was trying to achieve was incredible. It had an ambitious aim, to reshape healthcare delivery for pregnant women in El Salvador. Inspired by Hannah’s talk, I spoke to her about potential opportunities to make an impact in El Salvador and globally.
As a midwife with a passion for education and training, I knew I would be able to positively contribute to the project which has not been realised to be life changing for both myself and the people involved.
I have been lucky enough to be involved in El Salvador project since 2012. I have seen first-hand, the importance of working in partnerships with our local counterparts; to introduce change, the facilitation of change and by supporting local change agents to make a sustainable impact in global health. Strong relationships have been fostered through repeated visits and sharing of knowledge and skills from both the UK and El Salvador. The UK team’s impact, has been well received and has generated much interest, encouraging the local hospitals to look at the service delivery and staff Chin Swain RM MSc Senior Midwifery Lecturer University of Hertfordshire development. Our work has been supported by the Health Minister of El Salvador and many of our partnership work has been realised nationally. Learning and sharing new ideas from our El Salvadorian friends such as the introduction of the music therapy and reflexology in ICU is pioneering – music therapy for staff and patients is something I would like to see established here.
Recently, I have also volunteered on the Uganda (2016) health partnership with Addenbrooke’s Abroad, where we are working with our counterparts to develop clinical guidelines to reduce the leading causes of maternal deaths and the dissemination of them into practice. It was a humbling experience to work with such passionate and dedicated staff, who continue to strive with us to better care for women and babies.
The key to the success of the projects is to maintain a long term commitment to the project, this enhances the working relationship within the team and ensures sustainability of the projects locally. I am grateful to CGHP in support of such life changing projects.
I have developed a much greater appreciation of what the NHS and its healthcare professionals have accomplished and continue to achieve.
I have fostered strong relationships with the other team members and our El Salvadorian counterparts, we are a family, a global family who respects and appreciates the differences that enriches us, but with one goal – better care for mothers and babies.
I would highly recommend volunteering overseas to colleagues, as it is a rewarding way of sharing and gaining knowledge and to foster lifelong friends. Everyone needs a midwife and I am proud to be one.”
Chin Swain RM MSc Senior Midwifery Lecturer University of Hertfordshire
Cambridge Yangon Trauma Intervention Project
Reflections on the Review visit
“We shall not cease from exploration. And the end of our exploring shall be to arrive at the place where we started and to see it differently.” T.S.Eliot
As I return to ‘the place where I started’ I am only just beginning to process my responses and reactions to all that was so generously shared, all the warmth and hospitality that we received and all that I have seen in Yangon – a real tribute to all that has been achieved and learned by everyone involved in the partnership. As my colleagues and travelling companions have articulated I feel hugely privileged to have been part of the team and the review process.
The purpose of our visit was to support the monitoring and evaluation activity of the work undertaken by the teams of volunteers from Cambridge University Hospitals (CUH). These colleagues from CUH, have generously volunteered their time, on behalf of Addenbrooke’s abroad, over the last two years. Working with partners in Yangon, volunteers delivered a series of training programmes for doctors, nurses and physiotherapists to develop skills in order to support improved care for orthopaedic trauma patients in Yangon General Hospital.
It was especially helpful, to be part of such a dedicated and diverse group. The range of perspectives, the imagination and vision, together with the varied expertise, focused determination and strategic awareness of local systems from the Yangon colleagues, made for the most powerful partnership I have seen in a very long time.
At the core of the team was a strong sense of connectedness to AA, its values, its ways of working and the very innovative NGO culture. The team was open to learning, responsive and thoughtful in their reactions to all that Myanmar had to teach us!
The innovative work done, the teams of volunteers equipped and empowered to share skills and more especially, to the constant refrain of our partners. From the beginning of the week, to the very end, a commitment to the Principles of Partnership was absolutely palpable.
The warmth and kindness shown by our partners in Yangon, the local colleagues, the interests and concerns shared, the common agendas reminded me that although we so often focus on the differences between our worlds when we look at global health or any 2 form of aid and development. In fact, I am reminded of Jo Cox and her commitments, so eloquently offered, in her maiden speech in our own parliament, “We have much more in common than that which divides us.”
For me returning to this place, to my context, leaves me with time to think about our Myanmar partners and their context- the pressure of work in the Department of Pathology, the challenge of keeping staff motivated, working with equipment that needs to be maintained and replaced. The rector of University Medicine (1) juggling the roles of clinician and rector and sharing concerns about education and the development of the next generation of doctors.
All these concerns echo the concerns I hear from the clinical leaders I work with in the NHS. I have learned masses and feel as though I have been away for much more than five days. Despite the inevitable exhaustion after two long haul flights in less than a week, a packed programme, the demands of cultural adaptation and challenges inherent in working in such a different environment, I feel inspired and paradoxically refreshed as I return to the familiar.
My learnings are many and are still revealing themselves. In particular, I am impressed with and challenging myself to think further about the Principles of Partnership.
The Tropical Health and Education Trust (THET) have identified eight principles which offer a structure for us all to measure not just what we do, but how we behave in going about our work and contributions, whether for Addenbrooke’s Abroad, CUH, the NHS or any other organization concerned with collaborating for improvement. For my own part I intend to pin the list to our kitchen noticeboard and measure my partnerships against these criteria!
After just five days in Myanmar and in the company of a really very bright motivated group of people on all sides of the partnership. I return to my world feeling energized, reflective, focused on participating and contributing. T.S.Eliot’s words seem to appropriately describe my reactions. I can only begin to imagine the impact that longer more extended contributions by your colleagues from CUH will have on their own mind-sets and potential for reflection – a really very excellent leadership development opportunity for anyone willing to take on the challenge I am sure!
With much appreciation and a great deal of admiration for everyone involved.
Volunteering is a two-way journey; creating sustainable change both at home and away. Dr Mira Pecheva’s trip to Myanmar with a team of orthopaedic surgeons in May earlier this year highlighted this exchange of knowledge and learning. Trauma is and continues to be a leading killer in Myanmar. Whilst the hospital has increased its capacity for dealing with such cases, it still requires the clinical skills and expertise of volunteers such as Mira. Whilst at Yangon General Hospital, Mira identified the progress made and the important role that CGHP volunteers continue to play in this transfer of such vital knowledge and skills.
“Volunteering for the orthopaedic project in partnership with the University of Medicine 1 in Yangon was a great experience – to be able to build on the work Mr Norrish and the Addenbrooke’s teams did in the last few years and to see the surgeons there implementing the knowledge techniques, such as the use of external fixators. This trip was particularly useful as we were able to see the clinical challenges the surgeons face there – high energy trauma, young patients with significant injuries and industrial injuries. The most recent course we delivered focused on more advanced orthopaedic topics and limb reconstruction with frames, subjects which were highly relevant to the care of the patients there.
This was a very valuable experience to see such a wide range of clinical cases, be involved in the discussions with the surgeons about the management and to develop my own teaching skills. It also allowed our own team of registrars and consultants to develop our clinical, technical and non-medical skills – for example, as we encountered complex trauma or had to source equipment for the workshops at the local market in Yangon.
It was a great pleasure to work with the surgeons in Yangon, we are all looking forward to returning and building on the previous work!” Mira’s experience reflects the voices of many volunteers, whose work has a monumental impact both at home and away. Alongside an orthopaedic team, she is set to return to Myanmar later this year, and we look forward to sharing her experiences later in the year.
Dolores, United Against Dementia
Margaret Baron recently jetted to the Philippines with the mission of boosting dementia awareness. As a Resuscitation Trainer and Nurse, Margaret came to CGHP with a bank of previous healthcare related experience overseas.
All is not well in paradise . . .
Her trip lasted a few days, but had a huge impact on the community of Dolores, Eastern Samar. Dementia is a prominent disease in the Philippines, and as the population continues to expand, so does dementia. Margaret noted that the disease is often misconceived, and believed to be a fundamental part of ageing. This lack of awareness has been compounded by the Government’s recent focus on child and maternal health, which of course leaves the ageing members of society left by the wayside.
“There are no care homes in Samar, and most especially, it is very rare to have a Geriatrician or Gerontology nurse in the vicinity.” – Margaret
With this in mind Margaret embarked on an awareness raising campaign. Her work was dynamic and varied, as she engaged in a host of activities. From a memory walk, symposium on Safeguarding Vulnerable Adults, deliberating with government officials, promoting the establishment of a ‘Meals on Wheels’ service, all the way through to extensive networking, Margaret’s awareness raising campaign attempted to cover all bases.
The trip had a significant impact, both at home and away. In the Philippines her work marked a monumental step toward boosting understanding and breaking down the stigma surrounding dementia. Fundamental to CGHP is the bilateral exchange of knowledge and experiences, both exported internationally, and brought home to us here in Cambridge. Margret stated that she would continue to share her experiences and sense of fulfilment with her fellow staff at CUH;
“Lastly, I would inspire them to go the extra mile and realize that the paradigm of health begins in every family home. The more we empower families to take ownership of their member’s health, the lesser the need to institutionalize frail elderly, which will eventually solve the problems in healthcare workers’ shortage and health budget as well”.
With a vast cohort of Filipino staff here at CUH, we recognise the value and importance of establishing a partnership with this part of the world. With a scoping team soon to fly out, we hope that Margaret’s trip marks the beginning of a long and prosperous partnership with the Philippines.
Marta Coll Lastras
Volunteering in the most unreachable parts of Madagascar
Marta Coll Lastras, a junior sister at Cambridge University Hospitals received a grant from Cambridge Global Health Partnerships (formerly Addenbrooke’s Abroad) to do a placement with HoverAid, a charity that makes healthcare accessible for those in the most remote parts of Madagascar.
“One of the reasons I wanted to become a nurse, was because I wanted to help people who had limited access to healthcare. Last year I decided that the time was right to travel overseas, I didn’t know where to start, so I got in touch with Cambridge Global Health Partnerships. They have been really supportive from the beginning, Programme Officer – Neelam was very approachable and very encouraging from our first meeting and helped me find HoverAid.”
HoverAid, is a charity that works in Madagascar, with the aim to reach the unreachable. They regularly take teams of doctors to villages along the rivers with the use of a hovercraft, to remote locations as part of their medical healthcare programme, where they do consultations, dentistry, surgery and ultrasounds amongst other health checks and treatments.
My placement was in Beroroha, on the Mangoky river, where over 130, 000 people live along the main river and its many tributaries, have no access to healthcare.
The journey to Beroroha, was long and physically tiring, we travelled three days by car and then had to cross the river on a canoe. I can only imagine how people who were sick and needed medical assistance could cope with such a long and tiring journey to access emergency medical care.
It was an amazing experience to be part of such a supportive and lovely team. In Beroroha, we were sleeping in tents and having showers with buckets of water. In the camp, we were hosted by a welcoming Malagasy family. Living alongside the local community helped me to understand the local culture and healthcare situation.
Working in such a challenging environment with the Malagasy doctors, was such a hard and rewarding experience. we attended around 100 patients a day, some people walked long distances to attend the clinics and it was shocking for me to see patients who complained of symptoms there were having for months or even years.
It was such an incredible experience, I was able to adapt to work in a completely different environment and in a completely different culture.
I learnt a lot from the Malagasy healthcare professionals and the rest of the HoverAid team, including how important it is to maintain a positive spirit in difficult situations and always working to overcome challenges. I have returned to work with a sense of appreciated of the NHS.
Volunteering within such a different healthcare environment for the first time was definitely challenging at times, but the wealth of understanding I gained and using my skills to treat patients who, without HoverAid, would go with treatment, has reinvigorated me.
I will definitely be volunteering overseas again! Thank you to HoverAid for the amazing experience and for the invaluable work you do and to CGHP for your advice and support.”
Volunteering in the remote coastal communities of Central America
Dominika Pich, a Practice Development Nurse at CUH, received a grant from CGHP to support her two-week placement in Panama, this January 2018.
Her placement was with Floating Doctors, a non-profit organisation whose stated mission is to ‘reduce the present and future burden of disease in the developing world, and to promote improvements in health care delivery worldwide.’
“I started my experience with the Floating Doctors with a 4-hour hike, travelling to the most remote community in the mountains, Las Sabanas.
I soon got to know my new colleagues, a mixed team of students and healthcare professionals from around the world. It was fantastic to share stories and experiences with fellow healthcare professionals from such varied backgrounds.
During our time there we saw more than 150 patients from nearby villages and communities. The scope of disease affecting patients in Panama is vast. I was amazed to see families of 8-10 presenting with such varied problems; GI worms, scabies, head lice, headaches, backaches, dehydration and leishmaniosis were just some of the conditions I saw. This was an entirely novel experience for me and not one that I will forget soon.
I particularly enjoyed spending time with the local children where I was able to teach them how to wash their hands with soap and brush their teeth effectively.
In the second week we held two clinics; in Tierra Oscura and Valle Escondido. There we provided home visits for housebound patient and were able to give information on a healthy, balanced diet and avoiding Diabetes. ‘Sugar-free’ is a not a commonly used term in Panama, and I hope that the information we provided will help for many years to come. We saw a wide range of cases again, such as pityriasis versicolor, soft tissue injuries and patients needing contraceptive injections. In total over 200 patients were seen.
We performed weekly visits to Casa de Asilo, a state-run elderly care home in Bocas Town, Isla Colón.
Towards end of my stay we held an ‘ultrasound party’ on our base. For the first time in my career I was able to perform ultrasounds independently. It was a skill I picked up rather quickly and was soon successfully able to identify the baby’s sex and check the placenta. It was an amazing experience.
I cannot be grateful enough for what I experienced during my adventure with the floating doctors. I have always had a passion for helping people and making them smile, but the trip helped me to understand this even more.”
Want to find out more about the work of Cambridge Global Health Partnerships and how we can support you to volunteer?
Get in touch: email@example.com
Floating Doctors Website: http://floatingdoctors.com/
Cambridge Global Health Partnerships have been contributing to improvements in maxillofacial surgery in Botswana. This involves the treatment of diseases affecting the mouth, jaw, face and neck, usually drawing upon the work of more than one specialist surgeon. There is a long waiting list for treatment in Botswana, so patients are often referred to Johannesburg, South Africa for treatment. This is clearly unsustainable and usually distressing for patients. Since 2009, we have been sending a team of three to Botswana to help improve safety and quality of care. So far, the volunteers have operated on approximately 123 patients, including Rosinah.
Rosinah recounted her incredible experience with the Maxillofacial team from CGHP. Her story is a testament to the work of our volunteers, and the truly life changing effect they can have on people’s lives.
A nurse from Gaborone, Botswana, Rosinah had lived with a facial growth her entire life. Not only fearing that the lesion would become malignant, Rosinah had frequently been told by doctors in Botswana that it would not be possible to remove the growth.
In 2016 a Maxillofacial team went out to Botswana. Rosinah was delighted when she first met the CGHP team who immediately offered to help. She met volunteers Vijay, Julian and Val, who were confident that they could help to prevent her lesion from developing. However, Rosinah was pregnant and was unable to undergo surgery.
The following year, Rosinah received a phone call inviting her for a second consultation. The team returned in 2017, and the date of the surgery finally arrived. The growth was successfully removed, and only then did Rosinah learn about growth and type of lesion she had lived with for so many years.
Since the surgery, Rosinah feels as though her life has changed completely. From Botswana to Britain, Rosinah is one of many patients who have benefitted from the expertise of this team.
“I am so grateful; you have completely changed my life […] I am so free, I look amazing.”
Ike Phemo had a fused jaw bone, meaning that he could barely open his mouth. Day to day actions which we take for granted such as speaking and eating, posed a huge challenge for Ike.
The Cambridge University Hospitals Maxillofacial team, Julian Fraser, Vijay Santhanam and Valmiki Sharma travelled to Botswana in 2016 (see left), as part of the Botswana-Cambridge Maxillofacial campaign. During their visit, they met and subsequently operated on Ike.
One year later in June 2017, the team returned to Botswana. They met up with Ike, his father and brother at Princess Marina Hospital.
Neelam Dave – CGHP Programme Officer interviewed Ike and his father, Johannes (see image below).
“Ike is turning 13 in a few weeks, we are so happy that he has finally received treatment. Since the surgery he has been eating well and has started to grow.” Because of his fused jaw, eating had been difficult – he had to push food through a tiny gap between his teeth, this meant that he had not been getting enough nutrition.
“His older brother teases him now, saying that he is too fit! He will soon catch up with the other children.”
Johannes has been bringing Ike to Princess Marina Hospital, Gaborone for almost 10 years, but no one could help him. “Before the operation, he had an accident at school and he accidently got a 50 thebe coin stuck in his mouth. It was so scary because we thought he might swallow it and choke, we couldn’t get it out. It took a while remove it. I am very happy with the progress he has made. He is so happy now and he is eating well.”
Ike’s story is a testament to the skills and capabilities of our health professionals here at CUH. Health partnerships such as this, thus allow us to share skills and knowledge globally, ultimately developing sustainable health systems, and edging ever closer to universal health coverage.