In February 2018, a team of healthcare professionals from Northumbria Healthcare NHS Foundation Trust travelled to Tanzania to provide teaching and training to staff of Kilimanjaro Christian Medical Centre (KCMC).
In 2004 Northumbria Healthcare Foundation Trust was invited to assist with the introduction of laparoscopic surgery as a new health service for Kilimanjaro Christian Medical Centre and Tanzania.
Fourteen years on and the project has gone from strength to strength. This year the team focused on introducing day case surgery at KCMC and investigating the possibility of developing a day case unit.
As KCMC serves of catchment area of 15 million people, the development of a day case unit is of immense value as it would help reduce congestion on the wards.
Consultant surgeon Liam Horgan returned to lead the 10th national laparoscopic course with Dr Kondo Chilonga, Head of surgery. The course was attended by over 50 surgeons and residents from across Tanzania who travelled to KCMC to participate. Over the four days Mr Horgan oversaw the completion of 12 procedures, training the staff at KCMC in theatres – all whilst being recorded by Tanzanian television companies.
The team was joined by the first cohort of International Leadership Fellows, Julie Hogarth and Samantha Davidson who used their individual skillsets to undertake specific projects centred on improving hospital services.
Programme manager Brenda Longstaff directed the visit and continued to facilitate the partnership between Northumbria Healthcare and KCMC, which is approaching its 20th anniversary.
- Why Tanzania?
Tanzania is a politically stable country in East Africa but also one of the poorest countries in the world .
Government spending on healthcare is a tiny percentage of the UKs for example in the UK we spend around £3200 per person yet in Tanzania this sum is only around £45 per person.
This is evident in the lack of resources to deliver healthcare (medicines and equipment) and also the small numbers of qualified doctors and nurses employed within the health service who struggle to meet the needs of their patients.
- Why KCMC?
In the late 1990s Professor Richard Walker, a consultant physician at North Tyneside General Hospital travelled to Tanzania to undertake stroke research in the Hai District of north-east Tanzania. Whilst there he worked closely with senior doctors at KCMC and upon returning to the UK decided to seek out support for a formal partnership, to provide a helping hand. KCMC is one of only 4 hospitals across Tanzania to have senior doctors (consultants) and it serves a population of 15 million.
- What do we do?
We work closely with the Board of Directors at KCMC and follow their lead on areas they have chosen for development. Projects are agreed and written up in an annual business case that is signed off by the Boards in UK and Tanzania.
We provide opportunities for healthcare professionals, from across a wide range of professional backgrounds, to take part in project development in Tanzania. The aim is to teach and train so that over a number of years the Tanzanian healthcare professionals are able to train their colleagues and take ownership of new health services. The ultimate aim is for sustainability.
- What difference have we made?
Since the first international development grant was received in 2001 the trust has developed a number of projects that have really made a difference to health services in Tanzania, such as:
- Introduction of International Classification of Diseases (ICD10) training for clinical coders at KCMC and nationally so that Tanzania could report statistics on the prevalence of HIV/Aids for the first time. (2001 onwards)
- Development of an accredited short course in ultrasound that has been taught to hundreds of healthcare professionals from Tanzania and across East Africa (2003)
- Donation of equipment to establish Tanzania’s first endoscopy unit at KCMC in 2003
- Introduction of Laparoscopic surgery as a new healthcare service for Tanzania (featured in Tanzania Daily News) 2004
- Development of the first BSC physiotherapy degree course for Tanzania, the first cohort graduated in 2008.
- Development of Tanzania’s first dedicated burns unit at KCMC and training of staff to become burn specialists (2010 onwards)
- Who pays?
The Tanzania programme has a large support group that fundraises throughout the year to ensure that the programme can continue to go from strength to strength. There is a JustGiving link for supporters to donate to.
The volunteer group also applies for funding from grant-giving organisations to support major projects.
- Who is involved?
The trust selects volunteers who have the skills, knowledge and training to undertake the different projects. Over the years this has included doctors, nurses and therapists but also finance managers, IT engineers and administrators.
- What do we gain / Mutual benefits?
Involvement in international volunteering has proven benefits in terms of professional and personal development. Research has shown that healthcare professionals returning from overseas are more knowledgeable about global health issues, more culturally attuned and have a renewed passion for the NHS. They also develop higher level leadership skills by delivering training in a resource-poor environment, having to constantly think outside the box and develop solutions for issues when the usual back-up that they are used to in the UK is not available. Many people say that it is a ‘life changing’ experience.
- Can you really make a difference in two weeks?
Our work on each project is planned so that it builds on learning from the previous year. Through equipment donations, opportunities to visit Northumbria for intensive training and donations of teaching materials , we find that confidence grows and new services move to the next stage of development. The combination of hands-on teaching in Tanzania and observation of speciality services in action in the UK seems to keep up momentum with the team visit being the culmination of a lot of work throughout the year.
Although most visits last around 2 weeks , they are planned in great detail to maximise impact and ensure that the process of change keeps moving forward. For example through annual 2 week visits it was possible, over a period of 10 years, to introduce laparoscopic (keyhole) surgery as a new health service to Tanzania.
It began when in 2004 laparoscopic surgeon Liam Horgan performed the first laparoscopic procedure in Tanzania. In 2008 an audio visual link was set up to enable surgeons in the UK to talk the Tanzanian surgeons through live operations. By 2013 Tanzanian surgeons had performed over 800 successful procedures and by 2018 KCMC surgeons were delivering Day Case Surgery and training to other surgeons and nurses from across Tanzania.
- What next?
The international programme continues to grow with healthcare professionals from across the UK and further afield keen to share their skills with the Northumbria team.
We also recognise the importance of this work as a development opportunity for staff and Northumbria Healthcare has launched an International Fellowship programme whilst also working with Health Education North-East to improve resilience among junior doctors.
Recently, KCMC Directors have asked for our support to develop orthopaedics and a new diabetes service. So this will be a new focus for the years ahead.
We are planning to expand into other countries and we are frequently approached to work with other countries and have undertaken projects in Ghana and Nigeria.
- How does it compare to other health links ?
Northumbria Healthcare’s Tanzania Partnership is recognised as one of the largest and most successful international development partnerships in the UK. It has won numerous awards both in the UK and internationally.
- How can I get involved?
If you would like to hear more about our international work or support the programme, contact Brenda Longstaff at firstname.lastname@example.org.