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Experiences of Health Professionals Working Abroad

Zorina Walsh, St Mary's Hospital, Isle Of Wight

I have been very fortunate to be part of the St Mary’s Hospital, Isle of Wight – Juba Teaching Hospital Link (Southern Sudan). I have made 1 needs assessment visit in March 2008 and 2 further training visits. There is much to be gained by being involved in overseas links and all parties gain. Good communication and leadership skills are vital as there is no structure to training in Southern Sudan at present but we are working with the Ministry of Health to remedy that.An image of Zorina Walsh with a patient at Juba Teaching Hospital, Southern Sudan.

I have learnt the importance of being able to think laterally as there are very little in the way of resources, either for teaching or clinical use. It is important not to impose Western standards of care as it is impossible and would only serve to demoralise the local healthcare workers even more but by working alongside them it is possible to show them good practice and they are keen to learn – hence you learn to be patient and tolerant. One also learns humility. We in the Western world take healthcare for granted whereas in Southern Sudan only 25% of the population have access to any sort of healthcare and even that is very basic.

Zorina Walsh, Coordinator for the St Mary’s Hospital, Isle of Wight-Juba Teaching Hospital Link.

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Dr Mary Thompson, Senior Public Health Researcher

The KEMRI-Wellcome Trust holds £25 million of competitively awarded grants, mostly through the University ofAn image of the front of Nairobi Hospital. Oxford or London School of Hygiene and Tropical Medicine. My placement supported paediatric and surgical research in Kenyan hospitals. This was a great opportunity to incorporate clinical and managerial skills as well as my public health knowledge in a global health setting.

Working in the Kenyan health environment and academic environment has given me a great understanding and appreciation of the efforts made in providing high quality evidence and supporting health policies within a resource constrained environment. I am grateful to NHS South Central Strategic Health Authority for sponsoring me and allowing me to gain such fantastic global public health experience.

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Vicki Rowse, Community Children's Matron, Winchester and Eastleigh NHS Trust

As part of the Improving Global Health programme I was seconded to Cambodia from March to June 2010 to work with MJP in their Health Department. The MJP project was based in rural Cambodia and covered all aspects of development in the Samlout district, and former stronghold of the Khmer Rouge. As a Children ‘s nurse by profession, I found myself working on 2 projects with a completely different focus. One, a public health project to develop family planning awareness, knowledge and uptake of contraception amongst men; and the second to attempt to validate maternal mortality statistics, which proved to be a very interesting project, highlighting a lot of misconceptions and assumptions.An image of Vicky Rouse on secondment in Cambodia.

The experience was a fabulous learning opportunity, the greatest of which was learning flexibility and patience as nothing turned out to be as expected. Conversations were conducted through a translator, so communication skills and awareness of the components of communication were very valuable observations which have helped greatly back in the UK . Other learning was less tangible but included developed confidence through realising that one did not need to know a lot about a subject at the start to lead a successful project, enhanced awareness of service improvement tools and skills and the realisation that a question had to be asked in many different ways of different people to build up a true picture of a situation. On my return to the UK I am using all these skills and am leading a number of projects as a result.

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Dr Elisa Barcellos ( GP Trainee, Poole) and Dr Nicola Prys-Jones ( GP and Forensic Medical Examiner, Bournemouth)

An image of Elisa Barcellos and Nicola Prys-Jones at the Millenium Villages Project, Tanzania.

We were part of the pioneering group of international clinical fellows in the Deanery's partnership in Tabora, Tanzania: "Improving Global Health through Leadership Development". We spent 3 months in 2009 working with the Millennium Villages Project on health initiatives in urban and rural settings, aiding local people to develop sustainable health services and working towards achieving the Millennium Development Goals. Whilst there we definitely became more resourceful and confident working independently and in a variety of different teams and roles. We also gained invaluable leadership skills to bring back to the NHS , as well as forming multi-national enduring friendships. The project continues to grow and evolve, with NHS professionals from a wide variety of disciplines participating and bringing individual areas of expertise and engaging with the local health care workers, offering a unique possibility for personal and professional development for all involved.

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Dr Katrina Webster, Locum GP

I was fortunate to spend 3 months on an international placement in rural Western Cambodia, working for the NESC Improving Global Health through Leadership and Development programme.An image of Katrina Webster on placement in rural Western Cambodia.

This well supported placement began with surveying the local population’s family planning needs and speaking to the community’s health providers. Using this valuable information and being open to local ways of working I was able to combine their successfully used strategies with my own learning experiences to develop a method of promoting healthcare services to the public. The staff have since been able to use these methods and the confidence gained to further promote healthcare services to more remote areas, demonstrating sustainability.

With the upcoming shift in NHS management to more local determination of need and appropriate commissioning of services, the skills I have learnt will be invaluable. Realising that we cannot assume local area needs until we ask, recognising what already works and using local resources effectively as well as being able to empower local communities and staff to make sustainable changes and improvements are just part of what I feel I have brought back to the NHS.

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Dr Tamsin Griffiths, Consultant Paediatrician

I spent 6 months working in Cambodia as a fellow in the Improving Global Health Through Leadership Development programme, from September 2009-March 2010. Initially, I worked mainly on a project to improve the Children’s ward at Battambang Referral Hospital. During the latter half of my time in Cambodia, I spent more of my time in the rural area of Samlout. In particular, my work there involved working with the agriculture and education teams to develop and strengthen programmes to improve nutriAn image of Tamsin Griffiths with a mother and her twins, Cambodia.tional status.

Overall, my experience in Cambodia was tremendous. At times it was extremely challenging, and often pushed me well out of my comfort zone. Working within a non- NHS organisation and health system broadened my view of how different and innovative ideas can be developed. I learnt a great deal about resource management and service improvement – skills which will surely be useful in my future career. Teaching and training in a resource-poor environment really forces one to be creative and think laterally – and I think my education sessions back in the UK will benefit as a result. One of the most important things I learnt was the value of building good relationships within the community – it takes time but is crucial to success.

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Dr Perminder Sethi, Salaried GP An image of Perminder Sethi working with Mbola Millenium Villages Project, Western Tanzania.

I was in the first cohort of NHS International Fellows that went to the Mbola Millennium Villages Project (MVP) based close to Tabora, in Western Tanzania in October 2009. I was there on two separate occasions and spent a total of seven months out there. The MVP consists of several teams focusing on different areas, such as infrastructure, agriculture and education. I was working with the health team and our work was focused on the heath related Millennium Development Goals (MDGs). We worked on several projects in the villages, Kitete Hospital, which is the Regional referral hospital and also in Tabora town itself. Two of those projects I worked on were TB identification and Family Planning.

There were many obstacles and challenges in both our personal and work lives which, I feel helped us all to grow and evolve old skills and develop new ones. We lived and worked with each other 24 hours a day, taking teamwork to a whole new level. Adapting to a life with no running water, regular power cuts and a Tanzanian pace of doing things was interesting. Life was simpler, but immensely rewarding. Some of the things that struck me was the similarity between the Tanzanian health system and that of the UK , the amount of positive work that was already being done by some enthusiastic and highly inspiring local individuals and the fact that many of the challenges that one faces when trying to affect change or hoped for improvement are the same, no matter what country you are in (with some obvious differences too!).

I had the opportunity to do develop management and leadership skills during my time there as well as learn a lot about myself personally. I realised that we are indeed privileged to have the NHS and that change is a slow, but worthwhile process. It was a tremendous experience that I would recommend to anyone. I hope that I may have left something in the lives of the people that I met too, in the way that they left something in my life.

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