If these statistics remain unchanged, a billion people will never see a qualified health worker in their lives.
It’s for this reason that, back in 2011, the UK-based Tropical Health and Education Trust (THET) joined with the UK’s Department for International Development (DfID) to launch a Health Partnership Scheme (HPS).
Essentially, the idea is to form partnerships between UK health institutions and their counterparts in low- and middle-income countries around the world — to share learnings, to train peers, and to bring mutual benefits to both the UK and the partner countries.
And it’s proved to be a “catalyst for unprecedented levels of engagement” both for UK medics and their counterparts in Africa and Asia, according to THET in a new progress report published on Friday.
In fact, over the past eight years, over 2,000 NHS staff have now volunteered with the scheme and helped train 93,112 health workers — including over 46,600 female health workers — across 30 countries.
Medics have spent more than 103,000 days volunteering; 210 projects have been delivered; and 499,568 patients are now using improved services as a result, according to THET’s report.
Just one of these volunteers was mental health nurse Emma Gilbert, who spent nine months volunteering in Kampala, Uganda, within the Child and Adolescent Mental Health (CAMH) project implemented by the East London NHS Foundation Trust and Butabika Hospital.
When the project was first launched, there were just five child psychiatrists in the whole of Uganda — where 60% of the population is under 16, according to Gilbert.
“The lack of specialised human resources was appalling, so in implementing a training course for CAMH the partnership was trying to address a very obvious need,” she told THET.
The programme promoted a “multidisciplinary approach” to better integrate services in “a country where child health care often falls under primary care and there is a lack of specialist services.”
As well as psychiatric clinical officers, according to Gilbert, the training also attracted paediatricians, nurses, social workers, psychiatrists, and medical doctors.
“The enthusiasm of the people I was teaching was probably one of the best things of the job,” she continued. “They took time out of their jobs and travelled from all over the country to take part in incredibly long teaching days.”
Gilbert said there’s a broad spectrum of mental health disorders at the hospital, including episodes of psychosis and issues linked to trauma or abuse.
As many as 5bn people lack access to basic #surgical services, with only 6% of all operations being delivered to the world’s poorest...we're pleased to launch our latest #THETPositionPaper outlining our commitment to improving #GlobalSurgeryandAnaesthesia https://buff.ly/2S26per
“The majority of our cases, however, were epilepsy,” she continued. “The child’s family often believed that epilepsy was contagious or that the child was bewitched. In many instances we saw evidence of violence towards epileptic children.
“They were often brought to traditional healers and went through all sorts of ceremonies,” she said. “I saw a lot of brain injuries that could have been avoided if the patients had come to us sooner, but there is still stigma attached to mental health.”
For many families, according to Gilbert, going to hospital is often seen as a last resort. “The work that has been done with the trainees is also helping to overcome and challenge the wrong beliefs, but it is a slow process,” she added.
Gilbert highlighted that training has been “instrumental” in developing the CAMH services at the hospital, as well as generating the interest of the Ministry of Health.
“On a more personal level, I learnt a lot being forced out of my comfort zone,” she added. “In the UK, you’d be seeing maybe four patients daily. Here it’s more 30 to 40, so my clinical knowledge improved significantly.”
“I 100% feel that I am a better nurse after this experience,” she said. “The ability I developed to work with different people, and to be open and flexible, is extremely valuable back in the UK where I work with patients from diverse backgrounds.”
This is a very key emphasis of the partnerships set up through the scheme: that both partner countries are benefitting from the shared learnings that come out of it.
In fact, some 74% of UK volunteers reported bringing back new approaches and techniques that can improve their practice in the UK.
Another volunteer, Dr. Mark Lee, added: “I’m more acutely aware of service improvement and potential quality improvement projects in my NHS hospital.”
“Being exposed to high intensity environments where patients often present very late into their illness, is invaluable experience that can only make you a better doctor,” he said.
Just a few of the other projects supported by the initiative also include working towards reducing maternal deaths in Uganda; to improve the quality of hospital care for seriously sick and injured children and newborns in Myanmar; and to strengthen surgical and anaesthesia capacity in eastern and southern Africa
UK volunteers were also in Nepal before the earthquake struck and played “an exemplary role in assisting the country in its recovery,” according to THET.
Before its launch, funding for this kind of activity at this scale had reportedly never before been provided in the UK.
The focus for the scheme has been led by DfID’s health priorities — and include reproductive, maternal, and newborn health, as well as malaria prevention. Meanwhile, there is a strong focus on rural areas where health infrastructure is often at its weakest.
What’s more, DfID commissioned an independent evaluation of the initiative back in 2016, which reportedly found “overwhelming evidence” of the effectiveness of the partnership model in “strengthening the capacities of health workers and the institutions in which they work.”
It also noted that the scheme “represented good value for money compared to other approaches.”
According to Louise McGrath, head of programmes at THET, where health partnerships can really add value is through “enabling the sharing of learning and experience between health systems and teams, to identify where improvements in the quality of care can be made, and finding ways of working together to do this.”