2018 Report


2018 was an interesting year for MESCH. We made some hard and, in many ways, disappointing decisions about projects and started 2 new ones in Phan Rang.
MESCH project summary 2018
Project summary:
 Name    Site  Duration  Status  MESCH category  Co-ordinator
 Raga  Pentecost, Vanuatu 2013- 2018   On hold  Development  Narelle C
 Trauma care (first aid)  DaLat, Vietnam 2014-current  Inactive  Development  Cuong Vu
 Thanh Huyen  DaLat, Vietnam 2016-2017  Inactive  Development   Narelle & John C
 Trauma care  Ninh Tuan, Vietnam 2018-current  Ongoing  Development  John C & Cuong Vu
 Paediatric anaesthesia & surgery  Ninh Tuan, Vietnam  2019  Proposed  Development  John C


Community first aid project, Lam Dong Province, Vietnam

Trip Dates: Nil proposed. Members: Cuong Vu (Au Vu)
In May 2018 we ran 2 community based first aid courses. These were for the Red Cross and members of Prudential insurance. No further approach by GM Red Cross Lam Dong province, University “youth group” or from Mr Bao (on behalf of Mrs Tam or Thuy Anh - –Prudential and private businesswoman respectively) re NGO called Từ Tấm (“From the heart”) in furthering community first aid. Cuong V does not believe this course has a future in DaLat and will not actively pursue it.

Trauma Projects Phan Rang (Ninh Thuan Hospital), Vietnam

Visit Date: 7-15 September 2018. Members: Khang Vo, Bao Khue, Au V, Cuong V and John C.  
NTGH Dr The (Lecturer), Dr Hong (Lecturer), Ms Tuoi (Co-ordinator)

MESCH: John Cassey (overall Coordinator and lecturer), Cuong Vu (Lecturer and interpreter), Au Vu (Lecturer and interpreter), Bao Khue (lecturer and interpreter), Khang Vo (Interpreter).

The course content and general arrangements had been discussed with the hospital and lecturers through SKYPE, text and email over many months. The draft slide set had been modified by both VN lecturers. Detailed timetables, scenarios, evaluations, multiple choice questions and resource lists had been checked. Logistics of permissions, invitations, interpreters and so on were jointly organised between Ms Tuoi, Cuong and John.
Following arrival
The hospital provided transport from and to Cam Rang airport. Initial hotel was changed to one further from hospital because of comfort, food and noise considerations. It required a daily taxi fare (~$2.00) 
All course content was delivered by Dr The, Dr Hong, Cuong Vu, Au Vu and Bao Khue. John had input on occasion when requested for information or because some aspects needed further explanation. Scenarios were run by Dr The, Dr Hong, Cuong Vu, Au Vu and John
There were ~20 attendees at the community courses, 15 at the PTC and 10 at the PTC instructor’s course. The community attendees were almost exclusively Red Cross. The PTC ones were from Ninh Thuan hospital and various smaller hospitals or healthcare centres in Ninh Thuan province. They included emergency doctors, surgeons and nurses. Many attendees held administrative and clinical roles.  
Courses were held in a single location with good quality audio-visual equipment, seating and air-conditioning. However, it was too small a room for 3 scenarios to run concurrently and the corridor outside, whilst perfectly adequate for space, was hot. Equipment utilised in the scenarios consisted of: two Laerdal intubating mannequins (previously purchased by MESCH and provided on loan from LDGH), 2 “Little Anne” (MESCH) and 3 CPR mannequins (MESCH and NTGH) and other consumables from NTGH and MESCH.


Aims and outcomes 
1) Initiate Community first aid and instructors courses at NTGH was achieved but will not be continued.Smaller hospitals,at their discretion
2) Initiate PTC and instructors courses was achieved at NTGH
3) Acquisition of knowledge and skills was achieved and NTGH has planned dates for 2019 (direct observation and MCQ)
4) Build confidence that care can be was achieved achieved with a minimum of technology (Resources questionnaire and course evaluation)
5) Increased awareness of the need for training was achieved and for this to be driven from the senior staff.. MOU to continue
6) Introduce a new style of course delivery and determine participants perceptions of this was achieved and well received (course evaluation and direct feedback)
7) Understand what impediments might need to be resolved to improve trauma care in Ninh Thuan Province is in progress by both NTGH and MESCH
8) Begin to understand the structure and processes behind trauma care in is in progress by both NTGH and MESCH
9) Modifications to the PTC course is in progress by both NTGH and MESCH
10) Establish NTGH ownership of the course has been achieved

* Attempt at getting Vn language version of a free interactive (team building) game called “Spaceteam”.  Positive replies from developer and the 3 “Vu” brothers. No further suggestions or offers. John has emailed student groups at UoN, UNSW and Syd Uni.
** Video of simple jaw thrust airway management completed during the course by participants with assistance by Cuong, Au and John
1) Relevance:
Red Cross community members are unable to utilise this course. In addition, no organisation is directly responsible for community health education. Had we been informed about this prior to the course, we could have scheduled further PTC courses so that more staff from remote areas (theoretically more able to give community education) could have attended. PTC courses were highly relevant for all doctors and nurses.
2) Communication:
Language was not an issue
We do not have a clear understanding of what is motivating current lecturers. Nurse Nguyen is director of nursing for the province and has an education background. She attended the course and seems genuinely keen to teach the course to more nurses province-wide.
Communications between the hospital and the community and some remotely located participants was not ideal simply because of priorities within both NTGH and the other centres. It will not be possible to completely obviate this in the future.
3) Resources:
Equipment - More consumables would be ideal. Mannequins based at NTGH instead of borrowed from LDGH would help
Debriefs were good and frequent – usually at lunch or at the end of the day.
Having regard to the track record of previous PTC courses in Vietnam and, in particular, our experience in LDGH, what was achieved here was very encouraging.
MESCH is keen to continue support though we expect that this will be less hands on in future years.
Bottom Line: We will be working with Ninh Thuan hospital to develop the trauma “bundle” for 2 years. However, it seems likely that the first aid course will not continue. We need to clearly define who is interested in joining the project from Ninh Thuan Hospital and in what capacity. We would like mannequins for the courses.

Raga Sewing, Pentecost, Vanuatu

Members: Narelle C, Penny W, Steve T, John C
During our last trip in April/May this year a few things were noted and some actions were taken –
    The business was being run by the sewing ladies predominately by Pauline as the manager Isaiah was asked to leave in December the year before.
MESCH response…we had spoken prior to this trip with Andrew Rara (from Abutontora) and Debra Giginia (founding member of Raga) to try and find someone suitable. A young lady named Taniella from Abutontora who was studying business was interested. Due to being delayed by cyclone conditions we met with her in Port Vila before we left. She was shy and quietly spoken but really believed in the Raga business and wanted to be involved. We had already spoken with the sewing ladies about working together as a team with a manager. So Taniella was going to start as manager
    There was the usual issue of wages which has been a problem from early days…
MESCH response…we had moved to paying the ladies a percentage of what they produce for the last 18mths rather than the unrealistic hourly rate that we began with. They wanted to return to an hourly rate as they believe it is a better incentive to work than being paid for what is produced. We reminded them that there were issues with hourly payments when one worker was faster than the other and made more clothes but was paid the same. We came up with a compromise of being paid a small hourly rate and for what is produced per worker.

    There was a problem with prompt payment of accounts as well as wages by Ephraim…
MESCH response…we have had discussions with Ephraim before about the need to spend money in order to make money as well as needing to keep suppliers happy by paying their invoices as well as paying your workers for their work. We know Ephraim is very busy with his job as bursar for the school and decided that we would trial getting a second cheque book for Deborah so she could write the cheques as she is also a signatory. Unfortunately The Bank of Vanuatu requires two signatures but still Ephraim would only have to sign. We discussed this with Ephraim and Deborah and they both agreed to trial this. Deborah would pay the wages every two weeks when she came to the bank for her school.
    We had concerns about the management of the school now being the local church. The school is expanding and they need space including our sewing room. They had begun to dig up opposite the workroom for a toilet block. This would make the area very congested with students causing interruptions to sewing with requests to charge mobiles. We have recommended in the past that the door to the work room be kept shut during work hours.
MESCH response…We had asked on previous trips about the availability of other spaces for Raga. We knew of  space that would require a new building at village nearby. Deborah’s husband Haniel is chief of this village and told us that they would look after the business. Having the business in a school has made it difficult to define ownership and responsibility for maintenance especially without a capable manager. However on this trip when they realised that MESCH was coming to the end of its time on Pentecost they became quite animated and identified 3 other sites for us to look at. There was one at Abutontora opposite the medical centre that looked good. It was previously a community building for markets but had fallen into disrepair. We discussed this openly with the management and staff Raga as well as Andrew and other people at Abutontora. It was agreed to look further into this site and Andrew would look into quotes for repairs.
Several independent sources of feedback were subsequently received:
One of the sewing ladies, Harriet, had told her husband (who is on the school board) abou thtese ideas. There was a strong reaction to this from the board and we were told (second hand) that we could not move because Raga belonged at Lini and we would have to sign release papers. This confirmed our concerns about the Church’s intentions.
Andrew (working in Oz fruit picking) told us that, after we left last visit, he was verbally attacked by people from the school at Lini. They said that he and Abutontora were trying to take Raga away from them. He also told us that when Taniella asks the ladies to do some things they were refusing so she was thinking of leaving.
Deborah was unaware of the events regarding Andrew and was upset about it. She told us that Taniella had left and that one of the ladies (Harriett) had been in Vila since July to have her eyes fixed. She reported that some weeks ago she heard the Raga generator going at night and found the school was using Raga’s generator for power at night. She objected this but was ignored. The generator is now broken. They are have intention to fix it. Raga is now using the school power. Ephraim does not co-sign cheques that Deborah writes. Nothing we discussed and agreed upon during our visit has continued.

In the months since our last visit Raga FB following has doubled to over 1,000 followers. The comments on the last post were all of support for a 100% Vanuatu owned business which is rare. We have also been contacted by Radio Vanuatu to be interviewed about Raga.
MESCH considered:
We really can not have any more involvement in Raga if the people were happy with how it is running and that we could not inspire any more growth or change. 
Our concerns about the church interfering with Raga are confirmed. We suspect that the rest of the equipment like sewing machines, laptop, printer, sewing stock etc will also be seconded somehow.
Knowledge of Raga is spreading quite fast now, enough to get the attention of the national radio station. There are few Ni-van owned businesses so Raga is well supported. It has enormous potential to grow into a great business.
The Abutontora site is now owned by the hospital board and they wish for us to fix up the building and then they will discuss the rent we will pay.
Haniel’s village site is well positioned on the road to the port, near the airport and bank and is independent from any government or church organisation. Neither Hanile nor Deborah have made any steps at furthering this
Maylindah and Hollingsworth have a base in Vila and would market Raga’s products there.
The non-viability of the current site sits squarely on local individuals and church politics.

MESCH's final  response:
Raga needs to be totally independent of any church or government connections however vague.
This has been a very promising project which was well researched and built with a lot of careful community and “in house” (staff) consultation. If an equivalent start-up in Australia had the same positive social media presence, its success would be almost assured. At over 1000 Facebook followers (up from 600 a few months ago) and requests by Radio Vanuatu for interviews, the business has certainly caught the imagination of NiVan people. It’s longevity, the logo and its local ownership are likely big plusses. Quite apart from the income generated for the women, they have:
 Learnt: How to order materials and other supplies, maintain and (partly) fix sewing machines, new ways of communicating with westerners, organise workflows
 Been introduced to: another style of business structure that takes into account profit sharing and immediate and projected outgoings, marketing and sales, difficulties in logistics, future planning with staff training 
With the support of Andrew, Debra and MESCH, we reacquireed the equipment on Pentecost and stored it, temporarily, in south Pentecost, en route to Port Vila (Maylindah and Hollingsowrth). If we do not re-establish the business then the stock can be distributed to the people. 
Other Vanuatu:
Andrew is passionate about a small primary school they have started in Abuwontonura. We have expressed our willingness to consider any specific propositions for assistance. 


Paediatric anaesthesia and surgery, NInh Thuan Hospital, Vietnam

Discussions with Dr Phiem (Director of Ninh Thuan Hospital) and Dr Hieu (general surgeon) completed our week in Phan Rang this year. We have agreed to trial a paediatric anaesthesia/ surgery week there in late 2019. Volunteers will be Au V, Cuong V, Michael Dobbie and John C.


MESCH turns 10 in 2019!
Our mission statement “Our lives are complex journeys which change direction as opportunities or interests arise. Where we are now may well be very different from where we thought we would be. It’s easy to forget the privileges we are given - food, stable societies, access to education and healthcare, the English language.
MESCH works through education and training. We work on a variety of projects - empowering women, better outcomes from trauma, helping people who have the passion to change their lives but born without the ability to do so. By working in a sustainable framework, you help us jump-start their lives and watch them forge their journey on their own terms. We have their backs. We need you to have ours.”
People within the medical community in Newcastle know about MESCH, though relatively few are keen/ able to support it. Outside of that, we continue to struggle with this within Australia. Narelle has certainly made MESCH a recognizable entity in Vanuatu and Ninh Thuan hospital has publicised it locally in Phan Rang.
New Videos: new Raga video (Narelle C), jaw thrust airway video (created by Ninh Thuan hospital 2018), Ronni Khan (OzHarvest) support for MESCH

Current organisational memberships: Statutory (ACNC, Dept Liquor, Gaming and Racing); Google not for profits; Giving circle.

Current organisational associations/contacts: MedEarth (medical supplies); Newcastle Global Health; WHO road trauma; AVI; ABV; Application to UN submitted June 2017
Maitland city Library- Maitland City Library’s “Look Who’s Talking Local Stories” program. Scheduled 2019 - Steve T
Presentations:  John C to Hunter clubs in March, morning ABC radio session with Garth Russell (John C), ABC radio session with Paul Bevan. (Steve T). Steve T, Narelle C and John C find radio interview stressful.
Collective Heart and Probus – Steve T
John B for prepared these with assistance Narelle and John C.
Other activities by MESCH members
Overseas volunteers 
 - Raga (Narelle C, Penny W, Steve T, John C)
 -Trauma course (Cuong Vu, John C)
Executive (Penny W, Narelle C, John B and John C)
Penny W, Mich P, Narelle C and John C did mail out to Hunter doctors
Support by non-MESCH contacts (alphabetical)
  Angela Woods (Hickson’s lawyers) advice on website compliance
  Au Vu (assisted production of trauma project resources and taught at both courses Vietnam)
  Bao Khue (assisted production of first aid trauma project and taught at both courses Vietnam)
  David Woodcock (auditing and accounts)
  Hien Trinh (interpreter living in Australia) spoke several times with Ninh Thuan organisational contact Ms Tuoi and translated many documents and emails
  Khang Võ (Interpreter living in Vietnam) translated documents and PowerPoints for the trauma course and interpreted for it in Phan Rang)
  Leigh Bryant (Scorpion international) has continued to assist with networking for sponsorship
  Ronni Khan (OzHarvest) produced an affirmatory video clip for MESCH
  Sirocco assisted with website development – reduced rate and some pro-bono
  Stewart (Mr Stitches) refurbished industrial machine and updated Steve Threlfo’s knowledge on repairs
  ‘telligence (website design and hosting) continue to host website pro-bono and development costs at reduced rate
  Tony Rhodes (Mullane’s) considered involvement in Raga
  Vy An (Interpreter living in Vietnam) translated documents and liaised with LDGH about the proposed changes to the ED LDGH (pro bono) 
Australian Charities and Not-for-profits Commission Amendment Regulations prescribes external conduct standards for “minimum level of assurance that registered entities meet appropriate standards of governance and behaviour when operating outside Australia”. Begins in 2019. We need to comply to remain registered. Require: accounts; annual summary of activity; policies on protecting vulnerable individuals, anti-fraud and anti-corruption. It will be a little extra work to produce the summary. Members need to have completed training in this. 
 Fundraising and Support
a) Events
Rustica evening 17th March 2019. Mark Hosie (owner and chef) happy to arrange food/ beverages free, staff and his time free – all ticket sales and money raised to go to MESCH. Small committee established (Julie Bartlett, Lyn Gaye, Narelle and John C). Video message from Ronni Khan (OzHarvest) has been received with thanks.
b) Private Clinician Support to continue in 2019
c) Proposal to travel insurers to produce a film used by MESCH for publicity and insurers for market share and supporting MESCH in reducing poor outcomes from trauma – hence reducing payouts and premiums. No uptake.
e) Other
Michael Craddock (Newcastle based with VN national partner) very enthusiastic with suggestion he and his partner may make MESCH a beneficiary of funding from their charity dinner in 2019. Email from John to follow this meeting.
Phone call conversation and follow-up email to previous leader of Vietnamese community in Sydney. No current outcome. Newcastle Vietnamese community not interested.
Website update  “Sirocco” has made changes to SEO and we have made/ are making changes to sponsors, donation and project pages based on their advice.
  Donate is now part of header and donate and volunteer frame contact options
  All countries are combined into a single page – current with option to go to previous at bottom of page
  telligence have resolved domain name issues.
  Each current project has a financial target and a human interest story
  The European “General Data Protection Regulation (GDPR) came into effect recently and we have been given advice by Hickson’s lawyers (our long term legal consultants) as to how to comply. This involves 3 things: Do not accept money in currencies other than AUD, do not translate pages into     any EU language and do not accept membership or send advertising/ marketing to EU based people/ organisations. 
  Narelle has re-vamped the “donate” page and Sirocco and PayPal have completed these suggestions.
  Reports are finished, links on home page updated and "about" in centered
Proposed MESCH priorities for 2019
In order to continue to deliver meaningful project support and evaluation we need financial backing, input from individuals with specialist skills and support for both the project co-ordinators and executive. Although we have made some in-roads with presentations and contacts, this has been frustratingly slow.
1) Continue to look for a secretary to supplement our executive
2) Build community recognition of MESCH – continue to look for PR support
3) Foster support for project co-ordinators.
4) Pursue meetings with individuals we have identified as potential sponsors – individuals, corporate.