2019 Report
Projects
Our greatest strength is our commitment to socially relevant and achievable goals and there are very few opportunities in Australia to be part of those changes! The feeling you get of being part of the potential for change is amazing.
MESCH project summary 2018
Project summary:
| Name | Site | Duration | Status | MESCH category | Co-ordinator |
| Trauma care | Ninh Tuan, Vietnam | 2018-current | Ongoing | Development | John C & Cuong Vu |
| Paediatric anaesthesia & surgery | Ninh Tuan, Vietnam | 2019-current | Ongoing | Development | John C |
Trauma Projects Phan Rang (Ninh Thuan Hospital), Vietnam
Visit Date: 15-28 September 2019. Members: Lise Vu, Vy An, Au V, Cuong V and John C.
Affiliation
NTGH Dr The (Lecturer), Dr Hong (Lecturer), Ms Tuoi (Coordinator)
MESCH: We visited the course for short periods during the time we were in NTGH for surgery and anaesthesia
There were ~20 attendees at the course. There was no separate instructor’s course.
The course was held in a single location with good quality audiovisual 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.
Evaluation?
Aims and outcomes
Dr Phien remains supportive of this and has involved the health ministry to get financial support.
There have been 2 courses since we were in NTGH last year and one ran whilst we were there.
Dr Hong has less clinical responsibilities and remains keen on teaching. Both he and Dr The delivered the course with assistance from 2 course graduates from 2018. Since they are not borrowing mannequins from LDGH, the quality of their props is not as good. They are also not using many disposables. It is difficult to know how much commitment there is to this.
We discussed the possibility of using CCTV to both enhance the reputation of the hospital (by helping the community understand what is dealt with and how well that’s done) and use it to help staff recognize what they did well and how they can do better. We suggested, as a first step, editing the footage so all non-trauma material was removed. There was strong support from Dr Hong and little uptake from Dr Phien. Now that the hospital has well-trained instructors, courses can be, theoretically, delivered more easily with less strain on individual staff.
Evaluation
Achieved
Initiate PTC and instructor's courses
Acquisition of knowledge and skills in PTC
Increased awareness of the need for training and for this to be driven from the senior staff.
Introduce a new style of course delivery
Modifications to the PTC course
Establish NTGH ownership of the course
Less certain
Build confidence that care can be achieved with a minimum of technology
Practice of skills and system in acute trauma care
Completely unknown
Understand what impediments might need to be resolved to improve trauma care in Ninh Thuan Province
Understand the structure & processes behind trauma care in Ninh Thuan province
Paediatric anaesthesia and surgery, Ninh Thuan Hospital, Vietnam
Visit Date: 15-28 September 2019. Members: Lise Vu, Vy An, Au V, Cuong V, John C and Michael D.
Background: This was the first project visit to Ninh Thuan district general hospital (NTGH). It was initiated after an approach by the hospital to MESCH in 2016 - while we were working in Da Lat.
Aim was to assist in the upskilling of surgeons and anaesthetists to treat infants and small children.
Affiliation
NTGH: Dr Hieu and Dr Lam were the main surgeons - with Dr An, Pruyn and Thang assisting. Dr Vi was the nominated anaesthetist for the entire period. Some of the other anaesthetists joined for short periods. Administration: Dr Phien (Director of NTGH), Dr Thai (department of quality) and Mrs Tuoi (PA to Dr Thai and Phien).
What happened?
Active planning began in early 2019 with email and SKYPE. In the 2 weeks (15-28 September), both elective (31) and emergency procedures (4) were undertaken on infants and small children. Elective procedures were selected by the surgeons as having conditions for which they wanted to attain procedural competency. There was no specific plan from the anaesthetic department. We were consulted on patients in both neonatal and paediatric intensive care units. Separate group (anaesthesia and surgery) debriefs were conducted at the end of each day.
A suboptimal (cameramen did not bring a zoom lens) video of how to perform hypospadias surgery was made, over-dubbed by Dr Hieu and given to the surgeons. Documentation of the project was made into a video by “Limelight”.
Surgical competency was achieved in correction of both undescended testes and inguinal herniotomy and is well advanced for hypospadias. Anaesthetic questions became much more science based, turnaround times were dramatically improved, and the children were comfortable in recovery. Both the recovery room nurses and surgeons were very clear that they found this approach desirable. Routine maintenance on some of anaesthetic machines brought them back into function. Steve T has offered to do a course for anaesthetic techs and/ or anaesthetists in how the machines work and how to maintain them.
Evaluation
The backbone of this project is the patient support and skills of our interpreters.
There is both a desire and capacity to make this project a success - both from administration and staff.
The MESCH approach, a focus on communication, staff enthusiasm, their pre-existing knowledge and the relationships that developed, allowed surgical goals to be reached more quickly than anticipated.
Anaesthetic goals need to be established and a commitment made to their implementation.
The MESCH approach is very different to what local staff are used to from both other foreign aid groups and visiting Vietnamese doctors from HCMC (Saigon). This approach needs to be repeatedly addressed.in any future interactions with other staff.
What do we need to advance this?
Funding for VN-English interpreters ~ 400AUD./week, airfare and accommodation assistance
We will be back in Phan Rang in late 2020 to continue this project.
Anaesthetic goals need to be established and a commitment made to their implementation. This will progress through discussions with Dr Hieu within next few weeks.
Other
Community first aid project, Lam Dong Province, Vietnam.
Cuong visited Da Lat and tried both then and prior to contact Mr Bao and other interested parties. No reply and, hence, unable to get feedback. Will not follow this up.
Raga Sewing, Efate, Vanuatu
All equipment and supplies that were in Nth Pentecost went further south last Christmas (Narelle and John). Where they currently are (Ambae or Efate) is unclear. Narelle has spoken with and has an email thread with Hollingsworth (and Maylinda) over the last month or more. We remain unclear what their agenda(s) are, though suspect they are finance dependent. We do have feedback about whether they wish to pursue the business model of home-based production (including sourcing some from Nth Pentecost) suggested last year. Narelle has made it clear that we are prepared to make a submission the DFAT or for MESCH to consider a loan following receipt of a reasoned business plan from them. No response at this time.
Electronic readers for primary school, Abuwontonura, 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. Narelle has sought iPad and Android tablets and is in the process of putting educational material on them. She and John will deliver them to Andrew on weekend 30Nov/1 Dec
Thanh Huyen Massage, Da Lat, Vietnam
Cuong was in Da Lat prior to the project in Phan Rang this year. They have at least 8 masseurs and are seeing more than 40 clients/ day. They have adopted some of the business ideas proposed by MESCH.
Neonatal virtual rounds – NTGH Dr Thach (Neonatologist and 2 IC) and Dr Javeed Travadi (Neonatologist John Hunter Hospital, Newcastle)
Initial series of emails stalled. Concerns that neither side has the necessary commitment or resources (time, interpreters) to pursue this. Dr Hieu may have some influence. Discussions with Dr Hieu within next few weeks.
Organisational
Current organisational associations/contacts: MedEarth (medical supplies); Newcastle Global Health; WHO road trauma; AVI; ABV; UN (consultative status)
Amanda T at University of Newcastle – students interested in international development.
Newsletter
John B and Amanda T prepared this
Overseas volunteers
-Trauma course (Cuong Vu, John C)
Executive (Narelle C, Steve T, Amanda T and John C)
Au Vu (interpreter in VN, relationship building, logistics)
David Woodcock (auditing and accounts)
Linda Foggo (Secretarial support)
Naomi Spooner (MESCH website, Twitter and Facebook updates)
Richard Gorman (Sponsored La Cuong Vu’s ticket to Vietnam in September)
‘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) organised cameramen to film the paediatric surgery and anaesthesia project