International

Bangladesh Endoscopy Training Project Report

Visit by Dr Mesbah Rahman, Dr Dafydd Richards, Dr Umakant Dave, Mark Hillier and Sianed Dafydd.

We selected Bangladesh as our project venue as it is one of the poorest countries amongst the booming economies of Asia (ranked 161 to 183 in world ranking in various parameters by the UN and WHO). One of the members in our team has connection with Bangladesh which helped to set up vital links.

Prior to our visit, we conducted a postal survey of ERCP services in Bangladesh. This work has been accepted for a poster presentation at the "World Congress of gastroenterology- Gastro2013". A five member team visited Bangladesh for two weeks (January-February 2013). We conducted two days of seminars covering advances in gastroenterology/endoscopy in venues across the country along with local speakers and delivered keynote lectures in the Bangladesh Gastroenterology Society (BGS) annual conference. We conducted the first ever full day of live ERCP workshop (video link between Dhaka Medical College hospital and BGS conference venue) in Bangladesh. We also conducted the first ERCP/Endoscopy Assistants' hand-on workshop and the first ever hands-on ERCP workshop using models and accessories for ERCPists. We collected feedback from all the events we conducted and it was rated very good or excellent in almost all parameters.

In addition to a successful first visit to Bangladesh, there have been other achievements. We have already established a good relationship with BGS office-bearers and have continued discussions on future developments. Two consultant gastroenterologists (key partners from Bangladesh) attended the BSG annual conference in Glasgow and spent 2 weeks in Wales as clinical observers. Student exchange is being established between the College of Medicine, Swansea and Dhaka Medical College. We have established a charity to continue the project named GASTROENTEROLOGY TRAINING ACADEMY (registered with charity commission, UK; registration no: 1150282 http://www.charitycommission.gov.uk/find-charities/) and are organising fund raising events. We have participated in two live TV chat shows on Bangla TV to raise awareness about developments in endoscopy and this project. Two Bangladeshi gastroenterologists have joined the BSG as overseas members and another sixteen are in the process. We have provided some input to BGS in the development of draft guidelines on minimum quality standards in endoscopy. A draft proposal on a Bangladesh endoscopy training centre is being developed.

Cook Medical ® and Olympus ® supported the project. We thank BSG and hope BSG will continue to support this project.

Photograph showing travel arrangement from hospital to hospital (left to right: Mark Hillier (endoscopy nurse), Umakant Dave (consultant Gastroenterologist), Sianed Dafydd (radiology nurse), Dafydd Richards (consultant radiologist), Mesbah Rahman (consultant gastroenterologist) and Dr Rahman (BGS representative)).

Kamazu Central Hospital, Malawi - June Update

Visit by Dr Mark Hendrickse(MH) Consultant Gastroenterologist, Blackpool Teaching Hospitals NHS Foundation Trust

Previous visits by BSG member Dr Mark Hendrickse (MH) and other colleagues had established an endoscopy training Programme at Kamuzu central Hospital (see previous report on visit in Feb 2013 below). Basic skills and enhanced refresher courses have been run with MH as a visiting trainer. Gift Mulima was also formally assessed as being fully independent in diagnostic gastroscopy with experience in dilatation, stenting and variceal ligation. He has recently completed a formal Training the gastroscopy trainer course in Blantyre as well as an ex vivo therapy course. It was recognised that in order for the endoscopy service to expand, there is a requirement to develop further trainees to become independent endoscopists and potential trainers. Further trainees also required a basic skills course.

BSG Sponsored Endoscopy Training at Kamazu Central Hospital - Malawi

Endoscopy Training at Kamazu Central Hospital (KCH) Endoscopy Unit - Lilongwe-Blackpool Endoscopy Link 25th February – March 1st 2013.

Visit by Dr Mark Hendrickse(MH) Consultant Gastroenterologist, Blackpool Teaching Hospitals NHS Foundation Trust

Background

Lilongwe is the largest city and capital of Malawi. Kamuzu Central Hospital(KCH) is the main government funded tertiary referral hospital, with an estimated number of beds varying from 600 – 1000 beds. Upper GI bleeding from portal hypertension complicating schistosomiasis and oesophageal cancer are major causes of morbidity and mortality hence the need to have a comprehensive endoscopy service. Through links with the Mersey school of Endoscopy and the Liverpool Malawi Welcome trust previous visits to KCH endoscopy unit in 2011 and 2012 by MH, Dr Paul O'Toole (POT) and colleagues initially involved a basic skills in gastroscopy course for surgical registrars, assessment of endoscopy nurse practice / training and decontamination, and subsequent follow up of trainee endoscopist / endoscopy nurse training evaluation. Recommendations on endoscopy unit expansion, decontamination requirements and support in nurse training were also made. After visits to the Blantyre endoscopy unit and participation in endoscopy nurse training programme in 2011, Rachel Jiya (RJ) and colleagues produced a comprehensive report detailing suggested developments / improvements required in the KCH unit. This has been forwarded to The Matron and the Hospital director at KCH.

Aims of current visit:

  1. To assess endoscopy training requirements of current trainees
  2. To provide small group teaching with all surgical trainees on:
    1. management of upper GI bleeding with particular emphasis on Variceal bleeding (including use of sengstaken tube)
    2. endoscopic therapy particularly variceal banding, oesophageal dilatation and stenting
  3. Review endoscopy training for surgical trainees committed to GI surgery
  4. Provide a refresher / enhanced skills course for those with endoscopy experience
  5. Basic skills course for those with no or very limited endoscopy experience
  6. Evaluate more experienced endoscopist (GM), and run a training the gastroscopy trainer course
  7. Set up meetings with Hospital director, Matron and Head of Department to take forward recommendations from previous visits / report by RJ and colleagues
  8. Assess current endoscopy unit equipment / facilities and future requirement

A full report of the visit may be downloaded below:

Malawi 2012

GI Cancer: an emerging African priority in 2012

Report on a workshop on GI cancers in Lusaka, Zambia

7th – 13th September, 2012

This workshop was held in the University of Zambia School of Medicine and the University Teaching Hospital, Lusaka.

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