Implementing an EM training program in Nepal and Myanmar. Chris Curry

Transcription

1 Implementing an EM training program in Nepal and Myanmar The 2 nd IEC Symposium, 2013 Chris Curry Assoc. Professor, University of Western Australia Emergency Physician, Fremantle Hospital chris@chriscurry.com.au 1 Strategies Derived from New Zealand Papua New Guinea A perspective on developing emergency medicine as a specialty International Journal of Emergency Medicine 2008; 1:

2 Strategies - 1 For creation you need -champions -a union - administrator support - bottom-up development - top-down development -energy, endurance Brahma - creator 3 Strategies - 2 To prosper - use benchmarking - borrow from others - take advantage of local events - take advantage of local interests - recognize local appropriateness -link EM to primary care and public health Lakshmi- prosperity 4

3 Strategies - 3 To succeed - educate everybody -organize an independent training program -become instructors - look for sustainability - prioritize the direction of effort - overcome roadblocks Ganesh- success 5 Seven years in Nepal 2007 IEMSIG Newsletter - BPKIHS EMCON visit to BPKIHS 2009 Nepal Medical Association Conference visits to BPKIHS, TUTH 2011 Nepali delegation to ACEM Doctor of Medicine in EM at TUTH 2013 NEMsem13 Fellowship in EM at BPKIHS, PAHS Emergency nurse training 6

4 Textbook of Emergency Medicine Suresh David, Anthony Brown, Brian Nelson, Ashis Banerjee, V. Anantharaman Authors India 123 USA 42 Singapore 40 Australia 24 UK 17 China 5 South Africa 4 Malaysia 3 Hong Kong, New Zealand, Nepal 2 Bangladesh, Sri Lanka, Oman, Israel, Malawi, Liberia, Italy, France, Sweden, Germany, Canada 1 8

5 2008, 2009 BPKIHS, G Malla 9 Nepal Medical Association Annual Conference

6 2011-February Institute of Medicine October Curriculum DM Emergency Medicine Tribhuvan University Institute of Medicine Maharajgunj, Kathmandu, Nepal

7 2012 the old emergency room the new ED Red Area 14

8 2013 NEMsem first consideration of nurse training 16

9 Delivery of support to IOM/TUTH 2012 Mark Monaghan, Chris Curry (x2), Ryan Tan, Adrian Goudie, Gina Watkins, Athol Steward, Tony Mattick 2013 Jamie Hendrie, Chris Curry (x4), Adrian Goudie, Sanj Fernando, Tom Morton, Gina Watkins, Kavita Varshney, Brian O Connell, Ruth Burns RN, Mike Nichols, Guru Nagaraj, Jennifer Rush, Mark Monaghan, Ros Taylor, Rob Currie, Margaretha Offringa RN, Tony Mattick, Jo Koryzna 17 BP Koirala Institute of Health Sciences 18

10 Ten years at BPKIHS 2004 Owen Lewis Prof GP&EM Gyanendra Malla to Adelaide 2006 EM Curriculum Workshop - Suresh David, Anantha Application to Academic Committee 2008 visit 2009 visits 2012 New VC, BP Das, visited Perth Academic Committee approval 2013 Fellowship in EM: October Rabin Bhandari Gyanendra Malla 20

11 Delivery of support to BPKIHS 2012 hosted Vice Chancellor BP Das at Fremantle Hospital 2013 Chris Curry (x2), Gaynor Prince, Mark Monaghan, Ros Taylor, Rob Currie, Ric Todhunter, Jacqui Thomson 21 Five years in Myanmar 2008 Cyclone Nargis 2009 Primary Trauma Care 2011 Prof Zaw Wai Soe to ACEM ASM Sydney 2012 Symposium Myanmar 18 (M18) MEMIC PTC, EMST, ASSET

12 Champions - Myint Thaung, Zaw Wai Soe, Maung Maung Htwe 23 Myanmar EM Introductory Course (MEMIC) June

13 FACEMs in residence Chris Curry, Michael Augello, Shona McIntyre, Georgina Phillips, Antony Chenhall Courses ELSi, MIMMS, TotR, Pain Mx, ACLS (HK), Ultrasound (HK), APLS, Alfred Trauma, Toxicology AVID FACEM Rose Skalicky AVID Ambo trainer Nigel Klein Repeat of 18month Diploma in EM AVID positions x2 FACEMs, x2 ambo trainers Visiting short courses Etc Towards an MMedSc EM 26

14 For creation BPKIHS IOM/TUTH Myanmar - champions Owen Lewis Gyanendra Malla Ramesh Maharjan Pratap Prasad ZawWai Soe Myint Thaung Maung Maung Htwe -a union Myanmar Medical Association - administrator support In 2012 Partial Yes -bottom-up development Gyanendra Malla Ramesh Maharjan Some of M18 - top-down development VC, Rector Director, IOM Med. Ed. Dept. Minister ofhealth, Rector UM1 - energy, endurance Gyanendra Malla Ramesh Maharjan champions, M18 27 BPKIHS To prosper IOM/TUTH Myanmar -use benchmarking Timein Adelaide Visits to Australia Visitsto Australia, Hong Kong -borrow from others ACEM ACEM ACEM, RACS, IFEM, Hong Kong -take advantage of local events Change of VC Med Council India recognition of EM Cyclone Nargis -take advantage of local interests -recognize local appropriateness Rivalry with IOM Need to lead SEA Games Dec13 MDGPs in EDs MDGPs in EDs No ED at NayPyiTaw 1000 bedded hospital -link EM to primary care and public health MDGP MDGP Leading prehospitalcare training 28

15 To succeed -educate everybody -organize an independent training program -become instructors -look for sustainability BPKIHS IOM/TUTH Myanmar Under way Under way Under way Yes Yes Yes PTC PTC PTC, ELS Future credibility, acceptability, employment -prioritize the direction of effort To provide local faculty To provide local faculty SEA Games, ED leadership, MMedSc EM -overcome roadblocks 29 Realities Things to do.. take time in Nepal Things can change.. even in Nepal Culture trumps logic, seniors trump juniors, Nepalis trump foreigners 30

16 Great journeys are taken one step at a time 31