Abstract
The educational and training aspect of volunteer medical missions was an important focal point at the first International Conference on Humanitarian Medical Missions (ICHMM) held in Singapore from 30 October to 1 November 2014.
Two main components were discussed:
1) Education and training of personnel to work in missions that are designed to elevate healthcare in underserved regions and to respond to humanitarian emergencies.
The medical and nursing professionals of Singapore have a role, as citizens of this region, to help elevate its healthcare standards. Educational institutions have realized this and have incorporated programmes within their curriculum that foster this service ethos. At the Yong Loo Lin School of Medicine, National University of Singapore (NUS) the Global Health and Inter-Professional Education programmes encourage students and equip them with the basic skills necessary to carry out outreach projects. At Duke-NUS, students are given opportunities to participate in sustainable medical and health education missions to underserved parts of Asia through the Duke-NUS Overseas Volunteer Expedition (DOVE) programme. At the NUS College of Alice & Peter Tan, the Outreach and Community engagement programme runs courses such as ‘Hidden Communities’ that delve into the plight of underserved populations.
For people outside formal medical and nursing instructional courses, training resources to equip them for humanitarian and disaster relief missions are available in the Singapore Armed Forces Medical Corps, The Civil Defense Force and NUS HUM-LOG centre (http://www.tliap.nus.edu.sg/humlog). Outside Singapore, organizations like AUSMED (http://www.ausmed.com.au) run regular courses on disaster relief and humanitarian aid. Case Western Reserve University’s Health Frontiers has designed a course ‘How to help the children in disasters’ (ISBN 978–0–615–93257–6) specifically to address the needs of children in disasters.
2) The second aspect of education and training that was discussed at ICHMM centres on programmes that are directed at personnel in the aid-recipient countries.
It appears counter-intuitive to allocate the already-scarce time and personnel to training during disasters and while offering humanitarian aid. Nevertheless, it was agreed that, although programmes which are focused on training take up valuable resources in the short-term, they eventually lead to more sustained service outcomes.
Considerable time was spent discussing ways to make educational and training aspects of humanitarian medical missions successful. The following summary points were agreed upon as essential:
Choose projects that focus on a small area with discernible outcomes, e.g. KK Hospital, Singapore training midwives to reduce perinatal mortality rate in parts of Cambodia; multi-disciplinary cleft lip palate team.
Lower expectations on what can be done and always aim to augment and enhance existing programmes rather than replace or duplicate them.
Be creative and flexible in training personnel to perform a given task. For instance, a nursing aid or pharmacy assistant may be trained to provide vaccinations and dispense contraception advice, releasing nurses and doctors to do more complex tasks.
Consider the capability of the people being trained. Methods have to be contextualized, e.g. using communication boards may work better than PowerPoint presentations in some settings.
Aim to train trainers for sustainability; have a system of reviewing, auditing and improving the training continuously.
Peer-assisted learning is a useful tool; bring your trainees and let trainees of different backgrounds interact with one another. The greater level of cognitive dissonance between trainees will make learning easier.
Bring along people who originated from the recipient country who are currently working in the aid-providing country. They will help to bridge cultural differences and assist translation.
Ensure long-term commitment and continuity so that the training and service goals achieved are sustained and continuously enhanced.
Like any social endeavour, humanitarian medicine requires a continuous system of training and education to achieve foundational solutions to the multi-faceted healthcare needs of underserved regions; a là proverbial, teaching the person to fish rather than giving them the fish.
The first ICHMM has raised the banner for education in humanitarian medicine. It has brought to attention the limitations of current programmes. It has also laid the markers for development of good practice guidelines in this nascent field. There is yet much work to be done.