SHORT REPORT OF FM RELATED ACTIVITIES IN AFRICA

14 April 2010Pieter van den Hombergh

From 20 maart to 8 april I travelled to Kigali, Nairobi & Dar es Salaam. I mixed my holiday with some activities promoting FM.

RWANDA

In Kigali Mieke Visser organised a two days training course for residents in FM.

The content of the course you can find in a powerpoint presentation on for it is very much similar to what is presented in the NTC. (Netherlands Tropical Medicine Course). All 7 residents of FM attended the course as well as Michel Miller who is in charge of the organization of the FM-training. It was a great experience to work with so committed students.

Mieke and Andres Marin a registrar in FM from California also contributed to the course.

The seven residents were Mugali Anaclet from Kabgaye District Hospital, Vincent K. Cubaka, Rene Kabera, Gabriel Kabilwa, Theoneste Rubanzabiwi, Alfred Rutangenbwa and John Munyamaliza.

The training is financed from the CDC though the U of Colorado and Mieke got an allowance though the Primafamed progam.

Yet, the financial basis for the FM-training was very small, with few new applications for next year. Let’s hope that will improve.

Prof Barongo from Tanzania is head of the program but indicated that he wanted to resign.

Mieke and I had dinner with Dr. Corrado, who is doing research in PIH in Rinkwavu from Harvard and is supporting the FM-program. Invited were also Charlotte Bavuma and Gabriel. Both are internal medicine physicians and Charlotte is specialized in DM treatment.

Chronic care is key in FM and was taught to the residents in the community course of Mieke. Corrado was praising the managerial qualities of Mieke and her organizing of the community course.

The dinner resulted in short in some agreements.

  1. Mieke would be involved again in the community training program in September and ask for funding of her visit.
  2. Dr. Corrado will heavily try to raise funds for the FM to pay for faculty. He expects results only in October at the earliest. Then Mieke could be paid out of that money.
  3. Mieke will look for linkage of students to residents to jointly do research.
  4. All of us will work on a projectproposal that could be financed

Mieke and I travelled through Rwanda visiting friends of Mieke. The genocide of 1994 left severe scars and we were shown parts of it and how it is remembered.

KENYA

The 30th of March 8.00 am I met Dr. Agnes Gatome in the KEC in Waitumu house. She is in charge of the Catholic Health Commissionof the KEC and explained the involvement of the KEC (Kenya Episcopal Conference - Catholic Secretariat) in training nursing and other staff. They were not involved in training of physicians, but admitted that it was difficult to get MO’s in the hospitals.

We discussed the potential of FM and the possibility of mission hospitals to be involved in the training. KEC was regularly speaking with people from CHAK and the subject could be brought up in that meeting.

The visit was just to present FM and the current program. It was a pleasant exchange of ideas.

I hope KEC will find the FM-program challenging and get involved.

We were invited for dinner by Margriet van Enk, a Dutch FP in Nairobi with a staff of 40 people in her clinic. We agreed that it would be a perfect place for a dutch registrar to do an elective.

TANZANIA

In Dar es Salaam I had a chance to previsit the clinics Maxima was going to attend. Pharmaccess invited me to come along and Suzanne showed introduced me to health clinics that were upgraded to provide HIV-treatment.

Pharmaccess had done an enormous job upgrading the clinics all over Tanzania and assessing 500 and reassessing 1600 clinics in visits, using a PDA.

The instrument used in the visit checked for structure and process-indicators but it would be difficult to measure the clinical effectiveness of the clinics.

I spoke to an old (mze) respectable doctor in one of the clinics and he was very much a GP. He had no clue if MO could do extra training in his country in FM. He also didn’t see the necessity. The clinic also had a antenatal unit and a delivery room, but the midwife said that all deliveries were referred.

The police had its own HIV clinic with extensive testing facilities (CD4, Western Blot, etc.)

I spoke with Bjarne Jensen of Danida, who was a financial policy advisor in the MOH. He had been a former tropical doctor and that was what still motivated him in his present work. There was no awareness in the MOH of FM as an opportunity.

I spoke to Ype and Belia Smit, both FPs in Dar. They also were interested to host registrars.