Reflections on our visit to Poole Hospital, February-April 2012

 

Dr Majok Malek Ruom, Medical Director and Dr Garang Dakjur Lueth, Director of OPD, Wau Teaching Hospital

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 It was a great honour and privilege to receive invitations from the Poole Africa Link to come to Poole hospital for a 6 weeks clinical attachment. There were a lot of stumble stones on our way to UK but the Poole Africa link (PAL), Ministry of Health/RoSS and the British Embassy in Juba all helped us to get our visas, and make our visit a success.

On Saturday 25th February 2012 we landed Heathrow international Airport where we were met by Dr Frankie Dormon, consultant anaesthetist and an active member in the PAL. We could not believe that we had at last arrived after 26 days of our struggle since we left Wau Teaching Hospital on 30th January. Dr Dormon’s beautiful BMW shining car carried us comfortably, via a view of the English Chanel, to her wonderful house in Poole.

Later we went to a party at Harbour Heights Hotel, Poole. It was a very great occasion prepared for our reception under the theme ‘’SUPORT SUDAN AND DINE WITH US’ – the theme which I corrected in my speech to be ‘SUPORT SOUTH SUDAN AND DINE WITH US’ .There was a big attendance, the occasion was officially opened and a dinner was served by students of Bournemouth University. Speeches were delivered by Dame Yvonne Moores, patron PAL, Dr Anoinette McAulay, Chairperson PAL and one of us, Dr Majok Malek Ruom, medical director Wau Teaching Hospital and guest of honour which dealt with how to make the link stronger, and a fund raising was done to purchase a portable ultrasound machine for Wau Teaching Hospital.

The following day we went the St Peter’s church where we received a warm welcome by the congregation and then went shopping in preparation for our work in the hospital.

On Monday 27th February Dr Dormon took us to the hospital where we met Sister Hilary, the PAL coordinator, who took us to the occupational health office where we got ID cards and we had tests for HIV, Hepatitis B and C, rubella and varicella, a Mantoux test and a chest x-ray so that the hospital was sure about our safety. We toured the hospital to be acquainted with all departments and given a very busy time table to rotate in various departments.

 

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During our work in various departments we were well impressed by the following:

  • High technology in investigations
  • Nurses qualification
  • Cooperation among doctors and nurses
  •  Good communications between clinical staff and patients
  • Organogram of the hospital (we attended a Hospital Board Meeting )
  • Division of labour which we have seen during the hospital board meeting.
  • Clean and good organization of the hospital
  • Hard working, no negligence nor malingering.
  • Accuracy of time management
  • Patients are well educated medically so they discuss with the doctors plans for the management and the prognosis of their disease!!
  • On discharge patients are not just sent out from the hospital, but their fate is planned on how and where will they go – especially the homeless, elderly and those who have no relatives
  • On admission every patient receives identification name tag at his/ her hand.
  • Accommodation in Parkston House was very comfortable (clean, self-contained and everybody was in his/her own room with internet service).

Achievements

During our stay we learnt the following:

  • Use of Ultrasound
  • Additional clinical and surgical skills
  • Acute illness management (AIM) course.
  • Advance Trauma Life support (ATLS) course.
  • Time management
  • Managerial and leadership skills.

In addition we managed to lobby for more links with different institutions in UK and so we got the green light to link Rumbek State hospital with Dorchester, and the University of Bahr El Ghazal with the University of Southampton. We visited Bournemouth Hospital NHS where Dr Bushra Herieka, a Sudanese doctor, donated ARVs drugs for the VCT centre in Wau teaching Hospital.

We also learnt about English culture, were entertained by many people in Poole, London and Bournemouth, saw different places around Poole, and visited Bath and London.

Impressions

  • We noticed that, compared with South Sudan, there is a greater reliance on technology and relatively less on clinical skills. For example, we came across a patient in the Emergency Department who was just sent for a chest x-ray without putting a set scope on her chest to check for signs of pneumonia (which would have been diagnosed quickly on auscultation). Although the advantages of technology are many there are some disadvantages such as iatrogenic complications (e.g. injury of the CBD during laparoscopic cholecystectomy).
  • Our period of clinical attachment was very short in relation to the amount of work we had to do – so there was no concentration on one speciality. We took a little here and there so we sometimes felt like malnourished children given ‘too much’ food in one

Recommendations

  • To have a 2 years programme of attachment where doctors will receive sufficient knowledge on general specialization, or different major and minor specialities which will be beneficial for our young country without enough specialized doctors.
  • Carry out as soon as possible recommendations agreed at a Joint meeting with the Juba Link on the Isle of Wight on a South Sudan Basic medical training that will be based in Juba for the benefit of the whole of South Sudan.
  • Lobby St. Mary/Juba Teaching Hospital link to convince the various Royal Colleges in the UK to establish examination centres for part one examinations in Juba.
  • Establish an Intensive Care Unit and post-operative recovery care unit in Wau Teaching Hospital in collaboration with Poole Africa link.

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Conclusion

This visit to Poole was very challenging as we had visa and money problems and were delayed 2 weeks in Nairobi (where we were robbed). However we want to thank again the many people of the Poole Africa Link for their support and hospitality and the British Embassy in Juba.  Our thanks to Dr. Eluzai Hakim a committed South Sudanese physician in St. Mary’s Hospital, Isle of Wight for his tireless efforts to link our hospitals with UK hospitals. Above all our thanks must go to God Almighty who gave us the will to struggle, the power to overcome the challenges and the wisdom to understand our situation as a new born country with limited resources and many priorities. We are committed with the Poole Africa link to work together in delivering quality health services to the people of South Sudan through our tireless cooperation. 

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