MedicineAfrica Training in Ghana

In her previous blog entry, Georgina Newman described the project she’s been working on setting up a link between two paediatric oncology units using the innovative website MedicineAfrica. Here she tells us how the training in Ghana went…

After training the team at the Edinburgh Royal Hospital for Sick Children, I then travelled to Accra, Ghana, to introduce members of the paediatric department at Korle-Bu Teaching Hospital to the concept of MedicineAfrica. After an initial presentation, seventeen selected members of the department, including doctors, nurses and a pharmacist were given practical training in small groups on how to use the website.

During the training sessions we created medical cases, practised tutorials and even learnt how to upload X-rays to the cases. There were, of course, some glitches, which mostly centred around a sometimes rather slow internet connection. However, overall, the team were enthusiastic and felt the new technology would provide a useful teaching tool and be particularly helpful for discussing complicated cases. In fact, two of the doctors wanted to persuade their colleagues to join so that the website could also be used as an intra-departmental teaching tool.

Training completed it was time for our first tutorial! Fiona Bruce from Edinburgh tutored six nurses and one pharmacist from Korle Bu on the ‘Role of the Nurse in Oncology’. Participants were divided into two groups; each group had at least one computer literate member and shared a laptop. Initially participants were a little apprehensive but the tutorial soon generated a large amount of lively discussion and interest. Tutor and participants discussed the differences between the oncology wards in Accra and Edinburgh. The Ghana team members appeared to enjoy the tutorial and the opportunity to link up with the Edinburgh team. 

So what next? For the next few months, until the November workshop, the Edinburgh team at the Royal Hospital for Sick Children will be giving monthly tutorials to the Ghanaian nurses, who will access the website using the two laptops provided to the unit by AfrOx and World Child Cancer. It is hoped that the tutorials will help build the relationship between the two paediatric oncology teams and that they will promote knowledge exchange and skill retention, as they have done in Somaliland. The effectiveness of the tutorials will then be discussed at the November workshop. If found to be useful, the tutorials will be extended to all members of the Ghanaian oncology team. Please check back for an update on the project later in the year..

Time for the UN to Take Action

David Kerr is Professor of Cancer Medicine at the University of Oxford and President of the European Society of Medical Oncology (ESMO). He represented ESMO at a recent United Nations (UN) meeting in New York, held to discuss the upcoming UN Summit on Non-Communicable Diseases (NCD). He tells us about the NCD Alliance and what it’s trying to achieve...

You may know that, in an unprecedented move, for the second time only in its history, the UN is going to hold a high-level summit to discuss health. The topic that will be discussed is chronic non-communicable diseases.

The only time in the UN's history that it has met specifically to discuss health was around the AIDS epidemic. From that came UNAIDs and the extraordinary advances made globally against the AIDS epidemic. Those of us involved in chronic disease management (cancer, diabetes, cardiovascular disease, and respiratory diseases) have come together to form an NCD Alliance to lobby the UN Summit at the very highest level, so that action is taken when heads of state meet in the assembly at the end of September.

Working with the WHO, we would like to promote a greater degree of international cooperation, with those countries that have strong healthcare systems supporting countries with weaker healthcare systems, so that we exchange ideas and knowledge, create and even up partnerships, and move forward that way.

We would like to see the NCD Alliance continue because how often do you come to a room in which you find leading oncologists, leading diabetologists, leading cardiologists and respiratory physicians working together, singing from the same hymn sheet? Actually, we are usually lobbying against each other and competing for the same resources. At last, we have come together in what is a true partnership and alliance that seems very powerful.

A further area of action is about prevention. We want some very clear commitments from the summit and from global leaders. We need to improve our efforts in tobacco control, particularly in middle- and low-income countries. We would like to see dietary improvements with reductions in saturated fats, salt, and glucose, as well as better food labelling. We would like to see governments make efforts to reduce the harmful effects of alcohol.

With respect to treatment, we need to strengthen healthcare systems. Rather than trying to deliver cancer care or cardiac care or to manage diabetes separately, we need to take an approach in which we work laterally, so that we make an impact on all the chronic diseases that we are discussing. We also need to improve accessibility to drugs, to affordable cancer care, to vaccines - to the whole gamut.

Following the summit meeting, we imagine there will be warm words. But we need action to come from this. Again, we would like to stay involved as the NCD Alliance to monitor how governments put these warm words into effective action.

In Europe, 85% of all deaths are the result of the chronic diseases that we have brought together in this alliance. It is an extraordinary problem, but one which is increasingly faced by the developing world and places a huge burden on developing economies. Two thirds of all deaths in the world today are the result of chronic diseases. We must face up to it.

Global leaders, who will be attending the UN meeting, please listen. Let's go beyond rhetoric. Let's go beyond the semanticism of clever words. Let's come up with action because the world demands it, our patients need it, and there is an opportunity for us to work together in partnership and do something which is extraordinary.