Private international cooperation for healthcare workers’ training and capacity building in HuiLi County Hospital, Sichuan, China
Author: Tan Tock Seng Hospital, Singapore
Many rural areas in China’s Sichuan province are poor and backward. Health systems are particularly weak, not only in terms of infrastructure and service, but also staff training and motivation. There was a large unmet need for upgrading skills and providing high quality care to the rural population.
Tan Tock Seng Hospital (TTSH) in Singapore first received an invitation from Medical Services International, a non-governmental organization, to volunteer its services in the rural and poor areas of southwest China in 1997. After an initial learning needs assessment, staff translated the Basic and Advanced Cardiac Life Support (BCLS and ACLS) training materials to Mandarin. After six months of intensive preparatory work, they led a team of eight Singaporean doctors and nurses on a 2-week training mission to Sichuan, China.
In addition to training of healthcare workers in many aspects of clinical care, the TTSH team has also been involved in three capacity building projects at HuiLi county hospital. The first focused on infection control. .The second project was the development of the HuiLi county hospital Intensive Care Unit (ICU). The ICU started in 1999, housed in a converted room with two beds, one ventilator, one oxygen tank and one multi-function monitor. While the hospital planned and built a larger ICU, the TTSH team helped with many sessions of bedside teaching, classroom teaching, equipment training, sharing of protocols and practices, conducting morning and evening ward rounds and working alongside their HuiLi colleagues in caring for patients. The TTSH team introduced and reinforced many of the key ICU knowledge and skill-sets e.g. resuscitation, endotracheal intubation, good ventilator practice, skin care, infection control etc. The ICU team was very receptive and took great pride in providing quality care despite their resource constraints.
The third project was the introduction and setting up of physical therapy and rehabilitation medicine. Until 2007, the HuiLi county hospital had not had a physiotherapy unit and the HuiLi team was not knowledgeable about the role of a physiotherapist. After the establishment of the physiotherapy unit, the concept and understanding of therapy services and rehabilitation medicine took root, culminating in the setting up of a therapy centre in a converted ward in 2009.
The team of doctors from Singapore have shown their dedication to the transfer of knowledge and skills to train their Chinese counterparts so as to build capacity, leading to meaningful change in HuiLi county hospital. This cooperation led to the adoption of several good healthcare practices (such as using latex/ rubber gloves), institutionalizing infection care and the introduction of physiotherapy services. The team also enabled a transfer of several “soft-skills” in health care.
International collaborations for health workforce improvements can be an interesting model to emulate, under certain enabling conditions. The demonstration effect of good healthcare practices can be a powerful means of achieving systems reform and building the case for improvements, both institutional and infrastructure/ service-oriented.