Doctors Worldwide

POSTGRADUATE FELLOWSHIP

The overall aim of the PGF Programme in Bangladesh is to improve and strengthen the quality and delivery of healthcare provided to Rohingya refugees and local host populations at health facilities primarily located in camps around Cox’s Bazar, thus contributing to reduced morbidity and mortality rates.

The Postgraduate Fellowship in Refugee and Migrant Health (PGF) is a 13-week medical capacity building and training programme specifically designed to help local doctors working in humanitarian settings to improve their clinical practice. It targets those who have not worked in similar settings previously, or have not received specialised training to meet the specific healthcare needs of a migrant/refugee population.The PGF started in November 2017 in Bangladesh in response to the ongoing Rohingya crisis, and we have been working hard to grow and improve the programme to date. We aim to roll out the PGF in other countries from 2020 onward. To find out more or if you are interested in bringing the PGF to your community or area, please get in touch.

Background

The Rohingya people have suffered under decades of discrimination and lack of access to basic rights and services such as healthcare with high rates of attacks reported in 1978, 1991-92, and in 2016. Recently, In August 2017, a widespread attack in the Rakhine state of Myanmar (Burma), including murder, torture, rape, sexual violence, enslavement, triggered over 700,000 Rohingya refugees to flee to its neighboring country of Bangladesh. The UN Chief of Human Rights has reported it as a textbook example of ‘ethnic cleansing’. From a medical and public health perspective, there are immense requirements in the control of communicable disease, management of non-communicable disease and injuries, support for mental health and psychological trauma, as well as understanding reproductive health and coping with the effects of gender-based violence. These requirements are further challenged by the lack of health literacy amongst the Rohingya population stemming from decades of denied healthcare access.
Following on from a pilot run held in February 2018, DWW launched the PGF officially in July 2018 with its first cohort of 24 Bangladeshi doctors.

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Medical doctors trained
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Patient consultations benefitted
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Clinical shadowing hours conducted
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Teaching hours conducted

Programme in Action

In 2018/19, Doctors Worldwide trained approximately 96 local Bangladeshi doctors working within the Rohingya camps & host communities, with 24 doctors already trained between July 2018 – October 2018, and another 24 doctors trained until March 2019.

The estimated impact of the training directly reached approximately 6,000-7,000 Rohingya/host community patients per day by the end of 2019 based on 50 consultations per day per doctor. The PGF training programme involved 108 hours of classroom sessions and 288 hours of clinical shadowing over a 14-week period. The PGF was centered around the delivery of 7 independent modules:

  1. Health in Humanitarian Emergencies
  2. Triage and Acute Care Management
  3. Communicable Diseases
  4. Non-Communicable Diseases and Palliative Care
  5. Mental Health in Humanitarian Emergencies
  6.  Sexual and Reproductive Health, Family Planning and Gender Based Violence
  7. Clinical Assessment, Professional Practice, and Communication Skills

 

The teaching incorporates a wide range of methodologies including:

  • eLearning
  • didactic lectures
  • group discussions
  • case-based scenarios
  • simulated exercises with props
  • clinical supervision

 

All participants received PGF certificate outlining module competencies. In addition, several other certificates as part of the PGF programme were provided upon completion:

  1. The London School of Hygiene & Tropical Medicine certificate in Health in Humanitarian Crises (via FutureLearn)
  2. The WHO Emergency Triage Assessment & Treatment ETAT certification
  3. Basic Life Support BLS
  4. MHGAP for mental health
  5. IAWG’s Minimum Initial Service Package (MISP) certification for Sexual Reproductive Health

 

All local doctors working in the Cox’s Bazar region serving in the Rohingya camps were encouraged to apply. Our participants were carefully selected based on medical background and experience, and we continually aim to have a mixed cohort of gender, ethnic, religious, age & experience of Bangladeshi doctors.

The Doctors Worldwide medical faculty delivered the training and provided shadowing to Bangladeshi doctors within the camps. The faculty was made up of specialist doctors primarily trained within the NHS from the UK. Approximately 5 – 8 doctors were deployed per cohort to deliver the training and supervise patient consultations within camp clinics as part of the clinical development of Bangladeshi doctors.

Impact

  • Trained 99 medical doctors over 4 cohorts representing nearly half of all the medical doctors in the Rohingya camps.
  • Benefited over 900,000 patient consultations with doctors trained through the PGF.
  • Held 201 sessions (787 hours) of clinical shadowing conducted by Doctors Worldwide medical faculty.
  • Issued 594 additional professional certificates including MISP for Reproductive Health, ETAT, BLS, and LSHTM Health in Humanitarian Crises (online).
  • Represented by 36 NGOs, iNGOs and GOs across the trained cohorts.
  • 138 sessions (423 hours) of teaching conducted by DWW medical faculty.
  • Seen over a 20% increase from baseline knowledge demonstrated by each participant, on average, in addition to new skills learned.
  • Recorded over 1,500 workplace-based assessments in personal logbooks including case-based discussions, directly observed procedural skills, mini-clinical evaluation exercises, and reflective practice by DWW medical faculty
  • Deployed 26 expert faculty of doctors from Doctors Worldwide including primary care, emergency medicine, paediatrics, OBGYN, mental health, and more
  • Created a clinical support group for 179 Bangladeshi doctors run by Doctors Worldwide

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