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.
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.
Background – PGF in Bangladesh
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.
The Programme & Activities
In 2018/19, Doctors Worldwide will train 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 currently in training (ending March 2019). We estimate the impact of this training will directly reach approximately 6,000-7,000 Rohingya/host community patients per day by the end of 2019 based on 50 consultations per day per doctor (current number of consultations average is 100-150 per day, which we aim to reduce for better quality of healthcare).The PGF training programme involves 108 hours of classroom sessions and 288 hours of clinical shadowing over a 14-week period. The PGF is 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:
- didactic lectures
- group discussions
- case-based scenarios
- simulated exercises with props
- clinical supervision
All participants will receive a PGF certificate outlining module competencies. In addition, several other certificates as part of the PGF programme are provided upon completion:
- The London School of Hygiene & Tropical Medicine certificate in Health in Humanitarian Crises (via FutureLearn)
- The WHO Emergency Triage Assessment & Treatment ETAT certification
- Basic Life Support BLS
- MHGAP for mental health
- IAWG’s Minimum Initial Service Package (MISP) certification for Sexual Reproductive Health
Who are our participants?
All local doctors working in the Cox’s Bazar region serving in the Rohingya camps are encouraged to apply. Our participants are 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 delivers the training and provides shadowing to Bangladeshi doctors within the camps. The faculty are made up of specialist doctors primarily trained within the NHS from the UK. Approximately 5 – 8 doctors are deployed per cohort to deliver the training and supervise patient consultations within camp clinics as part of the clinical development of Bangladeshi doctors.
The long-term impact of the PGF in low-middle income countries includes better healthcare outcomes in Bangladesh for both the local host and refugee/migrant population as doctors will be better equipped to meet their health needs now and in the future. As these doctors work alongside their peers, and as they progress into leadership roles, the benefits of this training will also be passed on to their colleagues as well as the wider health settings within which they practice and operate.