MMTA Charity Update
Anthony Lipmann reports on the resumption of MMTAs Friends of Mufulira electives programme.
FOM April electives, Niamh Johnson and Dominik Sadczuk, in Mufulira with gynaecologist Dr Gilbert Mukuka, one of our local medical friends whom the team met while assisting with Mufulira diabetes programme
We are, in the UK, acutely aware of criticism of our health system. So I hope those reading about our elective programme will better understand the role it plays in the development of NHS doctors.
Let me reiterate – our MMTA charity’s primary purpose is to provide bursaries to allow final year medical students to experience a completely different health system than our own. It is part of their preparation for life in the NHS.
The fitness of our link with the copper mining town of Mufulira in Zambia, is because it is symbolic of health provision in many of the countries from which MMTA members source metals. Electives have a choice of what health system they would like to experience. Some choose to learn from services in countries who have a reliance on private health insurance (USA). Those drawn to developing countries are in a minority.
The two electives who spent April in Mufulira were Niamh Johnson and Dominika Sadczuk from Edinburgh University. In the last few months of their medical degree, they will become Junior Doctors after qualification in the summer. While able to assist and offer medical opinions, they are strictly speaking acting as observers.
Perhaps you will catch a flavour of their experience from this message Niamh sent us via Whatsapp while there:
“We’ve spent this last week on obs and gynae (Obstetrics and Gynaecology). It’s been very interesting and maybe the most eye opening so far. We were both able to assist in a C-section on Tuesday and each delivered a set of twins! Yesterday we were on the labour ward and saw a difficult delivery … we were quite shocked with the lack of any pain relief in labour and their general approach which was very different!”
On their first day, Niamh and Dominika witnessed two babies die in circumstances which in the UK may not have resulted in mortality.
Here is Dominika writing to Dr Robin Gleek (our FOM medical trustee):
Yesterday we had our first day at Ronald Ross . We were greeted by Dr Tumba and taken to paediatrics for our first week. We will rotate round different departments over the month, and we have agreed to have some days off at the end too. It was really interesting to see the variety of cases
on the ward – things we’ve only seen in textbooks! We’ve started a bit of a list of any issues that we come across and maybe any equipment that could be of use in terms of any donations. Our only concern was the lack of sharps boxes available on the ward with numerous unsheathed needles laying about and a senior Dr getting a sharps injury as a needle was left on the bed.”
From 2016, when our programme started, every student has told us their experience in Zambia helped them prepare for what they would face on the front line of the National Health Service (NHS).
The students learn to appreciate that even tick boxes can save lives. Much as it is easy to rail against bureaucracy, the students reported the effect on patients in its all too frequent absence in Mufulira, as well as lack of accountable organization.
Are we effective? Is FOM worth doing? Or are we merely using a system that we are unable to change to improve our own?
Against these charges, all I can say is that the faithful interaction between MMTAs FOM and Ronald Ross General Hospital in Mufulira is seen as morale-boosting in the local community. From the start, we have created relationships that go beyond the visits. Discussions about medical problems and practices are known to continue remotely after the students have left and trustees keep in touch with the local clinicians throughout the year.
During Covid travel restrictions (as MMTA members know) we were unable to send students, so we delivered equipment. One of the items we provided in that period was a ventilator. The purpose of such a machine is to assist breathing, especially for those suffering from Covid. But the application of its capacity to help patients ‘unable to breathe unassisted’ was not being used.
To maximise effectiveness, FOM provided funds for a doctor and nurse to be trained in intubation at the General Hospital in Ndola. On this trip our electives met the clinicians who had been sent out and were able to report that the machine was already saving lives in this way.
Each year students discuss with Dr Gleek and FOM trustees the details of their journey before departure – transfer from Ndola airport to Mufulira, accommodation, money, travelling within the town, personal safety, opportunities for relaxation, what level of PPE to take with them, whether to take PEP (Post Exposure Prophylaxis).
The support draws on Dr Gleek’s and my experience, as well as Dr Laura Tilling’s deep knowledge of the town as well as friends in the community ready to help.
Finally, I pay valedictory tribute to Simon Boon and Guy Darby who are stepping down as trustees. They have been steadfast donors and supporters of FOM since inception. While they are stepping back from active support, both have expressed their keen hopes for our continued effectiveness. As trustees, we would like to replace at least one with another member drawn from the MMTA membership. So, any member who feels the passion to be involved should contact me at alipmann@hotmail.com or freya@mmta.co.uk
Meanwhile we are delighted to welcome an application to the board of Trustees from two former electives who visited in 2017, Josh Hulman and Helen Wanstall, who are now married. All of us here will appreciate their involvement, as they will, through their recent experience, improve the advice that we can pass on to succeeding generations on what to expect, as well as advance FOM’s work.
In mid-July the next two electives, Rhyanna Morris & Benedict Dacre, this time from Liverpool University, depart, and I shall report back on their progress in a future issue of The Crucible.
By Anthony Lipmann
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