Sharing the learning
The mission in Cambodia at the Angkor Hospital for Children, Siem Reap, is a long-term project to provide:
- Cardiac surgery to children with congenital heart defects
- Training to local surgeons, cardiologists and anaesthetists
The project aims to develop an independent, free at the point of use, cardiac surgical provision to local children and their families. It is supported by a large Italian charity, “Aiutare I Bambini” (Help the Children), which funds a variety of different missions around the globe, including distance adoption, support for children affected by AIDS, and housing for women and children victims of abuse.
The project is now at its third mission over a 20 month period and has moved from the initial provision of cardiac operations to children with defects of moderate complexity (ASD, VSD, AVSD, TOF, DORV, Congenital coronary anomalies) to a full scale training program which has been implemented by the local training school. At the moment, the hospital is the only one in Cambodia to provide any training program in paediatric medicine, accident and emergency, surgery and intensive care.
So far, in two missions of five days each:
- 31 patients were examined
- 22 patients had operations (performed by Dr Marianeschi and Dr Viola, of University Hospital Southampton, with no mortality recorded)
- 8 patients were reviewed in follow up clinic
In the last mission (Dec 2013), in addition to the surgical activity, the project:
- Provided a written training program, adapted from the Israeli and UK training programs to the local reality and facilities (provided by Dr Viola and Dr Marianeschi)
- Provided 7 hours of formal teaching (provided by consultants)
- Provided 3 skill session (1/2 hours each) (provided by nurses)
- Instituted Paediatric Intensive Care Unit (PICU) rounds, briefing and de-briefing sessions on the surgical days, augmented the preoperative cardiac clinic to expand on the cardiology referral.
- Enrolled and activated three trainees in cardiac paediatric surgery and provided them with a training logbook
A fellowship in Italy (sponsored by “Aiutare I Bambini”) has been activated at the Ospedale Niguarda (tutor Dr Marianeschi) for one trainee (2014-2015).
While the hospital is working at completing the building work to a new ICU-Surgical block, the project aims to:
- Contine the missions (2-3 per annum) to completion of the training program, likely another 4-5 years.
- Continue to perform cardiac surgery for the same level of complexity in order to reduce waiting lists and provide training cases to local surgeons.
- Provide a second training fellowship (to a surgeon or perfusionist or ICU specialist) at UHS (2015-2016, funding to be sorted, possibly “Aiutare I Bambini” but any other solution is welcome…)
- Continue to involve the industry for provision of material and instruments (surgical tools, echo machines, ventilators and so on).