On Thursday 23rd June, GECCo (the Global Emergency Care Collaborative) brought together an eager and professionally diverse crowd to share ideas, approaches and challenges in the field of global emergency healthcare.
In Manchester the sense of excitement was palpable as attendees, or potential collaborators as the GECCo team would stress, chatted and made their way into the venue. Dr Anisa Jafar, Higher Emergency Medicine Trainee, NIHR Academic Clinical Lecturer and GECCo collaborator, kicked off proceedings with an introduction to the work and goals of GECCo. She explained that GECCo is not ‘a who’ or ‘a what’ but rather a resource for connecting those involved in emergency care with an interest in global health. Indeed, anybody with the time and interest to grow the collaborative is welcome and this thread of open invitation was woven throughout the afternoon. GECCo emerged out of an ongoing exchange of ideas between a group of clinicians who found themselves coalescing around related subjects in global emergency care and saw the need for a platform through which UK emergency care and global health could coexist. GECCo aims to provide this platform with a particular emphasis on sustainable and responsible practice. Dr Jafar emphasised that GECCo is its participants and encouraged us to share our ideas, make connections and identify areas for collaboration throughout the day.
The first session was delivered by a panel of current and past Emergency Medicine Global Health Fellows. If your attention is immediately hooked by this fantastical job title, you are not alone! The audience listened attentively to the experiences of Doctors Molly Howarth-Maddison, Imara Gluning and Bethany Fenby-Hodgson from the North Manchester, Bristol and Leeds programmes respectively. Whilst the fellowship offered by each institution differs in the details of its makeup, they all aim to provide post-F2 doctors with an opportunity to combine experience in the ED with experience working in a global health setting, as well as the time and funding to undertake relevant courses and gain experience in related specialities. For example, Molly shared her experience of undertaking the Diploma in Tropical Medicine and Hygiene, spending three months within North Manchester’s infectious diseases team alongside her ED work. As part of Imara’s fellowship based in Bristol, she spent two months working in Nanyuki Kenya, with a focus on quality improvement projects. It was encouraging to hear how these fellowships have taken the journey from idea to reality and that they are also increasing in number across the UK, creating more formal opportunities for early career doctors to integrate these interests into NHS posts.
This session was followed by a complementary panel discussion that explored how programmes such as the Emergency Global Health Fellowships can be crafted to meet the needs of NHS trusts and teams. Doctors Caroline Heggie and Katherine Potier, Emergency Medicine Consultants, and senior staff nurse Sara Visus-Marco shared their experiences of the ‘back end’ machinations of integrated global health work and NHS careers. Dr Katherine Potier, North Manchester, described the process of creating the North Manchester Global Emergency Medicine Fellowship and building support for it within the wider team and trust. Drawing on the hospital’s local context in which there is a relatively high burden of infectious disease, she saw the opportunity to create an attractive F3-type post which would provide invaluable experience for the fellow in both the ED and the infectious diseases department, as well as the opportunity for funded further study or international working. At the same time, the fellow would provide reliable service provision within the busy emergency department, facilitate more effective working across the ED and ID teams and be well placed to lead audits and quality improvement projects. This was an inspiring example of how creative solutions that support all involved can enable trusts to see such projects as being of direct benefit, rather than as luxuries that they cannot afford. Dr Caroline Heggie then shared with us her experience of her unique consultant post working on Shetland. This enables her to work clinically both on and off Shetland and provides protected global health time annually, during which she can undertake international projects. She explained how currently there are similar contracts available within General Practice, Obstetrics and Gynaecology and General Surgery, with posts in Psychiatry and Anaesthetics in the works.
Sara Visus-Marco, Senior Staff Nurse at Bristol Royal Infirmary, provided an invaluable perspective on the landscape of global emergency healthcare for nurses, which sadly at present reflects the asymmetry in access between doctors and other clinicians elsewhere in global health. Sara shared her experience of taking up a global health emergency medicine fellowship run through the BRI. As part of the fellowship, she spent 10 weeks working in Nanyuki, Kenya, with a particular focus on sustainable quality improvement projects in collaboration with local colleagues. Sara reflected on the opportunities presented by such an experience including increased exposure to paediatric, obstetric and gynaecological presentations, as well as the development of her research and teaching skills. However, she also shared some of the challenges including having to take unpaid leave to complete the fellowship. In the discussion that followed it was clear that the consensus in the room was that we must all take on the challenge to support the integration of the MDT into global emergency care. The benefits in terms of the invaluable contributions that the MDT can make to global health projects, as well as the gains in staff morale, professional development, and retention, more than justify an urgent review of the current situation, particularly with respect to funding.
Attendees were then introduced to the event partners including the Humanitarian and Conflict Response Institute, Doctors Worldwide and the Faculty of Remote, Rural and Humanitarian Healthcare of the Royal College of Surgeons of Edinburgh. Please do explore the range of resources and global opportunities they offer.
Next up, fuelled by some fantastic cake (gluten-free and vegan – thank you very much GECCo!) and tea, we pooled our collective experience and insights through a workshop steered by Bristol-based Emergency Medicine Consultant Andy Lockyer. In groups representing different stakeholders in the global emergency healthcare ecosystem, of which we drew up a list at the start of the workshop, we brainstormed how each party would define a successful intervention and how we can measure this effectively. The workshop generated much discussion and lively debate and Andy invited all involved to continue the conversation beyond the session – watch this space for new approaches emerging from the fertile ground GECCo has created.
Andrew Fryer, of the Royal College of Emergency Medicine’s Global Emergency Medicine Committee, then joined us remotely with an update on the committee’s current work. The goal of the committee is to contribute to developing emergency care systems globally and it currently runs partnership programmes in Egypt, Uganda, Ghana, India and Pakistan. It also provides a range of resources to interested international partners, as well as awards and grants, for example, the William Rutherford Award.
Last and certainly not least, we got out of our seats for several rounds of speed networking. This was a professional musical-chairs of sorts where attendees rotated through several pairings, each providing the opportunity to connect with and learn about each other’s projects and professional journeys.
All in all, GECCo succeeded in bringing people together whose interests and experiences run the spectrum of emergency care and global health. Conversations were initiated, people connected and everyone from FY1s to consultants were given an open invitation to get involved. The sessions were both enlightening and inspiring but perhaps most importantly, they were pragmatic with a focus on action. My take-home message from the day is that global emergency care must be a priority as we consider global health equities and it is us, the interested and the motivated who must carry these projects forward into real action. With the network of expertise and resources that GECCo has created, we are all far better placed to do so.
For more about GECCo and the fantastic resources they have available, please check out their website.
All photos credited to Dr Anisa Jafar.