How can healthcare workers best support each other across borders?

Health partnerships across borders can provide mutual support during this time of adversity, say Claudia Aguirre, Ben Simms, Sheba Gitta, and Johann Malawana

The sinews that connect the NHS to the rest of the world are under strain during this pandemic but unbroken. With at least 13% of NHS staff declaring a nationality other than British, it could hardly be otherwise. These NHS workers carry the additional strain of worrying for loved ones living elsewhere, including in parts of the world where health systems are ill equipped to deal with the covid-19 pandemic.

There are multiple other ties of professional friendship between NHS staff and their counterparts overseas, which continue even as people stretch to respond to covid-19 in the UK. This is most obviously evident in the patchwork of partnerships that link more than 200 UK health institutions with their counterparts in low and middle income countries (LMICs). These health partnerships have been nurtured over time and supported with significant funds from our official development aid budgets.

Travel overseas may not be possible right now but the strong ties of trust, collegiality, and professional respect built over many years of collaboration are alive and well in these partnerships. They are being used as channels during this pandemic for sharing information, expertise, and the mutual support which flows between peers facing a common challenge. 

It is a reminder of how globally engaged our NHS truly is. It also shows us how solidarity across borders is vital at this time and that health partnerships are particularly well placed to help respond to covid-19 as they build links between peers, facilitate professional connections, and enable rapid two-way learning.

To explore these crossborder connections and their possibilities further, in late April, THET (The Tropical Health and Education Trust) organised ”Partnerships in an age of Covid-19,” a one day online conference in partnership with Medics.Academy. We asked this question: as the pandemic passes from one continent to another, affecting all in turn, how can health workers best support each other across borders? 

There was a consensus that a focus on infection prevention control is paramount. Colleagues from the NHS, from the World Health Organization, from Zambia, Uganda, and from Japan all agreed that we need to redouble our efforts in this areaespecially around education and basic infrastructure. The partnership between Brighton and Sussex University Hospitals and University Teaching Hospital (UTH), Lusaka, Zambia, which was established in 2005, is currently implementing a project focused on improving antimicrobial stewardship. A central part of the project has been the development of hand sanitizer within the hospital in Zambia, using local expertise and equipment, significantly reducing the costs associated with procuring hand sanitizers for health workers on the wider market.

Protecting our health workers, no matter which country they practice in, is also a top priority and we should focus on standardising guidelines for personal protective equipment across borders while adapting them for different cultural contexts. Closely allied to this need to protect our health workers is a dual need to provide psychosocial support and show solidarity. Health partnerships can provide mutual support during this time of adversity and can encourage the adoption of simple home grown solutions—for example, using local tailors to create masks and gowns out of donated theatre drapes.

Another strong takeaway was the opportunity to innovate and how we can share such innovations across borders. We heard how the NHS is benefiting from the learning acquired through this kind of engagement. The Torbay NHS Trust, for example, has produced a training programme called GRASPIT (Global Recognition and Assessment of the Sick Patient and Initial Treatment) with their partners at the National Resuscitation Council of Kenya (NRCK). This is now being adapted for use as refresher training for NHS staff.

During the conference, participants also highlighted the need for developing learning communities and greater sharing of resources and information. The revolution in technology that enabled our conference not only highlighted the urgency of the moment as we tackle the covid-19 pandemic, it signalled the inevitable and desirable elevation of this virtual approach to many aspects of our response in a time of climate crisis. The necessity to use technology to facilitate the conversation also resulted in far wider engagement and accessibility. In a world after lockdowns, hopefully we will see a greater use of technology to give everyone a seat at the table of global health and shared decision making. 

As governments and donors gear up to mitigate the impact that covid-19 will have on our partners in LMICs, we must not forget the power individual health workers have to make a difference by sharing expertise and experiences across borders. Technological innovation provides us with the opportunity to achieve this at scale but at its heart, this is simple: it is about the common experience of being a health worker on the frontline at this moment of peril.

Claudia Aguirre is head of regional program university and hospital partnerships in Africa for Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Germany. She is also chair of the ESTHER Alliance on behalf of the German Ministry for Economic Cooperation (BMZ).

Competing interests: None declared.

Ben Simms has been CEO of the Tropical Health and Education Trust (THET) since 2015. He leads an organisation that is pioneering a health partnership approach to the training of health workers across 30 countries in Africa and Asia.

Competing interests: None declared.

Sheba Gitta is the THET country director in Uganda. She is a global health professional and public health leader in multisectoral programme management, including health systems strengthening, child protection, workforce development, multidisciplinary research implementation, as well as networking and partnership building.

Competing interests: None declared.

Johann Malawana is the founder and CEO of Medics.Academy, the founder and managing director of the Healthcare Leadership Academy, and the lead for education and training at Healthcare UK, Department for International Trade. Johann was a former member of the council of the BMA, the General Medical Council, and a board member of the Postgraduate Medical Education and Training Board. 

Competing interests: None declared.