This Link is a specialist eye link and is part of the VISION 2020 Links Programme. The VISION 2020 Links Programme was established by the International Centre for Eye Health in 2004 and aims to increase the quantity and quality of eye training in low income countries by developing sustainable eye links with a suitable UK partner.   We are just in the process of setting up  the linkage with Southampton. The process started  late 2009. 

Fields of work  

Ophthalmology

Current activities

1. Outreach activities at Ubima, a town in one of the local government areas
2. Quarterly eye expeditions at different areas as outlined by departmental resolution
3. Strengthening of the newly established subspecialty units in the department
4. Training in the different subspecialties of the consultants 

Additional information

The Link is currently involved with community eyecare activities in a locality in our environment.  Residents are sent to region on two monthly rotations and are supervised by consultants in their surgical activities.

The Link’s pediatric ophthalmology and vitreoretinal units are in its infancy. The Link wants to develop their subspecialties within Ophthalmology.

Link requests

Donations of equipment to ease delivery of eyecare particularly in paediatric ophthalmology and vitreoretinal-all equipment used in these. Additional needs include laser machines, portable operating microscopes, fundus camera, vitrectomy machines, portable slit lamps, low vision devices, GDx, squint surgery equipment , visual field analyser etc.

We also require assistance in training in the different subspecialties and help in using some of our equipment. We also need volunteers in our surgical expeditions. Sponsorships for procedures will also be appreciated by patients.

Contact information

Nigeria
Dr Adedayo Adio,
Head of Department, Senior Lecturer and Consultant Ophthalmologist
University of Port Harcourt Teaching Hospital
Rivers State.

Tel: +2348033108139

The key aims of establishing a cancer care link between Velindre NHS    Trust and cancer care workers in Sierra Leone:

• To assess the current provision for cancer care within Sierra Leone in the context of: Prevention, Treatment, Palliation
• To establish useful and practical links to individuals and health care organizations within Sierra Leone (SL) that might benefit from a link between Velindre NHS trust, Cardiff University and cancer care in SL.
• To identify key areas for partnership between Sierra Leone and Velindre NHS trust that might be developed.
• To assess the availability of postgraduate training in obstetrics & gynaecology and oncology.
• To support research activities in cancer and palliative care in Sierra Leone
• To support the personal and professional development of those working for or associated with Velindre NHS trust, through this link.

The first visit of the Velindre Team to Sierra Leone was funded by a grant from ‘Wales for Africa Health Links Fund’ with the aim of exploring the benefits of a cancer care link between Velindre NHS Trust and cancer care workers in Sierra Leone. This visit occurred in January 2010. The establishment of the cancer care link between Velindre NHS Trust is the first cancer health care link between Wales and an African country.

Fields of work

Cancer

Additional information

(a) Cancer poses a global problem, accounting for 12.5 % of all deaths worldwide in 2005; by 2020, new cases of cancer are projected to reach 15 million annually, 70% of which will be in developing countries, including over one million in the African Region1.  Whilst available studies and cancer incidence and mortality estimates in Africa are largely insufficient, African cancer registries suggest a rising cancer incidence due to infectious diseases, tobacco, polution and unhealthy diet.  Cancers in Africa  mostly occur in the economically productive age groups with major implications for communities and families, particularly the children.

(b) The most common cancers in Africa are cancers of the cervix, breast, liver and prostate as well as Kaposi’s Sarcoma and non-Hodgkin’s lymphoma2.  The precise cancer profile for Sierra Leone is not known as there is currently no cancer registry and no published accounts for cancer incidence and mortality2.  However, the published cancer profile from the Conakry cancer registry3 in an adjacent country, Guinea, suggests the highest incidence of cervical cancer in Africa, (see table 1 below).  In West African countries, Senegal, The Gambia, Mali, Niger and Nigeria cervical cancer is the most common female cancer followed by breast cancer and in males the most common malignancy is hepatoma with Burkitt’s lymphoma the predominate malignancy in children. 2

(c) Current evidence would support the potential for prevention of approximately 40% female cancers with HPV vaccination to prevent cervical cancer and hepatitis B vaccination with the potential to prevent hepatoma in males.  For other cancer there is the potential for potentially affordable treatment eg mastectomy and tamoxifen in breast cancer and cyclophosphamide based chemotherapy, which can be curative in 60% of childhood Burkitt’s lymphoma.  For all cancers there is the potential for palliation eg pain control with morphine.

1 WHO, Preventing chronic diseases: a vital investment, Geneva,World Health Organisation 2005.
2  Cancer in Africa-Epidemiology and Prevention IARC Scientific Publications No.153 IARC Press 2003
3 Koulibaly M et al. (1997) Cancer incidence in Conakry: first results from the Cancer Registry 1992-1995.Int.J Cancer, 70,39-45.

Contact information

UK
Dr Richard Adams & Dr Malcolm Adams
Velindre Cancer Centre
Velindre Rd
Whitchurch
Cardiff
CF14 2TL

Tel:02920196127
Email: richard.adams@wales.nhs.uk
Email: malcolm.adams11@yahoo.co.uk

Sierra Leone
Dr. Bash Taqi
Director of Non-communicable diseases research and postgraduate training
Ministry of Health and Sanitation
4^th Floor Yougi Building
Freetown
Sierra Leone

Email: dabashtaqi@yahoo.com

In 2004 Dr Abuh, Medical Director of ECWA Eye hospital, Kano, requested a link through the VISION 2020 links programme run by the International Centre for Eye Health. He wanted to develop his paediatric ophthalmic service – improving management of paediatric cataracts, developing his team’s skills in performing orthoptic assessments and visual acuity measurements in children, and enhancing his own strabismus surgical skills.  In 2008 Mrs Rosie Brennan asked ICEH to find a VISION 2020 link partner for WHSCT. The two institutions were considered a potentially suitable match and in Sept 2009 six people from the WHSCT made a Needs Assessment visit to ECWA Eye Hospital, Kano.  This group comprised a senior manager, an anaesthetist, an orthoptist, an optician, an ophthalmologist and a theatre sister.  A return visit of a team of six from ECWA came to the WHSCT December 2009.   This group comprised an ophthalmologist, an optician, an anaesthetic nurse, the theatre charge nurse,  a theatre nurse and an orthoptic nurse.  The Needs Assessment phase of the link was completed, a three-year activity plan was devised and an MOU signed.

Fields of work

Anaesthesiology, Cancer, Nursing, Ophthalmology, Surgery

Current activities

In April 2010 a team of six from the WHSCT will go to Kano for a week.  During this week  the following activities will occur.  For paediatric cataract management, biometry and postoperative care will be discussed focused around specific cases.  A specific children’s outpatient clinic will be set up.  Training will be given to 3 members of staff in visual acuity assessment in children, stereopsis assessment and how to perform the prism reflex test, cover test, prism cover test and how to assess ocular movements.  Surgical planning for concomitant squints will be discussed.  Horizontal squint surgery will be performed.   The WHO guidelines for surgical safety were implemented following the last visit.  There will be an audit review of this.  Biomedical engineering support will be provided by an engineer for preidentifed equipment.   The necessary parts for these repairs will be brought with the team.

Please see our website www.vision2020kano.org for our reflections on the visits so far, our expectations of the visit from the WHSCT team to Kano in April 2010, photos of our times together and details of our fundraising acitivities.

Link requests

A link with the Kenyan National Retinoblastoma strategy group.  Investigations into how to establish this are ongoing.

Contact information

UK
Mrs Rosie Brennan
Altnagelvin Area Hospital
Glenshane Rd
Londonderry
BT47 6 SB

Tel: +44 28 7134 5171
Email: rosie_brennan@btinternet.com

Nigeria
Dr Abuh Sunday Omogani
ECWA Eye Hospital
PO Box 14
Kano
Kano State
Nigeria

Tel: + 234 8060297605
Email: ecwakano@hotmail.com

This Link was established in 2009, though there has been a long established link between NHS Borders in Scotland and St Francis Hospital (SFH), Katete, Zambia since Dr Sandy Logie worked there in 1992. Both hospitals serve rural areas and are the same size with 350 beds each. Dr Dorothy Logie set up a charity to support the hospital after her husband’s death, and that now contributes to supporting the large HIV/AIDS clinic and the other work of SFH which serves a poor rural community of over I million people.

Fields of work

HIV/AIDS, Malaria and TB, Maternal and Child Health, Primary Health Care, Reproductive Health, Tropical diseases

Current activities

Work in progress is dependent  on an exchange of  skills and mutual awareness between health staff at NHS Borders and SFH in the areas of:

• Training of Labour Ward Skills modelled on the evidence-based Liverpool School of Tropical Medicine / RCOG (UK) training programme
• Setting up a service for, and training in, Syndromic Management of Sexually Transmitted diseases, including couple counselling
• Deliver paediatric training in acute emergencies to SFH staff
• Pharmacy support and installation of ACSCRIBE software to ensure constant drug supply

Additional information

Dr Dan Clutterbuck, STI and HIV/AIDS specialist in Lothian and Borders, has visited SFH three times to set up a STI service linked to the hospital HIV clinic, which now has 12,000 patients on its books. This clinic works with the District Health Service, and rural health staff, to train and support in: Syndromic Management of Genital Ulcers, enhanced Syndromic Management of Vaginal Discharge, couple counseling, and HIV clinical teaching, according to  Zambian Syndromic STI management protocol.  Funding has been found to appoint a part-time clinical officer to supervise and monitor the clinics. Regular visit are planned by NHS staff.

Link requests

Funding to allow further exchange of staff, to purchase and transport equipment, and for medical and technical exchanges for clinical teaching.

We hope to  continue the liaison with SFH and to support  the hospital in general.  (A Mission and 2^nd level government hospital).

Contact information

UK
Dr Dorothy Logie
Dr Brian Magowan
NHS Borders
Newstead
Melrose
Scotland

Email:
delogie@aol.com
Brian.Magowan@borders.scot.nhs.uk
bordershb@borders.scot.nhs

Zambia
Dr Shelagh Parkinson
Exec Director
St Francis’ Hospital
Private Bag 11
Katete
Zambia

Tel:  +062 52210/52344
Fax:  +062 52278
Email: stfrancishospital@iwayafrica.com

www.saintfrancishospital.net/