A Formal Memorandum of Understanding was signed in Leeds in 2008. The link is between the Ministry of Health in Madagascar ,the University Hospital in Antananarivo, Hopital Joseph Ravoahangy Andrianavalona (HJRA) and the SALFA group of hospitals. The link is facilitated and supported by Vision2020 (Marcia Zondervan).
Madagascar is a vast island of some 23 million people , much of it is remote and inaccessible in the rainy season. The political situation has been unstable since the coup in 2009 with increasing poverty. This has delayed our programme and continues to make progress difficult for our partners.
All programmes are reported on the website of Opt in (www.optin.uk.net) which is the charity within the Leeds Teaching Hospitals Trust which manages the link .A video of the work is on this site as well as current news .
The Ophthalmology Programme is based on previous work done by Mr Oliver Backhouse for many years previously (see MOSS,www.mossuk.net). The programme to date has included several visits to Madagascar including one where equipment for cataract outcome assessment was installed.
A return visit of ophthalmology nurses to Leeds in 2011 resulted in improved pre-and post operative procedures in HJRA and Salfa, Antsirabe. The Leeds team were part of a high level Madagascar Child Eye Health Stakeholders meeting in 2011 and in 2012 their clinical training programme was integrated into the new Madacagar Eye Health Programme. They participate regularly in the national annual opthalmology conference and continue to teach including on Orthoptic principles and on leadership and management .The nurses from Madagascar who visited Leeds have begun a highly successful one year eye nursing teaching programme .
The Nursing Programme
A scoping exercise for this programme was undertaken in 2010 and repeated in 2013. The programme to 2015 has focussed on teaching senior nurses on infection control, tissue viability, the management of pressure sores and related highly practical matters such as audit and their teaching of others .The extension of the completed 2 year programme is under active discussion.. Teaching always has a practical emphasis and ihas introduced such concepts as audit.
The Rehabilitation Programme
This has been to improve the capabilities and practice of the Rehabilitation Medicine specialists in the 8 regional centres and their senior physiotherapy colleagues (there are no other disciplines). We also teach Community-based Physiotherapists in the same multidisciplinary courses..
The education programme we provided by two or three visits yearly has been developed with the Ministry of Health in Madagascar to provide training to a mid level, examined Diplome Universitaire of the the University of Antananarivo. The teaching has a high clinical and practical content and is patient-focussed. All 8 doctors who undertook this course have gained this Diploma of the University of Antananarivo and are leading members, often directors ,of their rehabilitation centres.
At the end of their course in October 2013 they formed the Association of Physical and Rehabilitation Medicine of Madagascar .This now has a yearly congress with invited international speakers including ourselves .In spring 2014 they ran their first such conference ,a highly practical week's teaching of some 70 rehabilitation practitioners including physiotherapists. Our team taught how to feed, hold and handle children with cerebral palsy and how to assess their progress .They returned in spring 2015 and continued to teach in more depth .They have helped their Malagasy colleagues to establish some parent groups for these children .
The Malagasy Association is now a member of the International Society of Physical and Rehabilitation Medicine and Dr Sonia Andrianabela who leads gave a keynote speech at their last congress (2015 )about Madagascar's progress towards the WHO Disability Action Plan goals .A paper on the training will appear in autumn 2015 in J Rehabil Med .
Spinal cord injury rehabilitation is developing in the capital under the direction of one of the graduates of the Diploma leading with us supporting this exciting and important venture .we aim to establish a network of services across the country
Multidisciplinary teaching continues and has led to multidisciplinary practice. We will continue to support our partners helping them with continuing professional development, not only by face to face teaching but by e mail link and helping them to access the English language internet based teaching which is increasingly available.
Prof Anne Chamberlain
Opt in Co-Director
Academic Dept Rehabilitation Medicine
D Floor; Martin Wing
Tel: 0044 7850 542 027
Mrs Sharon Packer
Secretary, A and E Dept,
Old Nurses Home,
Leeds General Infirmary
Dr Sonia Andrianabela
Ministry Of Health
(Madagascar lead for the Rehabilitaion Programme)
Dr Hery Andriamanjato
Ministry Of Health
(Madagascar lead for the Ophthalmology Programme)