Training and Research in Reproductive Health in South East Asia
(Visiting professorship and training cooperation between the University Women's Clinics in Freiburg, Bonn, Heidelberg and the Universities of Ho Chi Minh City, Hue, Hanoi / Vietnam, Vientiane Laos and Yangon / Myanmar)
Country: Vietnam, Laos, Myanmar
Project management: Michael Runge
Funding amount: 1.65 million euros
Local project partner: See below
All sponsors: See below
Contact: Michael Runge
During our project from 1994 to 2001 it was always apparent that development aid services, including those of the Federal Republic of Germany, are limited to advisory activities at the ministerial level or, in the case of the German development service, to the “community level”. There were no multisectoral project approaches that included university structures. How can maternal and child mortality improve when the necessary specialist knowledge for doctors, midwives and nurses is only taught at the few universities. If there are no more specialists there and no up-to-date teaching materials, then the lessons of general practitioners, who themselves have not received sufficient training, will only be inadequate.
Expertise can only be acquired from specialist doctors.
The historical wrong decision of the international organizations like WHO and UNDP (United Nation’s Development Program) to shorten the training courses for midwives and nurses from originally three years to four months and the obstetric training of general practitioners made a real improvement almost impossible for maternal and child mortality at the end of the millennium. Maternal and child mortality was therefore 100 and 10 times higher than in the surrounding emerging countries of Thailand and Malaysia.
The departments of gynecology and obstetrics at the universities of Vietnam did not have a single full professor in this field in 2000, with a population of 82 million people.
Women’s health does not only mean having access to a safe birth, but also being able to expect correct treatment for so-called women’s ailments (gynecology). In our analysis in the poorest Southeast Asian countries Vietnam, Laos, Cambodia and Myanmar (at that time the least developed countries) we found that all subspecialties of gynecology and obstetrics were not taught due to a lack of specialists. For the patients with health problems in the field of infectiology, hormonal diseases, infertility, cancer and cancer prevention, urology, high-risk pregnancies, etc. there was no technically correct treatment. This means that large numbers of them were mistreated and often died prematurely.
Training course in gynecological infectious diseases in Hanoi 2002 (lecturer Prof. A. Clad Freiburg)
- a further reduction in maternal and child mortality and morbidity rates
- an improved training structure in gynecology and obstetrics at the participating universities, primarily in the postgraduate area (specialist training) and secondarily in the training of medical students
- significantly improved clinical diagnostics and care for women and newborns in the teaching hospitals of the participating countries, which act as knowledge multipliers
- for the first time, multimedia teaching materials in medical English and the national language for specialist training in gynecology and obstetrics were to be produced and used in the project countries
- Internationalization of the participating universities in order to pave the way for new partnerships and training cooperations
- 18 bilingual textbooks in the subspecialties of gynecology and obstetrics were developed for the medical specialists
- The new specialist knowledge was prepared in 18 CD-Roms with over 10,000 PowerPoint slides for the theoretical teaching of foreign and domestic university teachers
- For the practical training, 4 video DVDs with medical diagnostic procedures and operations were developed, which served as preparation for the practical parts of the course
- A further 17 university lecturers and professors from the participating European universities worked with the project manager on the production and teaching of the 18 modules (see above).
- All 18 modules were taught by the lecturers in 67 theoretical and practical workshops, each two weeks in length, at the universities of the target countries
- Total teaching time 134 weeks = two and a half years on-site presence
- Two new university partnerships have been established between the Albert Ludwig University of Freiburg, the National University of Laos in Vientiane and the University of Medicine and Pharmacy in Hue in Vietnam
- With the help of the medical technology industry in Germany, many technical retrofits in the clinical facilities of our partners could also be carried out cost-neutral as industrial donations. These were necessary in order to be able to apply the newly acquired practical and theoretical knowledge in everyday clinical practice to the benefit of the patients and newborns
- In the teaching hospitals, treatment guidelines were developed for the modules for everyday clinical practice
- The medical faculties and the ministries for education and training were advised on the creation of the new, more contemporary specialist curricula
- In order to be able to implement the above-mentioned activities administratively, three “Postgraguate Training Centers in Obstetrics and Gynecology” were opened in Ho Chi Minh City, Hue (Vietnam) and in Vientiane (Laos), in which not only the project is managed on site, but also the courses of the foreign lecturers were held.
- The specialist libraries of the participating institutions have all been equipped with our textbooks and other English-language titles
- The practical parts of the course were held in the respective teaching hospitals of the universities (consultation hours, ultrasound, operations, diagnostics)
Participants in the practical training course "Resuscitation of the Newborn" at the Hue Central Hospital in 2002
- At the participating Vietnamese universities, 123 specialists were theoretically and practically trained by 18 European lecturers and professors together with the local teachers as part of a new, revised national curriculum in gynecology and obstetrics
- In Laos there were no locally trained specialists until 2002, regardless of their specialty. For the whole country there were only 4 specialists for a population of 5.5 million who, with the exception of two, were trained abroad before the war. With our local counterparts, a curriculum for specialist training was developed for the first time and the training regulations for medical students in gynecology and obstetrics were revised
- In a second step, suitable candidates for successful specialist training were sought and included in the theoretical and practical training to become a specialist.
- By the end of the project, the first 12 specialists in Laos had been trained, tested and, with appropriate technical retrofitting, deployed and evaluated in their provincial hospitals
- The local teachers received practical “on-the-job training” and learned to carry out modern multimedia lessons with the help of the new teaching materials
- This “training of trainers” was a prerequisite for sustainable knowledge multiplication at the participating institutions
- To a large extent, our teaching materials have also been integrated into the “undergraduate” classes of medical students and have thus also contributed to an improved education
- The midwives and their teachers were invited to participate in the obstetrical-oriented modules (n = 7) and can now use the new knowledge together with their specialist colleagues
- In the ten years of the project in Vietnam and the first five years in Laos, after thirty years of war and political and economic isolation in these countries, the doors to an international opening and cooperation in health care were thrown open.
- Training and teaching, curriculum development, technical retrofitting where necessary, research and training grants, the development of teaching materials and university cooperation have proven to be powerful tools to ensure sustainable development not only in the sector of women’s health
- The textbooks and teaching modules developed by us have also been accredited by the European Board and College of Obstetrics and Gynecology (EBCOG) in Brussels for specialist training in Europe due to their quality. This in turn led to increased acceptance in the other project countries cooperating with us, especially in English-speaking Africa (see projects in Ethiopia, Eritrea, Ghana and Mozambique)
Lokaler Projektpartner: Ministry of Health, Hanoi-Vietnam, Vientiane-Laos, Yangon-Myanmar
Ministry of Training and Education, Hanoi, Vientiane-Laos
University of Medicine and Pharmacy, Ho Chi Minh City
University of Medicine and Pharmacy, Hue
National University/Medical Faculty, Hanoi
Tu Du Hospital, Ho Chi Minh City
Hue Central Hospital, Hue
Institute for Mothers and Newborn, Hanoi
University of Health Sciences, Vientiane, Laos und angeschlossene Lehrkrankenhäuser
Central Women’s Hospital Yangon, Lehrkrankenhaus der Universität Yangon
Alle Förderer: Wissenschaftsministerium Baden-Württemberg
Deutscher Akademischer Austauschdienst DAAD, Bonn
Mercator Stiftung Essen
Asia-Link Programm der Europäischen Union
Materra Stiftung Frau und Gesundheit e.V., Freiburg
Universitäts-Frauen- und Kinderklinik Freiburg
Freie Universität von Amsterdam Abteilung Geburtshilfe
Alle beteiligten asiatischen Universitäten wie oben
Karl-Storz GmbH, Tuttlingen