Training cooperation in gynecology and obstetrics from leading European and Asian universities
At the beginning of the millennium, Laos was by far the poorest and least developed country in Asia and the country with the highest maternal and child mortality, which was one hundred and fifty and forty times higher than in Germany. Similar to Vietnam in the mid / early nineties, the situation was not only due to the political and economic isolation after the Indochina War under a communist government with a planned economy, but also to the country’s geographical location without sea access and the difficult-to-access mountainous regions of the country.
Presentation of the teaching materials in gynecology and obstetrics produced for the Orotta Medical School and the Asmara College of Health Sciences
Health care was provided by far too few and poorly trained general practitioners. There was no specialist care outside the capital, and care for women was limited to that
the country has 85% home births cared for by poorly trained midwives or traditional unskilled midwives. Obstetric emergencies could not be cared for even in the district hospitals. 70% of these hospitals were unable to perform a caesarean section or emergency blood transfusions. Emergency treatment of newborns and infants was practically non-existent in rural areas.
In view of this catastrophic situation, the only five specialists trained abroad turned to us for support at the end of the 1990s.
In 2001 we therefore began to slowly expand our Vietnam project to the neighboring country of Laos. During this time, we opened our first postgraduate training center for gynecology and obstetrics on the campus of the medical faculty in Vientiane. We developed an initial curriculum for the initial training of gynecologists in Laos and started teaching with our first 18 textbooks and modules that we had developed for Vietnam.
Opening of the second practical training center at the Sethathirat teaching hospital in the presence of Dr. C. Kröner (center), the German ambassador (left) and the Laotian health minister (right).
- Reduction of maternal and child mortality and disease rates in accordance with the United Nations Millennium Development Goals by 50%
- Development of modern medical care for girls and women and their newborns
- For the first time, up-to-date specialist training for gynecology and obstetrics and an improved training of medical students in the country
- In order to put the specialist medical competence on a broader knowledge base, a further 10 were developed by the project manager and other lecturers of the participating universities in Europe in addition to the 18 teaching modules originally developed for Vietnam
- as there were not enough university lecturers for specialist training so far, a “training-of-trainers” program had to be launched. Suitable candidates were sent to Germany and neighboring Thailand with training grants to learn modern didactics, multimedia lessons, etc.
- the teaching materials had to be translated into Lao and edited because of the inadequate knowledge of the English language
- In order to include the north of Laos, which is particularly cut off from medical development, in the project, a third training center for medical students, midwives and nurses was to be set up there
- In order to improve practical training at the university, a second training center with a teaching clinic at European level was planned
- The project manager should live on site for 6-7 months a year, work clinically, teach and make it possible to carry out the project with the counterparts
- twelve other lecturers from Europe were willing to take part in the lessons (theoretical modules and practical training) for two weeks per module (28 modules)
- By 2011, 51 specialists in gynecology and obstetrics had been trained in Laos for the first time. Today they serve the 17 provincial hospitals of Laos and for the first time make it possible to refer sick women to specialist treatment in the provinces
- These colleagues are now in turn responsible for the modern professional training and further education of midwives, nurses and medical students in the district hospitals and thus carry the knowledge to the periphery in the long term
- Two more training centers were opened in Vientiane and in the north of the country in Luang Prabang. Together with the new university teachers, a clearly defined curriculum / training catalog and the teaching materials, these represent the backbone of gynecological care in Laos.
- The Luang Prabang Regional Hospital was named the teaching hospital of the University in Vientiane with the third training center and trains 50 medical students, midwives and nurses every year
- The new specialists at the 17 provincial hospitals received new technical equipment (ultrasound, colposcopy for cancer prevention, surgical instruments, microscope, examination chairs and, in some cases, delivery room beds, cardiac monitoring during childbirth (CTG), etc., so that they can also apply their specialist knowledge in practice can
- Five young university teachers were trained through scholarship programs (Thailand, Germany)
- 18 of the newly trained specialists received further training grants to the Khon Kaen University in neighboring Thailand to learn modern clinic management and the organization of further training events (CME = continuous medical education)
- In 2009 our project founded the first “Laotian Society for Gynecology and Obstetrics” together with our Laotian colleagues. To date, this specialist society has organized 11 annual annual meetings with all of our trained colleagues, the country’s midwives, with the participation of health policy and the WHO, and has contributed to their ongoing training
Participants of the fourth specialist course 2009 in Vientiane before the theoretical specialist examination ("multiple choice" exams)
- 1,800 of our textbooks have been made available for specialist training and the libraries
- the clinics in Vientiane, the provincial hospitals, the libraries of the med. Faculty and our specialists received 3360 CD-ROMs and video DVDs for the training and further education of all colleagues
- The “Albert Ludwigs University of Freiburg” and the “National University of Laos” have established a more extensive university partnership through our project, which will contribute to the future internationalization of the universities and international cooperation
A bedside medical specialist exam in Vientiane in 2008
And last but not least
- Maternal and child mortality fell over 50% in the 10 years of our projects in Laos (from over 600-800 dead mothers / 100,000 live births to around 280 in 2011
Patients before the consultation in the training center Luang Prabang 2010
Presentation of the medical certificate at the fifth annual meeting of the “Laotian Society for Gynecology and Obstetrics” in 2012
Local project partners: Ministry of Health, Vientiane-Laos und Hanoi-Vietnam
University of Health Sciences, Vientiane, Laos und
angeschlossene Lehrkrankenhäuser Sethathirat,
Mother-Child Hospital und Hospital Mahosot
University of Medicine and Pharmacy, Ho Chi Minh City
University of Medicine and Pharmacy, Hue
Tu Du Hospital, Ho Chi Minh City
Hue Central Hospital, Hue
Institute for Mothers and Newborn, Hanoi
All sponsors: Wissenschaftsministerium Baden-Württemberg
Deutscher Akademischer Austauschdienst DAAD, Bonn
Else-Kröner-Fresenius Stiftung, Bad Homburg
Stiftung Entwicklungszusammenarbeit (SEZ) des
Landes Baden Württemberg
Materra Stiftung Frau und Gesundheit e.V., Freiburg
Universitäts-Frauen- und Kinderklinik Freiburg
Freie Universität von Amsterdam Abteilung Geburtshilfe
University of Health Sciences, Vientiane
Karl-Storz GmbH, Tuttlingen