Magee Project
First Report- 20th April 2006
New Zealand
Protocols for Delivery Unit and High Dependancy
Unit
A University
of Auckland student –Aditi Chebbi- successfully gained
a summer studentship to work on protocol development. Over 4 months 12 protocols
were developed in consultation with Phurb Dorji in Thimphu.
A University
of Auckland website was developed
to initially host the protocols:
www.MFM.auckland.ac.nz
USS training
Phurb Dorji arranged for 12 Xray
technicians who are doing ultrasound scans throughout Bhutan
to attend a 4 week course in Thimphu
to be run by Emma and Dave Parry. The technicians were to come in 2 groups of 6
and replacement technicians had to be placed in their districts. The ministry
of Health approved and were to fund this initiative. The
Magee project was providing the teaching from Dave and Emma Parry. The
technicians training thus far had been 3 months observing scanning in India.
They then returned home and most had no supervision after. This compares to New
Zealand where training comprise 2 years hands on supervised scanning with 2
exams followed by positions which are supervised by senior sonographers
and sonologists (consultants).
Peter Stone kindly provided a
number of talks to Emma and Dave prior to their departure. It is hoped that by
raising the quality of
scanning throughout Bhutan
a real improvement in care, referrals and patient confidence in the service
could be seen.
Personnel Training
At the time of arrival of the Parry’s in Bhutan,
one obstetrician and two sonographers had been
dispatched to India
for 4 and 2 years of training respectively.
Capital expenditure
A high-end ultrasound machine had been purchased for the Perinatal unit in Thimphu and was expected to arrive in June
2006. A desktop computer and printer had been purchased and had arrived in Thimphu and were awaiting assembly. This
should happen by the end of the week.
Bhutan
On arrival in Thimphu the Parrys
had a week to recover and visit the Paro Tsechu (festival). At the hospital, great progress had been
made on the new 350 bed hospital. The external structure was almost complete
and outfitting remained to be done. A delivery unit with 6 individual private
delivery rooms had been secured with a separate tea room for the midwives and a
separate room for the doctors. An initial visit to the hospital with Phurb Dorji was to meet the
Director of nursing- Mrs Tandin
Pemo and the Medical Superintendent of JDW National
referral hospital- Dr Uygen Dophu.
Both Mrs Pemo and Dr Dophu had met with the Magee family in November 2004 and
were very positive about the project. In consultation with Mrs
Pemo, it was agreed that Emma would spend some time
on delivery unit assisting with cases and also getting a chance to get to know
the midwifery staff and how the unit worked. From this further protocols would
be developed with midwifery and obstetric input. After discussion with Dr Dophu, it became clear there was a hospital website that
the protocols could be hosted on. Dr Dophu was keen
that doctors from the peripheries could access these (as had been the original
plan) so that referrals were appropriate and timely as this was a major concern
for JDWNRH.
Protocols for Delivery Unit and High Dependency Unit
No further work at this time as main focus on training Xray technicians. However there is a possibility of hosting
these protocols at the JDWNRH website.
USS training
The first batch of 5 (1 could not
attend) Xray technicians arrived on 17th
April. In the days preceding this the course was put
together by Dave, Emma and Phurb. Two ultrasound
machines had been made available from 10.30 am
each day so that after this the students were scanning patients with Emma
providing hands on feedback. A copy of the course outline is attached.
Course materials were photocopied
and an MCQ and logbook prepared.
On the Monday morning the course
was officially opened by Dr Uygen Dophu
and Dr Phurb Dorji. Thanks
was expressed to the Magee family and the Parry family for their support and
help in bringing the course together. Initially all got to know each other and
levels of experience ascertained. Students had come from far and wide: Punakha, Gelegphu, Yebilaptsa and Thimphu.
The first week’s lectures focused
on physics (Dave) and basic scanning set-up (Emma). An MCQ was sat on the
Tuesday and will be repeated at the end of the course to show an improvement
(hopefully!)