The Tropical Health and Education Trust (THET)
Established in 1988, THET has developed longterm partnerships in eight African countries and with over eighteen UK hospitals. THET provides training for frontline health workers in the poorest settings, and develops the institutional capacity of local health institutions. This is achieved through focussing on the goals of the overseas partners and offering specialist support from UK based health professionals.
Somaliland
The self-declared Republic of Somaliland, situated in the Horn of Africa, was formed in 1991 after breaking-away from Somalia. It is still awaiting recognition from the International Community. The country ranks as 161 out of 163 least developed countries in the world www.reliefweb.int. Most hospitals were destroyed during the civil war of 1988-91 and the country lost many of its health professionals. The capital of Hargeisa saw 90% of its structures destroyed in the war. Approximately 800,000 people fled the country. Many are now returning to Hargeisa and camps are expanding on the outskirts of the town. Recent stability and successful multi-party elections have provided opportunity for real progress in many aspects of the reconstruction process.
Challenges facing health care include:
- lack of sustainable health economy
- few locally trained professionals
- no independent professional bodies for medical, nursing and allied professional personnel
Ahmed Mohamed is a former medical director of the main hospital in Hargeisa. While working at King’s in 1998-9 Ahmed first suggested a link between King's and Somaliland.
KTS Partnership
The KTS partnership is a multi-professional long-term initiative. THET have been instrumental in linking King’s College Hospital with medical institutions in Somaliland. Following a fact-finding trip in 2000, King’s staff (supported by colleagues from other NHS organisations) have continued to make regular teaching and training trips.
Health institutions in Somaliland
The Hargeisa Group Hospital
This is a government hospital which was established in 1953. It is the only general hospital in Hargeisa (population 600,000) and the only referral hospital in the country (population 3.5M). It was built to serve a population of 30,000. The hospital featured in the Comic Relief TV programme in 2003. Several KTSP projects are underway, focusing on A&E, theatre, general nursing, pharmacy, psychiatry, paediatrics and orthopaedics.
The Institute of Health Science
This reopened in 2003 and nurse education, which is so central to the countries healthcare, has begun again after a gap of 15 years. There are 7 tutors and the KTSP is planning how best to respond to the request for support.
The Edna Adan Maternity Hospital
This is an NGO hospital (45 beds) and nurse training school, which opened its in-patient facility in March 2002 to address the high maternal and child mortality and morbidity rates in the local community. The Somali diaspora, scattered throughout the world, have helped finance this impressive building. It has been a particular privilege for KTSP teams to have been involved at this hospital from the outset.
The New Medical School in Amoud
The first entry of 11 medical students in this 4 year old University are now in their first clinical year with 15 starting in year 1.We have been asked to support the students and intend to provide teaching during the regular trips to Hargeisa. Amoud is situated in the town of Borama in the west of the country near the border with Djibouti.
‘The visits from KCH are valued. The emergency room was not good before; now record keeping systems have been implemented and procedures have been set up that make the whole place more professional.’
Mr Mohamed Abby (Chairman of the Regional Health Board in Hargeisa)
‘THET's vision is for links to run as partnerships between two hospitals for as long as there is interest from both institutions. A link is determined by people, based on the need expressed and how this can be met. With interest, commitment and understanding from both partners, links can develop into effective, long-term partnerships with mutual benefit for both institutions.
One of the most rewarding and valuable aspects of links are the relationships built by link members in both institutions. UK NHS staff wanting to help overseas but unable to go abroad for long periods are able to share their skills and experience for short periods but over many years, and are therefore able to make a difference.’
Ms Sarah Adams (Senior Project Co-ordinator, THET)
‘The KCH team helped us when we opened our hospital and needed expertise to help start treatment protocols. Since then your team returned on several occasions to see how we are doing, assist us in training our staff and help us to improve the care we give to patients. As a result our hospital has become a referral teaching hospital for reproductive health for a wide geographical area in the Horn of Africa.’
Mrs Edna Adan (Foreign Minister and director EAH)
‘The attitude of the KCH team is very good. They look at the local situation and modify their practice accordingly; they make changes slowly and with respect.’
Ms Roda Ali (Nurse Tutor, EAH)
‘Many NHS staff from a wide range of disciplines participate in international development programmes and respond to humanitarian emergencies. Such work can be of lasting value to the people concerned. It can also provide individuals with personal inspiration, refreshment, and perspective, which can add to their professional development and growth as well as benefiting the NHS when they return.’
Sir Liam Donaldson (Chief Medical Officer for England)
International Humanitarian and Health Work, Toolkit to Support Good Practice. July 2003
'KTSP is an opportunity for a health service from the developed world to put something back into the developing world. Professionals from King's can open their knowledge and skills to others where that is needed. It will also provide a richness and variety to the professional lives of all clinicians who get involved in KTSP'.
Mr Malcolm Lowe-Lauri (Chief Executive KCH)
‘KTSP is the right way to support health services in the developing world. The work of King’s professionals in KTSP has the Trust Board’s strong support.’
Mr Michael Parker (Chairman KCH)
‘The link has been so useful. Since the war, there has been no training in Somaliland. When the team from KCH come they train doctors and nurses, theoretically and practically; they manage difficult cases and teach how to do them. They are very respectful. They come here and work with local people as colleagues, discussing all aspects of the link and work. They do not impose. Keep going with the link.’
Dr Gous Ibrahim Said (Obstetrician, Gynaecologist, Surgeon)
