Spanish doctors take the ‘MIR’ to poor countries

Project to increase the number of specialists in Niger.

The training is the basis for providing health systems with new health professionals trained to perform in the best possible way. That is why, for a few years, the Ministry of Health, through the State Foundation for Health, Childhood and Social Welfare (CSAI Foundation) and in collaboration with the Spanish Agency for International Development Cooperation (Aecid)has launched different projects in countries in difficult situations around the world with the aim of strengthening their health capacities.

This is the case of the actions that have been developed in Niger and in Bolivia. In the case of the African country, the ministry has deployed a project that has been underway since 2021 in order to train specialist doctors to strengthen the capacities of the country’s health system. A ‘mission’ of which the head of the Neurosurgery Service of the University Hospital Complex of Ourense (CHUO), Ana Pastor.

“The project consists of collaborating in the training of doctors in Niger to increase the number of specialists in Anesthesiology, Resuscitation, Surgery and Emergencies”, he explains to Medical Writing. Other projects have been dedicated to helping Primary Care by other homologous doctors in our country.

The advisory project will conclude, foreseeably, on October 31, 2023 and has a budget of 200,000 euros, of which almost 30 percent of the total has been executed so far. In it participate 10 healthcare professionals and three specific objectives are pursued: increase and complete the quality of the training of resident doctors in General Surgery and priority surgical specialties; support the development of training in the area of ​​Anesthesia and Resuscitation; and improve the organization and management of the emergency services of the Niamey National Hospital and its endowment through the donation of essential equipment.


Very poor health


The current health situation in Niger is very precarious; There are only 16 specialists in Anesthesiology for the entire territory, while in Spain, for example, we have numerous hospitals with more than 50 anesthesiologists each. Therefore, for Pastor it is a priority, therefore, “increase the number of specialists in Niger, and Spain is collaborating for this with various training programs for resident internal doctors”.

Given the high number of polytraumatized patients in Niger, initial efforts have been directed towards training on the management of these patients. In fact, “the training course in this regard has been given several times by us, until they manage to instruct enough Nigeriens so that they themselves can impart it to other local doctors”. It is what is called “training of trainers” and, in Pastor’s opinion, “constitutes one of the most effective actions for achieving the objective of implementing the desired training.”

To optimize our stay as much as possible, each doctor also teaches other specific courses for each specialty, which are:

  • General Surgery: damage control in emergency surgery, chest drain placement, etc.
  • Anesthesia and resuscitation: basic and advanced cardiopulmonary resuscitation, difficult airway management, utility of ultrasound for anesthetic blocks and for cardiopulmonary diagnosis, etc.
  • Neurosurgery: safe mobilization, helmet removal, cervical collar placement, interpretation of spinal X-rays and cranial CT, etc.

Pastor explains that Niger’s healthcare “is very limited”, both in terms of material resources and infrastructure, all of which is “essential to achieve up-to-date, quality and safe training”. “In Niger health is not public or universalTherefore, the population does not have direct access to it for free, which considerably increases morbidity and mortality”, he indicates, while recalling that Niger is one of the poorest countries in the world.


The Spanish project in Bolivia

Another example of Spanish health projects in other parts of the world is that of Bolivia. In this country, the Bolivian Ministry of Health is supported in the training and incorporation of health specialists and subspecialists for the provision of human resources. Through the project led by Spain, the Bolivian Health System will see the management and training of its human resources improved, by strengthening its National System of Medical Residency.

You know this project first hand jesus millan, who, among other things, is a Doctor of Medicine and Surgery from the Complutense University of Madrid, and a Doctor of Pharmacy from the same university. In conversation with this newspaper, he explains that in Bolivia he has come to work in “the strengthening the training of health specialists through concerted actions to design, implement and develop medical residency programs”.

The activities are carried out with the local leadership of the Bolivian Ministry of Health and the national organization that regulates the training of health specialists in Bolivia, which is the National Committee for Teaching, Assistance and Research Integration (CNIDAI).

Thus, Millán explains that the development of the project “has allowed us to open fields of collaboration in different fields that help and complement the activities in order to achieve the final objectives and that are none other than to improve the health of the population in Bolivia through the improvement in the training of health professionals”.


The role of MIRs, key

MIR also participate in this project, something that is “key to the success” of the project itself. “Many of the activities that we carry out are planned and focused on them., and towards their participation in them, since it is regarding them understanding and visualizing the orientation that must be given to the training programs, that they become familiar with their philosophy, that they know and assume the evaluation processes of the learning that will reveal the results of their own training, their areas of improvement and their areas of strength”, as indicated. Therefore, he considers that they must be the true protagonists of their trainingand therefore, “it is not that we can count on them in the projects, it is that they must be integrated”.

As a reflection, he ensures that all health systems have problems, “and whoever thinks otherwise is not telling the truth”. “It is true that the problems can be of a different nature in different places or regions. I think that the problems of financing, and management in the provision of services are always very decisive, ”he settles. Lastly, she stresses that the urban-rural distribution in Bolivia is equally so, “although fortunately They have a telehealth and telemedicine system that is very usableincluding the possibility of a training channel that helps us in the projects”.

The information published in Redacción Médica contains affirmations, data and statements from official institutions and health professionals. However, if you have any questions related to your health, consult your corresponding health specialist.

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