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Brighton & Sussex Medical School

Brighton Lusaka Health Link

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Brighton Lusaka Health Link

The Brighton Lusaka Health Link (BLHL) empowers Zambian and UK-based health care professionals to share skills and knowledge within an overall goal of improving healthcare in Zambia.

The overarching aim of the Link is to provide educational and clinical support for the Healthcare Professionals in UTH to help provide a high standard of care in Lusaka. In some cases this has led to clinically orientated research projects too.

We raise funds which are used to support scoping visits allowing colleagues from Brighton and Lusaka to meet and develop projects that tackle a need that has been identified by Zambian colleagues. These visits allow relationships, friendships and ideas to develop into a programme of activities. The Link supports the development of bids for more substantive funding from other sources (e.g. the British Council, larger charities and private donors).

 

BACKGROUND IMAGE FOR PANEL

About us

 

The Link was established in 2005, building on discussions between Melanie Newport and Dr Peter Mwaba who was then the Medical Director at the University Teaching Hospital (UTH) in Lusaka.  

There was clear potential for a health partnership between the organisations they each worked at – university teaching hospitals that trained doctors and nurses whilst providing specialised hospital care for their communities.  Advice was sought from THET (www.thet.org), a charity founded by Professor Sir Eldryd Parry to support health partnerships between UK hospitals and their counterparts in low-income countries and the Brighton Lusaka Health Link took off. 

With a small grant from THET, a team of four from Brighton visited UTH to meet Zambian colleagues from many different health disciplines. Areas were identified where working together could have big impact on improving health care in Lusaka.  Two areas in particular stood out – providing better care for people who were unwell as a result of HIV infection and developing the role of nurses more widely to empower them to make a difference. 

These two areas were combined to underpin our highly successful first project – the HIV Nurse Education Project.  We went on to set up a number of projects in paediatrics, in response to the concern at UTH caused by the number of children who were dying from preventable causes.  Projects include the development of the first paediatric nursing course in Zambia, now run independently by the Ministry of Health adding 30 newly-trained paediatric nurses to the workforce each year, and a ‘training the trainers’ programme which means all staff looking after sick children can provide acute paediatric life support.

Brighton Lusaka Health Link (BLHL) was registered as a UK charity in September 2011.  It is a separate organisation from UHS NHS Trust and is governed by a board of Trustees. Open meetings have been held at regular intervals where updates on BLHL activities are presented to a general audience – anyone with an interest in the Link is welcome .to join it!

Our trustees

The current Trustees are:

Professor Melanie Newport, Chair
m.j.newport@bsms.ac.uk

Melanie Newport is Professor of Infectious Diseases and Global Health at Brighton and Sussex Medical School and chairs the Board of Trustees.  She has previously worked in The Gambia and is currently involved with research projects in Ethiopia, Cameroon, Rwanda, Eritrea and Sudan.  Melanie has been involved with the Brighton Lusaka Health Link since its inception, first visiting Zambia in this context in 2006.  

Dr Sophie Morris, Treasurer
sophie.morris7@nhs.net

Sophie Morris is an Anaesthetics Consultant at UHS and Treasurer of the Link. She has travelled to Zambia to work with Clinical Officers in Anaesthesia on multiple occasions on behalf of the Link, as well as working in several other countries in sub-Saharan Africa. She is particularly keen to promote exchanges for healthcare workers from the UK and from Zambia to travel to each other’s countries and take advantage of the many learning opportunities so that both can benefit from this sustainable partnership 

Professor Paul Seddon
seddop@googlemail.com

Paul Seddon was a consultant paediatrician and who spent time as a junior doctor working at St Francis Mission Hospital in Katete, to the East of Lusaka.  His interests included respiratory medicine and neonatology and has worked with colleagues in Lusaka to develop a specialist respiratory clinic in Lusaka.  He has acted as the External Examiner in Paediatrics at the University of Zambia School of Medicine and has supported Advanced Paediatric Life Support training in Lusaka. 

Dr Eileen Nixon
eileen.nixon1@nhs.net

Eileen Nixon is a Consultant Nurse in HIV medicine at UHS and one of the original founders of the link.  Following a visit to UTH in 2006, and with the support of the British HIV Nurses Association, she linked up with the Director of Nursing at UTH to develop one of the Links early successes – the HIV Nurse Education Project. 

Contact

If you would like to get in touch with us, please email any of the Trustees at the addresses given above or Debbie Miller (d.miller@bsms.ac.uk), Prof Newport’s PA.

We are always looking for volunteers to help with projects and other activities such as fundraising, managing the website and helping promote the charity through social media. 


BACKGROUND IMAGE FOR PANEL

Current Projects

HIV & Sexual Health

With support from the Link, we have developed a sustainable education and research partnership between collaborators from the UK (BSMS, University of Sussex), and institutions associated with Sexual Health and HIV clinical care in Zambia including the University of Zambia and the Zambian Medical Association, and the Centre for Infectious Diseases Research (CIDRZ).

The partnership has successfully attracted funding from the UK (BMA charitable funds) to deliver an educational course on Sexual Health and HIV for health care workers in Lusaka, that aims to increase capacity to conduct research in Lusaka by providing education and training to health care workers and Zambian researchers in the management of STIs and HIV. 

This course, developed in association with the British Association for Sexual Health and HIV (BASHH), and was delivered in 2017. The University of Zambia and the Zambian Medical Association are already collaborating with BSMS in projects addressing Sexual Health problems in Lusaka, and other Zambian provinces. Zambian collaborators include Dr Owen Ngalamika, Consultant Dermatovenereologist, Head of the Skin and STI Clinic at the Lusaka UTH, and Dr Aaron Mujajati, the president of the Zambian Medical Association who has links with government officials, at the Zambian Ministry of Health, and whose contribution will be essential to advance health policy in Sexual Health in Zambia. 

With support from the Link Dr Owen Ngalamika visited Brighton in 2017 as part of a knowledge exchange initiative supported by the charity.

Previous articles

Read more here >

News

In April 2020 Dr Jaime Vera, Senior Lecturer in HIV Medicine, was awarded a grant for a new project, 'The challenge of ageing with HIV in Africa: developing capability, partnerships and research in ageing and HIV in Zambia'. The number of people ageing with HIV in Sub Saharan Africa is increasing as a result of improved access to antiretroviral therapy. In high income settings ageing people living with HIV have disproportionately high incidence of major non-communicable diseases and reduced health-related quality of life. Evidence of this situation happening in Zambia is lacking. This proposal aims to establish a multidisciplinary research partnership to increase research capacity and capability in ageing and HIV in Zambia. Jaime has been awarded more than £19k by the University of Sussex's International Development Challenge Fund and Sussex Sustainability Research Programme for this project. Jaime has also been involved with the development of digital vending machine technology for the distribution of HIV self-testing kits to key communities affected by HIV in high and low-income settings, including Lusaka.

Neonatology

The majority of newborn babies require minimal intervention at birth to establish normal breathing and transition to life outside the womb. However, on a global scale, many babies still die during labour or shortly after birth.  Many of these deaths are easily preventable if trained health care workers attend the birth.  The University Teaching Hospital (UTH) in Lusaka is the largest hospital and main referral health institution in Zambia. It has a busy delivery suite with a rate of around 60 births per day and approximately 20,000-25,000 deliveries per year.  Faith Kayembe, originally from Zambia, is a Senior Lecturer in midwifery at Canterbury Christchurch University in Kent.  Faith got in touch with us to see whether her skills and knowledge could be applied through the Link to help improve care for newborns in Zambia. Working with her colleagues in Lusaka, Faith identified a number of challenges, including low levels of clinical specialisation and a lack of continuing professional knowledge and skill development opportunities for Zambian midwives.  She developed a bespoke programme that aimed to build capacity by training key staff to deliver rolling training in newborn resuscitation. Faith went to Lusaka to set up the programme.

Over 40 staff who attend deliveries received training and a core group of facilitators were also trained to deliver the training to ensure a sustainable programme.

In another newborn project, Professor Heike Rabe, a consultant neonatologist working in Brighton, has developed a new collaboration with the Medical School in Lusaka and other international partners. Called MODERN (Mother Driven Best Practice Implementation), this project is testing new mother and baby-focused, digital intervention strategies to increase access to, and implementation of, evidence-based quality care during and after pregnancy. The project will support the broader implementation of World Health Organisation care pathway recommendations for care before, during and after birth reducing mothers’ and babies’ deaths.  Watch this space for further updates as this project develops.

Find out more about Prof Rabe’s research here >

Ongoing Projects/Grants

New-born babies' hospital care to be enhanced >

Advanced paediatric life skills

Around sixty children out of every 1,000 live births die before their 5th birthday in Zambia. These rates are much better than they were a decade ago but still high compared to the UK (around 4 per 1000 live births).  Many of these deaths could have been prevented if the right treatment was given sooner (e.g. fluids for dehydration or antibiotics for severe pneumonia).  An audit at the University Teaching Hospital (UTH) in Lusaka found that two thirds of childhood deaths occurred within the first two days of admission.  Whilst there are often delays getting to hospital (families may live far from the hospital and not be able to afford transport, for example) consultant paediatrician at UTH Dr Somwe Wasomwe wondered whether better care at the time of admission might improve outcomes and save lives.  He and colleagues noted that nurses who looked after sick children were not trained to look after children and many had lost their skills once they qualified due to a lack of ongoing training. One of the results of these observations was the development of the diploma of paediatric nursing. The other was to develop training in advanced paediatric life support (APLS). Dr Wasomwe and Professor Paul Seddon, a paediatrician at the Royal Alexandra Children’s Hospital in Brighton, were already working together and started working on this idea. They successfully applied for funding from the THET Partnership scheme and were able to get a team of APLS trainers from the UK and from South Africa together in Lusaka to develop the programme. The courses were aimed at health care professionals who looked after very sick children at admission and enabled them to resuscitate and treat very sick children soon after arrival at UTH.  A number of more senior practitioners were identified and trained to ruin the APLS course such that the programme was sustainable and continues to run new and refresher courses. 

 

Pharmacy

In April 2016 a team of six pharmacists from Brighton were invited to visit colleagues at University Teaching Hospital (UTH) Department of Pharmacy and also the University of Zambia Department of Pharmacy. The main aim of this visit was to develop partnerships and collaboration towards enhancing the quality of pharmacy practice and education bilaterally. A number of areas were identified which had potential for development of partnerships and collaborative projects.  This visit was reciprocated in the autumn of 2017 when a team of pharmacists from UTH visited Brighton to develop joint activities around knowledge-sharing and best practice in both the practice of pharmacy as well as education.  The role of the pharmacist tackling anti-microbial resistance is a particular focus of the group. Many germs that cause serious infections have become resistant to the antibiotics used to treat them (called antimicrobial resistance or AMR) and this is a major global problem.  Many factors contribute to AMR and its spread around the world, one of which is the inappropriate use of antibiotics.  Pharmacists are in a key position to have impact here and the Brighton Lusaka Pharmacy Link is focusing on ways to reduce the overuse of antibiotics in hospital settings, both in Zambia and the UK, and on capacity building amongst healthcare professionals. 

News 

The Commonwealth Pharmacists Association announces the launch of a training video to support local pharmacy teams in the production of World Health Organisation formula alcohol-based hand sanitiser >

Recent article and projects

Read more here >
Read more here >
Read more here >

BACKGROUND IMAGE FOR PANEL

Past projects

Anaesthetics

The anaesthetic link has been running since 2015 as BrightZAP (Brighton Zambia Anaesthesia Partnership) and works closely with Clinical Officers in Anaesthesia (COAs) from across Zambia. The BrightZAP team have delivered several well received multidisciplinary CPD conferences and workshops to both Physicians and COAs and are working with the Zambian Ministry of Health to develop a new BSc in Anaesthesia to help recruit and retain more skilled anaesthesia providers.

Delegates have particularly enjoyed the multidisciplinary nature of the events organised to date, and the interactive nature of the workshops. Improving the communication, camaraderie and professional status of COAs throughout Zambia remains one of our most important objectives. Combined with the high quality of our consultant delivered training, we believe that the BrightZAP initiatives are delivering immediate patient safety and quality improvement results, as well as contributing to the longer-term needs of safe surgery in Zambia by increasing the number and skill level of qualified anaesthesia providers. 

Contact info: sophie.morris7@nhs.net

 

Critical care nursing

This project was developed in response to a lack of much needed specialized nursing care for critically- ill and unstable patients.  Nurses were expected to care for very sick patients soon after qualification without any further training and there was only one nurse in Zambia at the time this project was develop that had been trained in critical care (in South Africa).  With funding from the British Council’s England Africa Partnership scheme a post registration diploma in Critical Care Nursing was developed by the School of Nursing and Midwifery in Lusaka (now Lusaka University College of Nursing and Midwifery) and its counterpart at the University of Brighton.  The Critical Care Nursing Programme was established in 2012 and was validated by the Zambian Nursing and is now run independently by the School of Nursing and Midwifery in Zambia.

 

HIV Nurse Education Project

The HIV Nurse Education Project (HIVNEP) began in 2006.  It was the first project the Brighton – Lusaka Health Link embarked on and was developed following discussions with Mercy Mbewe who was at the time Director of Nursing at UTH. She told us: “I remember one time, I think it was in 2000, we recorded almost close to 36 deaths, and we noticed that there was never a day in a month when you didn’t bury two or three nurses. So, what should we do as nurses about this?”

“I find it challenging, the fact that over the years I have stayed in job things have changed dramatically since the advent of HIV/AIDS.  Whilst we are grappling with the infection, we are also grappling with the fact that we have had a major, major brain drain from this hospital, which is the national hospital and it’s the flagship for health services in Zambia. We have had a lot of people moving out. Most of our senior nurses have left in all areas of specialities and from a projected 1500 establishment currently, we have just 500 nurses”. 

Mercy had a vision that nurses were part of the solution to tackling the HIV epidemic in Zambia and highlighted the need to enhance the nurse’s role and to motivate nurses to make a difference:Mercy linked up with Eileen Nixon, nurse consultant in HIV in Brighton and Sian Edwards who was at the time a Senior Lecturer in Nursing at the Institute (now School) of Nursing and Midwifery at the University of Brighton to develop the HIVNEP.  A detailed questionnaire was sent to 30 nurses in Lusaka to identify their current level of knowledge, what they felt their needs were and focus groups were held with Southern African nurses working in Brighton.  With funding from the National HIV Nurses Association (NHIVNA) Sian and Eileen visited Lusaka. A six-day course was developed that covered wide-ranging topics including HIV pathogenesis and the role of nursing in caring for HIV patients. Stigma and discrimination workshops were included.  

Nurses attending the first HIVNEP courses:

Evaluations included: “I have appreciated the different modes of teaching. It has really helped and enhanced my understanding.” “It was very valuable. I have learnt a lot. It will really have an impact on both my nursing practice and teaching.” In the interests of sustainability, six Zambian nurses from the first cohort were trained as trainers to deliver the course independently. 

The project was well-received and its success manifest in a number of ways including:

  1. The development of a 1-week course covering wide ranging aspects of HIV from basic biology, clinical manifestations and treatment through to stigma training and the role of the nurse in caring for people living with HIV that is now included in the curriculum for all trainee nurses 
  2. The training of Zambian nurses and educators to deliver the course
  3. >200 nurses trained
  4. Roll out from UTH to Kafue and Mwumba
  5. Development of HIV in the workplace policy adopted by the Zambian Ministry of Health
  6. Development of Post Exposure Prophylaxis policy for University Teaching Hospital, Zambia
  7. Improved attendance of male partners at antenatal clinics
  8. Increased HIV testing of fathers
  9. Improved management of HIV and other infections in pregnancy
  10. The instigation of Nursing Grand Rounds

 

Oncology

The oncology project is relatively new and so far, a team from Brighton have visited their counterparts in Zambia to meet and identify areas of joint working.  Cancer is the second leading cause of death globally (accounting for about 1 in every 6 deaths), of which approximately 70% occur in low- and middle-income countries. Growing international concern at the paucity of cancer services in these resource poor settings has led to all United Nations Member States to adopt Sustainable Development Goals with the aim to reduce cancer-related deaths by a third in the next 15 years.  

Under the auspices of the Brighton Lusaka Health Link, the Sussex Cancer Centre and the Cancer Diseases Hospital (CDH) in Lusaka have agreed to a training partnership to build a specialised clinical oncology service by the creation of a cost effective and sustainable programme. The CDH is a government funded modern centre situated in the capital city Lusaka and serves the whole of Zambia. In 2017, CDH treated approximately 2500 new patients, which is about quarter of estimated cases nationwide. It provides care for all adult and paediatric malignancies, except for leukaemia’s. CDH has good radiotherapy and chemotherapy capability, making it an ideal training centre. There is a well-developed radiographer training programme that takes students from across Africa. 

To provide a comprehensive cancer service across Zambia an estimated 120 clinical oncologists will be required. Currently Zambia only has 7 clinical oncologists. Prior to February 2018, there was no local training programme in clinical oncology in Zambia and all specialists were expensively trained in South Africa. Establishing a local training program in Clinical Oncology was vital to reduce the costs of training. The Curriculum, approved by the Zambia Colleges of Medicine and Surgery, is a four-year postgraduate training programme. 

Paediatric nursing 

The paediatrics and child health nursing program has been training nurses in paediatrics in Zambia since 2014. Currently the sixth cohort started the training on 7 January 2019. The aim of Zambia Registered Paediatric Nurse Training Programme is to educate students to become competent and professional practitioners in the delivery of care to children, within a family centered framework and to ensure there are sufficient qualified Registered Paediatric Nurses graduating annually to meet the needs of children in Zambia.
To date 181 nurses have completed the training and they are working across Zambia. The programme is a partnership between the School of Nursing and Midwifery at the University of Brighton and Lusaka University College of Nursing and Midwifery. 

Read more re: Development of the first paediatric nursing course in Zambia >

Read More re: The implementation of the first Paediatric Nursing course in Zambia >