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CANCER TRAINING AND EDUCATION

CANCER CONTROL 2015 83

evaluation of the International Health Links Funding Scheme

(5) several projects identified the utility of international

volunteers mentoring clinicians who had experienced

"professional isolation". Many senior positions are held by

clinicians who are relatively junior, making the opportunity

to be mentored by senior clinicians from the United

Kingdom even more valuable. While their motives may be

altruistic, visiting clinicians also gain from their experience.

United Kingdom health workers report that their experience

in LMICs strengthens their practice in the NHS, particularly

in terms of teamwork, leadership and resourcefulness (6).

More work is required to quantify the costs and benefits of

volunteering within health partnerships for individuals and

institutions in the United Kingdom but analysis suggests that

the skills acquired through volunteering are transferable to

service delivery within the NHS and that the benefits to

individuals and institutions could be maximised when

volunteering is formally embedded within continuing

professional development processes (7).

Long-term perspective

Health partnerships provide a flexible framework for people

to work together effectively and responsively for longer

periods than typical global health development projects.

Institutional agreements provide continuity and strategy

beyond the life-cycle of a single project or the involvement of

a particular individual. They are the framework within which

small-scale projects can broaden into more integrated

support for health systems such as national and institutional

health strategies, standards and protocols. For example, the

University of Edinburgh Palliative Care Partnership is

working to strengthen and integrate palliative care through

a public health and primary care approach into national

health plans in Uganda, Zambia, Rwanda and Kenya. The

Palliative Care Association of Uganda (PCAU) is working

with the Ministry of Health to develop indicators to be

included in the country's health management information

system. In Kenya, the national association (KEHPCA) has

supported advocacy activities that have led to an increased

availability of morphine in hospitals. Zambia, through the

national association (PCAZ), has adopted as national

documents symptom control management guidelines

initiated by the Makerere University Palliative Care Unit,

which have been shared through the project. In Rwanda, an

allowance for palliative care medicines is now included in the

national budget. (Fig. 1).

Health partnerships often work with professional

associations or teaching hospitals to build a faculty's

capacity to deliver training and contribute to development

or revision of the training curricula. In Zambia, THET works

directly in partnership with local training institutions to

establish diploma, undergraduate and postgraduate courses.

To ensure the quality of training, THET supports north-south

and south-south exchange of professionals from academic

and government institutions like the recent five-month

clinical placements for Pathology Masters in Medicine

trainees.

Adaptability

Health partnerships are a model for international

collaboration that can adapt to the context of the developing

country partner. Partners agree priorities cooperatively and

in response to needs at the level of the LMIC health

institution and health workforce - and adapt them as the

need and context change. This flexibility reflects their

relatively small size and the personal relationships at their

heart. A testament to this adaptability is the valuable role

partnerships can play in emergencies. For example, King's

Health Partners (KHP) have remained in Sierra Leone to

support the ongoing national and international Ebola

response in an advisory and clinical role. In another health

partnership, KHP have aided the emergency response to the

recent escalation in the conflict in Gaza, in parallel with

ongoing training to Palestinian surgeons in the management

of major trauma and in post-traumatic limb reconstruction.

Conclusion

Health partnerships are an adaptable model of global health

development that sits comfortably within existing systems,

often complements other methods of aid delivery and

development co-operation and offers a means for clinicians,

technicians and other professionals to work with

counterparts in other countries in a structured and strategic

way for the long term. However, the approach is not without

Figure 1: Mentoring interior APCA Nadia Betaga of the Diana Fund

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