Acute staff shortage is costing lives
As Nelson Mandela said, education is the most powerful weapon which you can use to change the world. SolidarMed is therefore investing in the training and development of medical staff so that people can access quality healthcare.
“People are dying or living with poor health simply because there are no doctors, no midwives, no clinical staff and no one with sufficient training,” says Jochen Ehmer, head of medicine and public health at SolidarMed, explaining the impact of too few and insufficiently trained health workers. And it is not only the quality of training for medical professionals that is lacking, the governments of these countries don’t have the money to hire enough staff and pay salaries. He adds that sadly he has often seen people die because a medical professional failed to take the right action or a patient had to wait too long for a diagnosis and the right treatment.
To ensure that SolidarMed’s investment in training and development brings long-term success, the organisation doesn’t establish a parallel system in the countries, but instead works closely with authorities and educational institutions. “We are very actively involved, for example in designing the training curricula for nurses in Zambia,” says Jochen Ehmer. He explains that a model was developed there in collaboration with the government through which various vocational groups can complete their basic training together so that fewer trainers are needed. The Swiss dualtrack vocational training model can also be applied very successfully in the healthcare sector. “Governments are usually glad of the support, and so we’re members of technical working groups on educational matters, for example,” says Ehmer.
Everyone must prepare a part
SolidarMed’s promotion of training and development shouldn’t be a one-sided process, however. “Reverse innovation is really important to us,” he stresses. This means that modernisation and innovation should not always be driven by the countries of the Global North. In Switzerland, too, there is a significant shortage of staff, particularly in the treatment of patients with chronic conditions. “Here, non-physician practitioners (or medical licentiates as they are known in Zambia – who have completed shorter medical training than a doctor, could for example be deployed, as is the case in a number of project countries and increasingly in France and the United States. They can deliver important diagnoses and treatment, and are at a level between nurses and doctors,” says Ehmer.
SolidarMed is playing a part in training significantly more medical staff and is also improving the quality of the training. This requires residential accommodation at training facilities, school buses and better teacher training for instructors, who should not only stay abreast of the latest developments in their field, but also be familiar with various methods of instruction. In three training facilities in Tanzania’s Morogoro region, SolidarMed is breaking new ground using the capacity sharing method. This involves participants having to prepare some of the training themselves in small groups. “Everyone is important, everyone needs to be able to identify with the content, and everyone knows something,” says Federica Laurenti, project manager of the ‘A Good Start’ project, under which midwives and nurses receive further training.
The advantage, according to Laurenti, is that because everyone has engaged with the material in advance, they are more involved and can take ownership of sharing their knowledge with others. “This is only possible because these three facilities support specialists who ensure that the training content is up to date,” says Laurenti. The knowledge and expertise of upskilled professionals save lives.
SolidarMed supports training and further education in various professions:
Lesotho: Community health worker Likabiso Nkune
Twenty-seven-year-old Likabiso Nkune lives in Koholokoe in northeastern Lesotho. While seeking work, she heard that the Ministry of Health was looking for people who had graduated from high school. Nkune was subsequently nominated by the village community and chosen as a community health worker. “I did the first of three training courses in March 2023,” she explains. The training lasted 18 days altogether and was delivered by nurses from various specialties such as psychiatry and ophthalmology as well as by doctors and pharmacists. The training taught Likabiso Nkune the theory and equipped her with practical skills. “I’m now responsible for measuring people’s blood pressure in my community and testing their blood glucose levels for diabetes mellitus as the nearest healthcare facility is a long way away,” she explains. She enters the data straight into her tablet. Depending on the result, the community health worker can also treat sufferers. In doing so, she works closely with her mentors – mostly by phone – who can also visit patients themselves if necessary. “I never would’ve thought that I’d end up caring for patients, but the training has given me the knowledge I need to examine people and help them if they need it,” she says. Likabiso Nkune is looking to the future and says that she’s keen to train in family planning, too.
SolidarMed finances the ComBaCal project, which trains community health workers.
Tanzania: Midwife and nurse Gloria Tembo
The head of the maternity ward at Kibaoni Hospital has already completed several further training courses. “I always want to be up to date with the latest developments in my field,” she says, describing what motivates her. Gloria Tembo has completed training in the prevention of mother-to-child HIV transmission, obstetrics and gynaecology, voluntary medical male circumcision, and gynaecological emergency and neonatal care. The training programmes were held in special training rooms at Ifakara Hospital. She was also part of a 20-day mentoring scheme. “This involved two gynaecologists overseeing the work of our team and improving our knowledge and skills,” explains the 35-yearold. She considers what she learned about preventing mother-to-child HIV transmission as particularly important. “I want to provide mothers and their babies with excellent care. The training courses significantly improved my knowledge and skills. I have been able to save the lives of so many patients and reduce the number of referrals,” she says, with pride. Before attending the further training courses, critical deliveries had to be referred to a larger hospital despite the time pressure. “Thanks to what I learned on the courses, I was able to help a pregnant woman with severe anaemia give birth safely,” she says.
SolidarMed facilitates further training for midwives and nurses in Tanzania.
Mozambique: Hygenist Angelica Zacarias Adolfo
“My dream was always to help other people. The nursing training didn’t work out but I’m really happy as a hygienist as I still get to help people,” says Angelica Zacarias Adolfo. The 61-year-old is responsible for ensuring that patients can be treated in hygienic conditions. “We collect waste, separate it according to type (infectious, anatomical and conventional), and then dispose of it accordingly. We also wash the hospital linen,” she says. The hygienist took part in a two-day training course on waste management and the use of incinerators. “First, we had a theoretical part and then we did practical exercises on site. For me the key insight was that waste that is processed incorrectly is a danger to everyone’s health. I’m now aware of the Ministry of Health’s guidelines and understand why we shouldn’t mix waste.” The team now works together more effectively, which results in a cleaner health centre. A current campaign, for example, aims to raise awareness about correct use of the toilets, which benefits patients and visitors.
As part of the IPC (Infection Prevention and Control) project, SolidarMed promotes further training for hygienists to prevent hospital infections in Mozambique.
Zimbabwe: Peer Educator Siria Magunduru
Siria Magunduru may be only 16 but she’s very motivated in her role as peer educator to create a space for young people to talk about issues affecting them. At the same time, she is keen to combat stigma. “I want to take ownership, support other young people, and educate them about their sexual health and reproductive rights,” she says. She completed a five-day training course run by medical professionals at the Bikita Training Centre. “One of the things we learned was how to address our peers,“ she says. At first she thought that as a peer educator she would be advising other young people. “Actually, it’s much more about figuring out a solution together,“ says Magunduru. This was the case, for example, when one of her classmates was using drugs. “I seized the opportunity and talked to him about it. He told me how it had gotten to that point. Then we sat down together and decided he should ask his parents and the school for forgiveness. He has since been to rehab and is now clean,” she says, with a smile.
SolidarMed funds the health project for young people in Zimbabwe and trains the peer educators itself.
Zambia: Medical Licenciate Pass Shimuunza
Pass Shimuunza is completing the five-year training to become a medical licentiate (or non-physician practitioner) as he wanted to develop his knowledge and skills. The 42-year-old is now in his last year of training as a medical intern at Mongu District Hospital. “There’s a fine line between us and doctors. In rural areas in particular, we carry out almost the same tasks,” he explains. Due to acute staff shortages, SolidarMed has been supporting the training of medical licentiates since 2010. These non-physician practitioners can carry out straightforward routine interventions. One thing that concerns Pass Shimuunza is the high level of maternal mortality. “Through training in the skills lab with manikins and clinical rotations, I’ve been able to consolidate my skills in obstetrics and surgery,” explains the 42-year-old. This is particularly important to reduce the level of maternal mortality in his work as he estimates that between 60 % and 80 % of births are high-risk.
SolidarMed provides organisational support for the training and development of medical licentiates in Zambia.
Training and further education for health personnel
Read more about SolidarMed's commitment to the education and training of health personnel in southern Africa.
Training medical personnel
Africa lacks qualified health professionals. Resilient health systems need trained health workers.