What does it mean to provide assistance to developing countries? How do we measure success? How effective are conferences, medical texts and lectures from visiting speakers?
I have had the opportunity for the last two years to help with diagnostic haematology in Binh Dinh Province in Vietnam, under the New Zealand Vietnam Health Trust (NZVHT). This has been a steep learning curve for me, Kit Norrish (scientist) and the Vietnamese laboratory staff in Binh Dinh General Hospital and the more remote eleven district hospitals.
To make a difference, there must be mutual respect, good relationships with local decision makers and laboratory staff. There needs to be an understanding of the limited access to tests and treatments that we take for granted. There is a lack of qualified personnel and limited resources including appropriate training material. In our experience there is a significantly different spectrum of disease and treatment options.
Making changes towards best practice requires a comprehensive approach that starts with ‘hands on’ time in the laboratory. This includes good quality control, an accurate complete blood count, the making of a good blood film and interpretation. Diagnosis requires an understanding of haematological disorders with appropriate and practical algorithms for the laboratory staff and clinicians.
The aim is to enable local staff to manage patients safely and appropriately with the resources available, hence reducing the need for unnecessary travel and expensive treatments at a specialist centre.
I would like to share some of the challenges and what we have learnt from our experience working alongside our Vietnamese colleagues.