EBME Forums Forums Management Training Advice would be really appreciated

Hi all,
I usually enjoy reading posts here but never have the time to post myself but I am now hoping some of you can assist me with the identification of and prioritisation of modules for a new Biomedical School I am helping to coordinate.
I am a biomedical engineer advisor - my job is to advise Pacific Island nations on health issues and most specifically on medical equipment management. In the Pacific we have a common issue in that aid agencys and the MOH's will purchase equipment but never allow for cost of life nor have a maintenance and repair procedure which currently means that if the device fails for any reason it is discarded and worked around with the subsequent negative impact on health care. I have been advocating we set up a training school here and that has been enthusiastically accepted by all countries involved (14).
It will be based through the Fiji National University and will be a modified 3 year Diploma in Electronics course with medical modules from the Fiji Medical School and biomed modules that I and several others will compile - what I would welcome are your thoughts on is what electronics modules do you consider are the most suited to a biomedical technician - I am biasing more in favour of digital and IT but really would like to have others thoughts on this as we design the curriculum in three weeks and I really want this to be a long term solution here
Many thanks in Advance and all comments welcomed

Welcome to the forum, Andy.

I must admit that the sad news that the state of affairs you outline remains the case after all this time astounds and disappoints me.

I am old enough to remember reading a WHO paper in the late '80's written by a small team who travelled the globe reporting on such sorry circumstances ... together with sound suggestions to remedy them, and assurances given by Ministries here, there, and everywhere.

One can but wonder where all the money went.

After all this time ... and you only have three weeks?

Meanwhile, have you seen this thread?

OK ... let's be positive.

You asked for advice, so here goes:-

Firstly, you need to get some sort of deal in place so that, once trained, the techs are retained to work locally, in government hospitals (I presume) for the Good of the People ... not "attracted" to servicing companies, or to the idea of [censored] off to seek their fortune (with their newly marketable skills) elsewhere.

In my opinion, unless you can get that sorted out, all your efforts may well be in vain.

Many thanks Geoff,

its a common issue still - I am also working with Project Care from the US - they send medical equipment to Africa and have a keen interest in this as they encounter exactly the same issue there.
I do have a relationship with WHO and actually use their guide to donated equipment as a basis for a lot of advice to donors - I should perhaps clarify that I have been here for two and a half years and proposed this at a meeting of Heath Secretarys in Fiji in June 2010 - - it has taken a year and a bit for the aid agencys to analyse their existing programmes and consider it as a,hopefully,better alternative - I have been working on it for all of that time but now it has been accepted it has been given high priority and is moving very quickly so we can have it running early 2012.
As for money - sadly there are a lot of fly by nighters who pray on small island nations lack of expertise and sell them poor quality equipment at huge markups - often 400-500% - I have spent a great deal of time getting procurement procedures into place and obviously a spin off of having knowlegable locals trained in medical equipment will be to assess and avoid equipment offers for themselves.

As regards retention its a tricky one - there exists a bonding scheme for clinicians and we intend to use that - a large proportion of income - in fact the majority, in these countries comes from overseas relatives in Australia, New Zealand the US or the UK sending money home so even if we do lose some at least it indirectly contributes to the economy and prosperity of the home country. Also studies have shown that in middle age most of these overseas based nationals will return home so long term we hope to have a mature knowlege base.
Thankyou for the reference to the other thread - it will be useful to compare and add to my ideas.

I know a bit about medical aid groups. Good folk, no doubt ... but also lots of "agendas" there as well, in my opinion.

Having "hands-on" techs out there is the way I would tackle the problem(s) too.

In all honesty, I don't see the need for University Training. Good leadership, and training at vocational level is what's required, in my opinion.

That plus back-up as required (funding, and availability, of parts for example).

Regarding the "other thread", it might be useful for you to get in touch with Mr.nerobot. I have his email address, so send me a message (or an email) if and when you want it.

The course offered through the FNU is a diploma level course not a degree - they are the only institution in the region able to offer the course. I still see a need for engineers for several years - of course the day one of my graduates comes up to me and says I want to go to Australia and do a degree and have your job I will hug them, shed a few tears and have a few beers in celebration - we have been down the path of imported hands on techs since 1999 - it has proved non sustainable as as soon as these techs leave the countries revert to what was before - this is a vocational course but you have to remember that this is the second or third world - by using outside techs we have created a dependency that hinders development.
As for funding - don't go there - in at least one of my countries the finance secretary has caught my wrath on that issue to the point he thought I was goint to hit him - the fact i had him by the shirt collar probably gave him that conclusion.

Ah ah ... the "hands-on" style of management. That's what I like!

Dependency? No. Those days are over (or should be, at least).

"Imported techs" is a phrase that I had not heard before. But I hear what you're saying. Hands in the bucket of water, splashing about ... and afterwards:- then what?

But again, no. That can only be a short-term expedient, at best.

"Helping Them to Help Themselves" is the mantra ... that, and "No Junk for Jesus" (or whomever), of course.

But (obviously) without funding (and as you know it can come in many forms:- aid, taxation, sponsorship or what-have-you) the whole idea is, I'm afraid to say, a non-starter.

PS: the preferred term these days is, I believe, the "Majority World"!

Not known for my political correctness Geoff - just ask the one of my health ministers who I suspect dislikes me because I called him a fool when he advocated we purchase the equipment to perform routine open heart surgery as they are the only place in the Pacific with first world operating theatres - I sorta lost it a bit and told him that rather than think of personal prestige think about the several hundred people that die each year because they will not fund a renal suite!
We call them developing or emerging countries here to be technically correct.
As for the Junk reference - my version is if its junk there its junk here - I coined it and titled a confrence paper with it - someone in Australia quoted it at me the other day so it seems to be gaining some acceptance and hopefully will be bourne in mind when institutions donate.

Yes, I'm sure we can all agree that limited resources (and they always are limited ... even in places like the UK where successive governments keep bunging mega amounts of money at health services [just to appease the Masses - or the Media ... or even more likely, both]) have to be rationed with due care. That is, with an eye to the likelihood of "Quality Outcomes" for the Many, rather than the Few ("high profile" cases).

But, as many of us know (and as you have alluded to), some ministers seemingly cannot resist a good "photo opportunity" should one arise.

Yes, junk is junk. But even (sending out) junk can produce that warm, happy, feel-good feeling at this end. I've seen it (but I hasten to add, not felt it) a few times myself.

But (just out of interest) where does the open-heart stuff get done, then? Do patients get flown out to Oz, or some such place?