Cascading Capability - An O&G Pilot Project

SingHealth Residency is known for training well-rounded Specialists, its rich opportunities for academic medicine research and an unwavering commitment to patient care. Beyond the hospital walls, this culture of care is extended by our Residents who volunteer their time and expertise for a good cause.

In line with the annual nationwide movement, Giving Week (29 Nov – 5 Dec 2016), we focus on the great work being done by our Residents across charity sectors. Caring for the needy, ensuring that rural communities get basic medical care and perpetuating sound medical practises, which combat common (but often deadly) healthcare challenges are just some areas our Residents are active in.

Read on to find out about ongoing projects as well as how you can help. In a special Medical Students Connect section, our Residents' Committee shouts out to all SingHealth Residents and medical students to get involved in contributing back to our society. We look forward to a better, brighter and healthier world together!

Cascading Capability – An O&G Pilot Project 
Featuring Obstetrics & Gynaecology Residents, Dr Ku Chee Wai (R02) & Dr Kwek Lee Koon (R01)

In SingHealth Residency, the passing on of knowledge is firmly entrenched into our culture of academic learning. With this philosophy, the KK Women's and Children's Hospital (KKH) piloted a programme in 2015 to provide local healthcare professionals in Tamil Nadu, India with learning opportunities to build their capacity for providing care – and more importantly, undergo the training to lead in medical education themselves. This project, which has potential for immense multiplier effects, addresses the gaps in emergency obstetric and neonatal practices. Local healthcare professionals also attend interactive lectures, case discussions, workshops and simulation training.

In July 2016, O&G Residents, Dr Ku Chee Wai and Dr Kwek Lee Koon were part of the KKH team that travelled to the 4th largest district in Tamil Nadu for a follow-up on this 'Train the Trainers' programme. "Since its inception, the response to KKH's medical education and training programme has been overwhelmingly positive. We are heartened by the local medical fraternity's thirst for knowledge and enthusiastic participation," says Chee Wai.

Tiruchchirappalli, more affectionately known as Trichy, is home to about 2.7 million people, with an estimated 40,000 deliveries conducted in total per year. Based on WHO statistics, Trichy has a high Maternal Mortality Rate (MMR) of 72 per 100,000 & Infant Mortality Rate (IMR) of 23 per 1,000. The main causes of maternal mortality are PPH, PE and sepsis. In emergency situations, a multi-disciplinary team comprising obstetricians, midwives, nurses, neonatologists and anaesthesiologists must work well together to achieve the best outcome. However, lack of teamwork, inadequate knowledge, training and skills, poor preparedness as well as communication may hinder the process.

During KKH's first training programme last year, 25 "master trainers" were identified from the pool of local healthcare professionals, said Lee Koon. They were trained to conduct simulation training and techniques of debriefing by the KKH team that included O&G Residents, Dr Fairus and Dr Carmen Tong as well. This year, this group of master trainers were once again engaged with the KKH team to train new participants over a period of four days. Lee Koon explains, "This time, we identified the second cohort of 16 new master trainers – a mix of doctors and nurses from public healthcare facilities like Primary Health Centres to ensure the continuity of the programme in Trichy. These master trainers are responsible for conducting subsequent simulation training for their peers and juniors to improve clinical expertise in management of the emergencies within the community."

The team from KKH has big ambitions. The third phase of the programme would focus on the readiness of master trainers from the previous two training regimes to work independently, thereby securing the sustainability of this programme. Both Chee Wai and Lee Koon envision a locally-led 'Train the Trainers' programme that can be replicated across South India. "Despite the challenges they face, such as severely limited resources of manpower, equipment, transport and facilities, the healthcare professionals in Tiruchirappalli demonstrate great resilience in coping with emergencies," Lee Koon adds.