Part 1 of 3: Survey Results – The Top 8 Areas of Need for Medical Missions

The following is from a presentation titled “The Next 10 Years in Medical Missions The Greatest Needs; the Greatest Opportunities.” originally presented at the 2019 Mobilizing Medical Missions (M3) conference in Houston, Texas. The data presented is based on responses from surveys of mission hospitals and clinics in Malawi, DR Congo, Kenya, and Haiti.

In this three part series, we are going to first review the need on the ground today. The second part will cover what you can do to make an impact and the third part will cover what I project will be the significantly changing needs in the next 10 years.

Global Medical Missions - What's the Urgency?

Let’s start our conversation with a very startling statement – the global Christian church is in very real danger of losing its long standing and most effective platform for proclaiming the gospel – medical care. The Church around the world has used providing quality medical care as one its best tools for both tangibly showing the Love of Christ to the poorest of the poor as well as an opportunity for sharing the gospel with people who do not know Jesus.

Historically, faith-based healthcare has been 50% of all healthcare in Africa but change already underway could sideline the historic leadership of the Church. In part 3 of this series we will deal with the projections for the next 10 years and the changes that are sweeping international medical care. To begin, it is best to start with the current medical needs.

Driving Everything – The Global Burden of Disease

In order to fully understand the needs that demand our participation, we first have to understand the basic healthcare burden that underlies everything. Looking at the basic health statistics helps to make clear what we must be prepared to face no matter where in the world we start. Consider these realities for Africa:

  • Communicable diseases account for 70% of the disease burden vs. 40% for the rest of the world (TB, HIV/AIDS, Malaria, Hepatitis B, Hepatitis C)
  • 58% of public healthcare facilities lack essential medicine
  • Africa accounts for 60% of the global burden of malaria
  • Africa represents the largest number of death for children under 5 globally
  • 52% of rural population have no access to clean water
  • 75% of rural population have no access to quality sanitation

At the highest level what does this tell us? These disease and health statistics drive Africa’s top medical priorities. When you go you will need to be prepared; the top 3 most important medical issues you will face are:

  1. Communicable diseases (TB, HIV/AIDS, malaria, hepatitis B & C)
  2. Childhood diseases (Diarrhea, pneumonia/ respiratory infections)
  3. Pregnancy and childbirth (Prenatal care, childbirth complications and treatment protocols)

Given the general, overall medical mission priorities, we can then move to taking a closer look at a more specific example to help you be better prepared. In 2018 at the beginning of a major initiative for primary clinics an evaluation of 20 primary care clinics in Malawi was conducted.

The results of that assessment were sobering:

  • Only 42% of the clinics met the criteria for safely delivering babies
  • Only 44% of the clinics met the criteria for pre and post-partum care
  • Only 19% we meeting the most basic standards for routine nursing

Even more concerning were some of the details of the individual clinics assessed:

  • Of the 20 clinics surveyed only 6 had a functioning otoscope
  • One clinic did not even have one stethoscope and only 5 had more than one.
  • Three clinics did not have a functioning blood pressure cuff and only 4 had more than one for the entire clinic.
  • Eleven clinics had a glucometer but only 6 out of 20 actually had sticks available

The Top 8 Most Needed Topics for Staff Training in Primary Care Clinics

Based on the survey results of the 20 clinics in Malawi, standardized protocols were targeted and a training program was adapted for them. The following top areas for focused training were established:

  1. Hand Washing – education, training and implementation of proper procedures
  2. IV Lines – proper labeling, storage and safe administration
  3. Sterilization – education and training on proper sterilization/disinfection techniques
  4. Neonatal Resuscitation – methodology and staff training.
  5. Apgar Tests – properly conducted and documented for each newborn
  6. Newborn Physicals – standard physicals for newborns conducted and documented
  7. Proper Postpartum Hemorrhage – protocols established, staff trained and supplies in place ready to go
  8. Resuscitation Equipment – overall equipment standards and staff training

One thing learned from the medical missions work in Malawi is that this priority list would most likely apply to a majority of primary care clinics anywhere in the developing world; if you were prepared to educate and train on one or more of these topics you would not only be welcome, you would make an immediate impact. Now let’s take a look at another part of the world

The 7 Greatest Nursing Continuing Education Needs for a Haiti Hospital

MBF partners with the Hôpital St. Croix (Holy Cross Hospital) in Léogâne Haiti. For this year the nursing department has established a schedule of continuing education topics for their staff based on their identified greatest needs. Of their list of 20 topics planned, the following are the topics for which they don’t currently have anyone available to present:

  1. Emergency Care
  2. BLS/ACLS/CPR training
  3. Immobilization Restraint, Care and Monitoring
  4. Nursing Care of Asthma Patients
  5. Pain Management
  6. Respiratory therapy basics
  7. Nursing care of burn patients

Clearly for Hôpital St. Croix the nursing leadership has identified a very clear need to nursing continuing education but does not have the local resources with enough training and experience on the specific topics. Anyone with the skill and experience on any one of these topics would be well received and put to immediate use.

Now What?

If you are a little overwhelmed with the scope of need here, you are not alone. The good news is that we have the tools. We have the knowledge. But we have to connect the right resources with the right people. So at one level the answers are painfully simple. But simple is usually not easy.

Have you been looking for the opportunity serve? Hopefully this information has provided you with the starting some of the basics you can be prepared to teach and train.

In next week’s post I will continue to report on MBF’s 2018 survey of needs for our global partners, and make some additional recommendations on what we as individuals can do to make a difference.

My hope is that this sparks new thinking – or perhaps it confirms what you are already doing. I don’t know. But I do know that I would be interested in your feedback and/or questions. Please feel free to contact us here

Andy Mayo, CEO

MBF | Medical Benevolence Foundation/The Center for Global Nursing Development

P.S. To look at the full presentation, CLICK HERE to download the full PDF.