Interview mit Sabine Rens (MSF Academy for Healthcare)

Ärzte ohne Grenzen (Médecins Sans Frontières- MSF) leisten seit 1971 weltweit unbürokratisch Nothilfe – vor allem im medizinischen Bereich. Der gemeinnützige Verein ist in 70 Ländern aktiv. 2019 entstand mit der Academy for Healthcare ein neues Projekt, das medizinisches Fachpersonal vor Ort aus- und weiterbildet. Diese lokalen Fachkräfte aus den Ländern sind stets die ersten Ansprechpartner:innen der Bevölkerung und stellen den Großteil der Ärzt:innen und Pflegekräfte sowie medizinlogistisch Ausgebildeten von MSF. Die Ausbildung neuer Fachkräfte sowie ihre stetige Weiterbildung wirkt sich unmittelbar auf die Qualität der medizinischen Versorgung der Menschen in MSF-Ländern aus. Die Academy for Healthcare bildet dafür den Rahmen. Sabine Rens aus Brüssel (daher ist das Interview auf Englisch) ist stellvertretende Leiterin der MSF Academy for Healthcare und erklärt im Interview Ausgangspunkt und Ziele des Projektes. 

Dear Sabine Rens, how did the idea to create the Academy for Healthcare come up?

The MSF Academy’s creation stems out of an old recurrent realization that the volume and specificity of MSF’s medical work deserved it’s own specific learning unit, which should focus on upscaling and professionalising the quality of learning for healthcare workers in MSF. Moreover, the continuous confrontation with so many crises of Human-Resources-for-Health (HRH) in the countries where MSF intervenes was a significant driver in this ambition for more action.
One of the main drivers in improving the quality of healthcare is to increase the competencies of the workers providing that care, be it in terms of knowledge, know-how or attitude. The MSF Academy for Healthcare has thus been created in 2016 to tackle this challenge by investing in the healthcare workforce, and progressively developing concrete initiatives to address this at various levels, thus tackling various target groups of learners.

The project started in Sierra Leone and will be transferred to other African countries. Why did MSF choose Sierra Leone as the starting point and what other African countries will be included in the program?

Sierra Leone was an obvious place to start. The Ebola epidemic that hit the country had further aggravated the serious HRH crisis they were already facing: over 500 Sierra Leonese healthcare workers died due to Ebola. MSF had the ambition to develop operations that would contribute to lowering the mortality rates in the country with a paediatric hospital in Kenema. At the same time, MSF wanted to ensure a longer term of contribution to reinforce the HRH capacity in the country. The MSF Academy for Healthcare thus organized the training of 22 diploma nurses and 25 diploma midwives through a 24-months-training-program in Ghana. They all graduated in December 2019 and integrated the MSF team in Kenema. It also sent out 12 Sierra Leonese nurses for a 18-months-specialization in anaesthesia-reanimation in Ghana. They all graduated in November 2020. Six of them are Ministry of Health staff and the remaining six will be working within the MSF-Kenema-team. At the moment in the Kenema hospital are continuous professional development programs on basic clinical nursing care with all nursing staff of the hospital and a more paediatric clinical program targeting the clinical officers of the hospital.
In 2019, the MSF Academy started to roll out its continuous professional development program in both the Central African Republic and in the Republic of South Sudan, focusing on the hospitals in which MSF is intervening. This program is composed of a transfer of knowledge using innovative means (videos, games etc.), practicals in safe environments (simulations in skills’ labs etc.) and the transferring into the daily work through mentoring of the learners. In 2021, the MSF Academy intends to continue the roll-out into other MSF-supported structures in these two countries, but also in at least two additional countries.

Who are the students of the MSF Academy and what are their professions?

The MSF Academy for Healthcare has several initiative, targeting different audiences. At the present time:
- The nursing initiative – the biggest – is targeting all staff carrying out nursing duties in the MSF-supported structures where it intervenes. This includes nurses of course, but also assistant nurses or staff with no formal nursing education but performing nursing duties. In rural areas of CAR and South Sudan, nursing staff have often had no formal education. It also includes midwives and all staff performing midwifery duties, as they are also concerned by the basic clinical nursing competencies.
- The anaesthesia initiative targets diploma nurses, as this is the prerequisite to be accepted for the specialization course.
- The fellowship in medical humanitarian action targets medical staff that are presently or will in the near future hold positions in which they will be in charge of defining and running medical strategies and programs. The course will start in April 2021.
- The post-graduate diploma in infectious diseases developed in partnership with Stellenbosch University in South Africa will be targeting medical doctors specifically. The course will also start in April 2021.
- Finally, the outpatient care initiative targets the staff in charge of providing clinical consultations in healthcare centres. In the countries, where we intervene, this task is usually carried out by nurses, who have not received any formal education on clinical diagnosis or treatment.

The MSF Academy has an approved budget until 2023 and there is the idea, to make it a permanent structure within MSF. What are the requirements for this to happen and is an expansion of the concept to other countries possible e.g. to Asia?

The global team of the MSF Academy is limited in size and has focused on setting the basis, developing the right curricula and tools for an effective transmission of information and getting projects off the ground in various countries. These past two years have confirmed that there is a clear need for the MSF Academy to take on this challenge in the long run within the movement. This aspect is currently being analysed to identify the best setting for the future structure of the MSF Academy. 
Finances are of course a core element in the design of the future of the MSF Academy for Healthcare. It is important to find funding to enable this initiative to expand its efforts in strengthening the competencies of the healthcare workforce in the places where we intervene, and to allow us to expand further in Africa and elsewhere – and yes, why not in Asia? We are currently assessing whether to adapt our tools to Bangladesh.

Thank you very much!