“Clinical shadowing has improved my clinical knowledge. I saw two faculty members, but I really wanted more, they really helped us to improve our knowledge and shortcomings. I can share one experience with you: we have so many patients coming for drugs…during my shadowing I had one of these patients. The faculty member suggested sending the patient to counselling. Before, I did not have this in mind. I sent the patient to MHPS [Mental Health Psychosocial Support] and they found out this patient was suffering from PTSD and that is why he was complaining of pain, but I could not find a reason why. They were very happy that I diagnosed that patient. Thanks to the faculty members, they opened my eyes to see the bigger picture. Before sending any patient for drugs, now I think twice if they are suffering from anything else that I had not considered.” - PGF Participant Cohort E, 2021PGF Impact Report >
The Rohingya people have suffered under decades of discrimination and lack of access to basic rights and services such as healthcare with high rates of attacks reported in 1978, 1991-92, and in 2016. Recently, In August 2017, a widespread attack in the Rakhine state of Myanmar (Burma), including horrific acts of violence, triggered over 700,000 Rohingya refugees to flee to its neighboring country of Bangladesh. The UN Chief of Human Rights has reported it as a textbook example of ‘ethnic cleansing’. From a medical and public health perspective, there are therefore immense requirements in the control of communicable disease, management of non-communicable disease and injuries, support for mental health and psychological trauma, as well as understanding reproductive health and coping with the effects of gender-based violence. These requirements are further challenged by the lack of health literacy amongst the Rohingya population stemming from decades of denied healthcare access. Following on from a pilot run held in February 2018, DWW launched the PGF officially in July 2018 and completed 5 successful training projects until 2021.
The Postgraduate Fellowship (PGF) in Refugee and Migrant Health is a short-term to medium-term medical capacity building and training programme specifically designed to help local doctors working in humanitarian settings to improve their clinical practice. In response to the Rohingya refugee crisis, the PGF was designed and developed by Doctors Worldwide and was implemented in Bangladesh from 2017 to 2021 training 5 cohorts of Bangladeshi medical professionals. The programme targeted junior doctors who have not worked in medical humanitarian settings previously, or have not received specialised training to meet the specific healthcare needs of crisis-affected populations. It was taught by DWW medical and educational faculty of experts from around the world.
The PGF is centred around the delivery of 8 independent modules in primary care and humanitarian medicine. Each module is tailored to the contextual needs of the local refugee communities, local host populations and healthcare systems whilst also embedding international standards for shared learning opportunities. In addition, we utilised eLearning and certifications through highly reputable institutions and learning platforms. Each participant also gets 1-1 clinical mentorship sessions using case-based discussions, mini-clinical exercises, and direct observations through procedural skills by our trainers throughout the duration of the PGF programme. The teaching incorporates a wide range of methodologies including:
Doctors Worldwide recruited over international medical experts with primary care, emergency medicine, mental health, sexual and reproductive health, maternal health, and pediatrics backgrounds to deliver the training and clinical mentorships.
The long-term impact of the PGF in low-middle income countries includes better healthcare outcomes in Bangladesh for both the local host and refugee/migrant population as doctors will be better equipped to meet their health needs now and in the future. As these doctors work alongside their peers, and as they progress into leadership roles, the benefits of this training will also be passed on to their colleagues as well as the wider health settings within which they practice and operate.
“The PGF has proven to be a sustainable, comprehensive programme, which has successfully trained healthcare leaders who are determined to provide quality of care to the communities they serve” - PGF Project Manager
“PGF is unique in many ways…the PGF focused on our clinical and other skills and knowledge, including our leadership and governance which was interesting”. - PGF Participant
After 3 years of successfully implementing the Postgraduate Fellowship in Migrant & Refugee Health (PGF) in response to the Rohingya Crisis in Bangladesh, we are now planning to expand the project globally into other regions facing humanitarian crises, working closely with key medical experts who have played a vital role since the project’s initial inception. With an aim to roll out the project from February 2022, we will be welcoming all interested agencies, institutions, government bodies and healthcare networks to come forward with their interests for the PGF to be implemented in their setting.
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