”I am a pediatric nurse at Karolinska University Hospital in Stockholm, Sweden, and in January 2020 I took part in my first field trip with Pediatric Health Initiative. The main purpose was to join the team providing training in emergency care at Muhimbili Hospital in Dar es Salaam, assisting the Tanzanian medical simulator trainers on a course in Care of the Critically Ill Child. I learned that there were quite a few aspects of basic emercency care at the hospital which required improvement. Working closely with the Tanzanian colleagues, we could share our own experiences and knowledge, and also learn plenty from them. I got insight into their ability to prioritize and make use of whatever medical equipment there is access to in a low-resource environment. My volunteering experience with PHI gave me an opportunity to grow, both on a personal level and as a pediatric nurse.”

In November 2019 I went to Muhimbili National Hospital in Tanzania for two weeks to teach at their 8-weeks long course in neonatology. For me this was like a dream. I am passionate about neonatology and want to spread this knowledge where it really matters, and where many lives can be saved.

Earlier I had worked in a missionary hospital in Tanzania but transferring knowledge at that rural setting was a challenge. There was no pediatrician and the doctor in charge of the ward was unavailable four out of six weeks. Furthermore there was a high turnover of nurses and the intern doctors only stayed a short time in each rotation. In contrast at Muhimbili they had taken the initiative to this course by themselves and are very dedicated to make a change for the better in their ward.

They had invited experts in neonatology from all over the world, both nurses and doctors, and applied for funds to partially finance travelling. It was six students in the doctor’s course, all pediatricians, and five in the nurse’s course. They had been working in the ward for 8 months up to seven years and all planned to stay.

On a typical day in the doctor’s course we had a lecture for 1-1,5 hours in the morning and then did the clinical ward rounds together focusing on the difficult cases. Apart from the students in the course, other doctors who had the possibility also attended the lectures. The strengths of this project are many. Since the course is initiated and partially financed by the Neonatal unit at Muhimbili they are really motivated to learn. Having parallel courses for nurses and doctors emphasizes the importance of teamwork in neonatology. Being a team of a Swedish nurse and doctor we could really show them bedside how to do it. Also Muhimbili is the largest hospital in Tanzania and referral centre for the whole country, with many interns and residents in pediatrics passing through, so teaching the permanent staff at Muhimbili can benefit the entire country.

There are still many challenges at the Neonatal ward at Muhimbili but I am looking forward to see the progress and hopefully continue to take an active part in this journey!

PHI CHRISTMAS LETTER 2021

Stockholm, December 2021

New Year letter from Pediatric Health Initiative

Dear friends,
Among the many organizations that work for the benefit of children’s health, we believe that Pediatric Health Initiative (PHI) holds a special place: PHI develops sustainable relationships between colleagues who are working within child health to develop skills, knowledge and collegial networks in contexts where resources are limited. In these challenging times of the Corona pandemic– the world has experienced how children’s health has been put under increasing strain. Despite these difficulties, PHI has managed to increase its activities and cooperative endeavors throughout 2021.

PHI’s focus during 2021 has been the initiation of a regional partnership with the Busoga region in Uganda and the collaboration with Muhimbili National Hospital of Tanzania. We have widened our network and deepened our common understanding of the health systems that our partners are facing. In our work with Busoga Region, the specific activities are developed with colleagues at Jinja Regional Referral Hospital and the non-governmental organization Busoga Health Forum with different projects planned to start in 2022.

During the autumn of 2021, PHI has worked closely together with the medical faculty of the Muhimbili University and Alliances (MUHAS) in Tanzania which has just initiated the country’s first Master program in Neonatology. We believe that this is a huge step forward! MUHAS has, with financial support from different partners, been able to offer eight pediatricians a place in the program. We are proud that much of the educational content has been provided by neonatal doctors and nurses through PHI. Lectures, webinars and journal clubs have been important components in the program. If the state of the pandemic allows for it, PHI has planned for an on- site neonatal education in February 2022. And we are really looking forward to it!

We would like to take the opportunity to warmly thank all of you who have supported us during 2021 Your invaluable support continues to assure us that we are doing the right things to contribute to a more equal and fair health care for children globally.

From all of us at PHI - we wish you all a peaceful and prosperous 2022!
Viveka Nordberg, Chairman PHI

Sommarbrev från Pediatric Health Initiative

I denna ljusa sommartid kommer här en hälsning till Er alla och en återkoppling om vad PHI har jobbat med under våren. Vi har utmanats av pandemin och de annorlunda förutsättningarna har givit oss nya idéer och arbetssätt för att kunna bidra till en likvärdig barnsjukvård globalt.

Webb-baserad kommunikation har tagit fart

Vi har samlat våra kollegor från Malawi, Tanzania, Sydafrika och Uganda kring webbinars där sjukdomstillstånd hos både nyfödda och äldre barn har diskuterats. Under våren har vi arrangerat webbinars varje månad med teman såsom smärtlindring hos barn, nyföddhetsgulsot, leversjukdomar, ryggmärgsbråck och svår blodsockerbrist. Dessa webbinars har inbjudit till interaktiva diskussioner och påvisat komplexiteten med att arbeta i med olika kliniska och ekonomiska förutsättningar. Engagemanget för dessa webbinars från våra kollegor, från universitetsjukhus till landsortssjukhus, i våra olika samarbetsländer, är imponerande har bidragit till bildandet av nya nätverk. Användandet av webbinars har därmed kommit att bli en kärna i PHI ́s verksamhet.

Vi intensifierar våra samarbeten – och har fått möjlighet att skapa nya

Vi har sett att PHI kan spela en stor roll för i kunskapsutbytet mellan barnsjukvårdspersonal i olika delar av världen. PHI har, tillsammans med andra internationella aktörer och Muhimbili University of Health Allied Sciences (MUHAS), arbetat fram ett curriculum för att starta Tanzanias första neonatologutbildning. PHI ́s neonatalteam kommer att spela en viktig roll som lärare och handledare när den första kursen startar i november 2021.

Vidare så har ett av PHI ́s neonatalteam etablerat kontakt med Royal Victoria Teaching Hospital (RVTH) som är det enda barnsjukhuset i Gambia. I Gambia finns det totalt sex utbildade barnläkare och diskussionerna mellan PHI och RVTH avseende ett kliniskt samarbete är fortfarande i ett tidigt skede. Om finansiering fastslås och ter sig långsiktigt så kan även detta bli en del av PHI ́s aktiviteter för att stödja likvärdig barnsjukvård i resursfattiga områden.

Ett utav PHI ́s största framgångar hittills är ett nyligen etablerat samarbete mellan PHI och barnsjukvårdspersonal i vår systerorganisation Busoga Health Forum (BHF) i Jinja District, Uganda. Detta samarbete är ett regionalt partnerskapsprojekt mellan BHF, PHI, Astrid Lindgrens Barnsjukhus samt regionpolitiker i Stockholm samt i Jinja och är ett av åtta projekt som erhållit medel från Internationellt Centrum för Lokal Demokrati (ICLD). För oss i PHI betyder det att kunskapsutbyten mellan barnsjukvårdspersonal kan finansieras på ett långsiktigt vis. Det ett stort förtroende att få vara en del i detta och ett tydligt styrkebesked i att PHI gör rätt prioriteringar. Vi har rätt mål i sikte.

Vi utvärderar våra aktiviteter

Alla PHI`s aktiviteter har utvärderats efter avslutat genomförande. Här kommer vi dock under hösten fortsätta att slipa våra verktyg. Vi ser fram emot det!

Vi förbereder oss för framtiden

Vi i PHI förbereder oss nu för den aktivitet som vi sen tidigare värderar högst, nämligen de kollegiala mötena och utbildningar vi genomför tillsammans. Vi planerar för uppstarten med Jinja District (Uganda), fortsatta kliniska utbildningsaktiviteterna och utbyten med Muhimbili National Hospital (Tanzania) och landsortssjukhuset Kagando Hospital (Uganda) och ser även hur vi kan jobba vidare med eventuellt samarbete med Gambia.

I höst hoppas vi veta när det kan bli möjligt att återigen resa. När det är säkert för alla så är våra team så redo att mötas igen.

Från oss alla i PHI tackar vi för att Ni tror på oss och för Ert enormt viktiga stöd.

Trevlig sommar!

Viveka Nordberg, ordförande PHI

PHI CHRISTMAS LETTER 2020

Christmas letter from Pediatric Health Initiative

An entire world is affected this year. The pandemic is sweeping the earth and people and entire societies are bowing to its power. Some have been affected more than others and we know that global child health deteriorates when countries are put in a crisis, especially in low-resource settings with already weak health systems and fragile social security networks.

During 2020, PHI has been continuing our work with bilateral exchanges of clinical knowledge and to maintain and deepen our collegial relations. As traveling is impossible in a safe way at the moment, PHI has taken a short break from travel. We are following the advice from authorities and embassies on this issue. We are also learning from the way other aid organizations act during the pandemic. We will defer collegial exchange until it is safe for everyone to travel again.

The acutely ill child - we have trained the trainers

In January PHI hosted our fourth course in pediatric emergency care at Muhimbili National Hospital (MNH) in Dar Es Salaam. This time, PHI members from Sweden and Tanzania successfully trained the trainers of this course. Pediatric staff from five hospitals in the region attended. This course could not have been possible without the generous donations we received for it.

Web-based communication with our sister hospitals has been developed!

The pandemic has encouraged us to develop our collaborations digitally. During the year we have had webinars between Sweden and Tanzania about management of Covid-19 in our respective workplaces, but also about how other important infections affect

children during the neonatal period. Upcoming topics for webinars, during the early winter, are how we can optimize respiratory support of newborns and diagnosis and care of common neonatal malformations in a resource limited setting. Joint webinars lead to increased knowledge and clinical understanding while they point out future areas for improvement for PHI to work on.

We are intensifying collaborations –to support a more equal pediatric care

During the year 2020, we have broadened our network of contacts and we have discussed with other Scandinavian university hospitals about the role that PHI can play in existing staff exchange projects. In January two pediatric residents from Sweden started a clinical rotation at Kangando hospital in Uganda. The visit was interrupted by the pandemic but the collaboration was successfully initiated. PHI's work has become a voice in the Swedish debate on global child health and this year we have initiated talks with Doctors Without Borders and the Swedish International Development Cooperation Agency. During the spring PHI participated in meetings with MNH adressing educative knowledge exchange between health care personell in the hospital's newly opened pediatric intensive care unit. More to come!

You have shown us that our priorities are right

The financial support that PHI receives from monthly donors, companies and organizations, large and small, makes us understand that our priorities are right. We continue to support the initiation of quality improvement projects at our sister hospitals and share their satisfaction at proceeding towards the goal. As soon as the pandemic is under control we plan to launch new long-awaited clinical exchanges and with your support they will be securely financed. Together we are strong!

We wish you all a Merry Christmas and a safe 2021!

On behalf of the PHI-board

Viveka Nordberg