Lives saved and healthcare services significantly strengthened.
These are the outcomes pioneering gastroenterology and endoscopy training programs have been responsible for achieving in the Asia Pacific region since 2007.
Thanks to the efforts of members of the Australian and New Zealand Gastroenterology International Training Association (ANZGITA), the first-of-their-kind training programs have built the skills and capacity of specialists and their colleagues.
The Association comprises more than 100 volunteer medical professionals – primarily RACP Fellows, Gastroenterology nurses and some surgeons – along with other stakeholders from Australia and New Zealand. All work in partnership with local communities and workforces to deliver a range of tailored training programs and services.
“Over the last 10 years in Fiji we have delivered skill transfer and development in gastroenterology – to the point where the team at the Colonial War Memorial Hospital are wonderfully competent and equipped to address most of the luminal gastroenterology challenges presented to them,” explains Professor Finlay Macrae, who initiated ANZGITA.
“We have seen a cessation of patient transfer from the region to centres in Australia and New Zealand as the work is now competently done in Fiji and a lot of procedures – like variceal banding and polypectomies – are done across the entire region by graduates from the ANZGITA programs.”
Professor Macrae says infection control has also been a focus of ANZGITA’s work, “as our nurses have emphasised the potential for multi-resistant organism transmission iatrogenically, including by endoscopes”.
“We oversaw the implementation of tel-education and the benefits it brings, including allowing specialists in remote areas to access ‘over the shoulder’ assistance as they deal with challenges in real time across the Pacific,” he says.
“We have seen an insatiable appetite for our training formula of skill transfer, response to articulated need, academic curriculum support, gastrointestinal nursing expertise and some capital equipment support – especially for semi-automated cleaning and disinfection systems developed in China – across the regions in which we work.”
Professor Macrae says ANZGITA members appreciate the highly privileged healthcare and training systems that we have in Australia and New Zealand and respond to opportunities to assist our neighbours.
“We have an immense amount to offer to many countries in our region, many of which are the poorest in the world,” he says.
ANZGITA offers a ready way to engage, according to Professor Macrae.
“The only thing needed of colleagues is their time. We do the rest. Having said that, we are oversubscribed with offers from RACP Fellows, and to meet our budget requirements, we also need funding support from governments and the Fellowship if they are not in a position to offer their time right now.”
Fellows and nurses derive enormous satisfaction, often experiencing life changing approaches to their life and careers, as a result of their experiences on ANZGITA programs across the Pacific, Timor Leste, Myanmar and now Nepal.
Professor Macrae says doctors donate their time and pay for their own airfares to undertake work in the Asia Pacific.
“Nurses donate their time. The training cost gaps are largely filled with philanthropic funding.
“The Australian Government’s Department of Foreign Affairs and Trade (DFAT) provides funding to the Royal Australasian College of Surgeons (RACS) Pacific Islands Program (PIP) and through the South Pacific Community. This funding then assists us because it allows for trainees from across the Asia Pacific region to be transported into the training hub, and for evaluation programs to take place.
“PIPs is currently evaluating ANZGITA’s programs with a view to some further core support. ANZGITA is quite independent but enjoys a close working relationship with RACS.”
Professor Macrae says ANZGITA needs additional funding to continue its work.
“We are convinced that our programs of capacity building are extremely effective and cost effective.
“Australia gains so much on-the-ground prestige from activities such as ours, where we are improving the quality of healthcare, as well as building capacity and capability in the healthcare system. Such simple but flagship activity is so important in the Pacific in the current climate of international competition for influence in the region.
“We have fully subscribed training programs to continue in Suva, Timor Leste, Solomon Islands and Nepal in 2019 through ANZGITA’s membership. On invitation, it is likely we will continue across Myanmar.
Professor Macrae is a member of the RACP International Strategy Reference Group (ISRG). He provided a clinical gastroenterology service in Suva for a decade before initiating ANZGITA in 2008.
ANZGITA has supported the training centres at Colonial War Memorial Hospital in Suva and Yangon General Hospital in Myanmar to be recognised as World Gastroenterology Organisation Training Centres.
The success of ANZGITA has been acknowledged. Professor Macrae now chairs the WGO Training Centres Committee that has oversight of all 23 WGO Training Centres in the world.
He has been actively involved in delivering gastroenterology and endoscopy training internally since 1979, when he first undertook a Monash medical student elective in Papua New Guinea.
Along with other RACP Fellows, he took a leading role developing the College’s International Strategy.
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