Overseas volunteering is increasingly seen as a way for health professionals to get involved in improving global health. Here, Deji Oyebode explains how it works

The World Health Organisation, Department of Health and British Medical Association all advocate sharing the skills of UK-based health professionals with developing countries.

The challenge is in turning these recommendations into reality. Creating an effective model for overseas assignments - which promotes consistency and sustainability in the developing country and provides financial support, training accreditation and personal development for UK volunteers - requires the commitment and vision of a number of people and institutions.

The Royal College of Psychiatrists, in partnership with South West London and St George's Mental Health trust and Challenges Worldwide, an international development charity specialising in overseas assignments for volunteers, recently achieved this with the successful completion of a three-month project inGhana.

Groundwork

To prepare for the project, I visited Ghana with Challenges Worldwide to make professional and logistical arrangements, including arranging accommodation, transport and temporary medical registration, as well as making a work plan for the assignment and establishing a professional peer group for the doctor to join.

Sadly, psychiatric care in Ghana is a last resort for many families, often sought many years after the patient first shows symptoms. Retaining doctors is also a major problem. The position of medical assistant, nurses with an extra year of general medical training, has been introduced to help cater more effectively for rural medical needs.

Recruiting a doctor in the UK to take part in the project was carefully managed. Applications were submitted to the trust human resources department and then interviews and assessments were conducted by the trust, the Royal College of Psychiatrists and Challenges Worldwide.

Dr Norman Poole, a final year specialist registrar on the trust training scheme, was successful and the placement was agreed with Dr Akwasi Osei, acting chief psychiatrist at Accra's psychiatric hospital.

Challenges Worldwide helped to establish a partnership with the Ghana health service. Dr Osei helped the charity identify areas where specialist registrars could offer sustainable support through short-term assignments.

The placement

Dr Poole was based at Pantang Hospital, outside the capital Accra. During his placement, he taught trainee doctors and medical assistants, did clinical work and helped develop more effective systems, such as a protocol for managing aggression. He also travelled to the north of Ghana for one week and supported outreach clinics.

"For me, the experience was tremendously enriching and it is to the trust's credit that they acknowledge overseas experience can benefit NHS staff while assisting other healthcare systems," says Dr Poole.

"However, the project will only be successful in the longer term if senior trainee psychiatrists from the UK take up this exciting opportunity."

Balancing books

The model aims to be cost neutral for everyone involved. It was approved as part of the accredited training (as an out-of-programme experience). The trainee was paid two months' salary (minus London weighting and on-call allowance) for the three-month placement. The last four weeks of the term were granted above and beyond the contractual annual leave.

One month's salary was paid to Challenges Worldwide for development, training and management costs. Assignees are required to cover the costs of professional indemnity insurance, flights and their personal spending, but some funding is available to contribute to these costs through the college or sponsorship deals.

Training accreditation was achieved through the provision of a mentor in Ghana, in this case Dr Osei, and a UK mentor, Dr Peter Hughes, consultant psychiatrist in general adult psychiatry at Springfield University Hospital London and training programme director.

During the assignment, Challenges Worldwide provided ongoing e-mail and telephone support, including a 24-hour emergency contact line. A post-assignment debriefing and feedback session allowed all involved to assess the assignment and plan for the future.

In future, the programme will continue to focus on organisational development and capacity building, rather than service delivery or emergency response. Assignment vacancies will be available for specialist registrars and ST4s and above, for similar three-month placements. These will fit within a strategic three-year programme that will send trainees on a rolling basis. The plan is to expand the programme to include different trusts and additional countries.

More information

For further information, please contact Dr Deji Oyebode deji.oyebode@elcmht.nhs.uk,Joanna Carroll, jcarroll@rcpsych.ac.uk, or Alison Denny alison@challengesworldwide.com.