Reflections from Jessie Mbamba, Montegut Global Scholar in Seoul 2018

Jessie Mbamba, family medicine registrar from Malawi, received a Montegut global scholarship to attend the WONCA World conference, in Seoul, in 2018. The Montegut Global Scholars Program (MGSP) was established by the American Board of Family Medicine Foundation (ABFM-F) in 2010. The MGSP was established to foster international education, research and collaboration, in the specialty of family medicine. Jessie is pictured above with African and Korean colelagues and below reports on her experiences:

The 22nd WONCA World conference in Soeul, Korea was a reality and an experience and a half! Thanks to the Montegut scholarship.

The pre conferences were a bonus for me - both the young doctor’s movement (YDM) and WONCA Working Party for Women in Family Medicine (WWPWFM). The WWPWFM have been my personal motivators. I remember from WONCA Africa 2017 sitting in the Chiawelo community practice, in Soweto, at the pre-conference and connecting with the most powerful women in the world. It was great to be part of the team again in Seoul. The process of mentorship between the young and the old beginning to unfold and being part of it was a big opportunity to address both professional and personal challenges faced by women in WONCA.

Meeting the young doctors from around the world and Africa strengthened my interest in Family medicine networking. I have been included within the AfriWON forum of the Young Doctors’ Movement (YDM) and I recruited fellow Malawian doctors to this group. Currently I represent the FM 360 exchange programme for AfriWON, I would not have imagined this. The creation of special groups within WONCA helps to bring out ideas and interests and identifies people with similar agendas and goals.

The theme for the conference was ‘primary care in the future: professional excellence’ which aimed at helping us to focus on making a medical home for the patient in our clinics and hospitals. How the medical home can be established in chronic illnesses by aligning the primary care blocks of comprehensiveness, continuity, coordination and accessibility to achieve professional excellence patient and family centred care. The question that arose in my head after being raised by the presenter, Prof Amanda Howe, was do my patients have a medical home? I thought of the patients I see in the hypertension and diabetic clinic that are also HIV positive, who need a separate date for their HIV management because my clinic is not fully equipped for integrated care. How can these patients get a comprehensive and affordable package to avoid routine care for each illness?

From the plenary on rural research I learnt about the Delhi declaration which talks about realigning the research agenda to have research centres in rural areas and move academia into rural practice. I was encouraged to be more inquisitive and take ownership of the health related research work that is being conducted in my catchment area. I practice in a hospital where many organisations have research projects being carried out. I have been on both sides, as a researcher and a clinician wondering about certain research projects. In most cases the project comes in with their team without much inspiration or exposure to the staff of the institution. The presentation highlighted the importance of integration of the facility staff in research to encourage a spirit of ownership and continuity. If the research project findings prove to be beneficial and require handover and continuation, it is easier if the staff were involved.

The rural research and practice meetings were of particular interest to me, because for the past four years I have been working in the semi-urban district hospital of Mangochi, with a wide rural catchment area, helping patients that face challenges of access to the main hospital where I work.

There were a list of actionable solutions from the WONCA rural forum to improve rural capacity, the daunting challenge of lack of well trained staff. To mention a few they included: provision of housing, medical school loan repayment, free medical education for rural students within that catchment, social support by job matching and spouse match making, establishing competent medical training both postgraduate and undergraduate teaching facilities in rural areas.

The case studies presented by fellow young doctors, reminded me of the case studies bank that I have been collecting throughout my residency which could easily be published and be learning material to others. I could relate to quality improvement projects carried out in developed countries, one particular which was from Japan; ‘Case analysis; Emergency transportation from primary care hospital to tertiary emergency hospital.’ The aim was to assess the acute care system and analyse triage criteria for case transfer (from primary emergency Kaita hospital to Iizuka tertiary emergency hospital), which was undocumented. The lack of a defined referral triage is a similar challenge in my context and cases of emergency may not be urgently referred. Thoughts of repeating the study in my setting was quite interesting with referrals to central hospital from my hospital.

Sightseeing in Korea was better with the young doctors, with trips to the Gyeongbokgung palace, to the big night markets of Korea with the African bargaining techniques and the sharp Korean tongues. Viewing Gangnam city from the Namsan Soeul tower that is 236.7m high was both breathtaking from the top and nerve-wracking especially from the cable uphill elevators.

All in all WONCA Seoul 2018 was a platform for networking, learning forum, introduction to special interest groups and introduction to innovative ways to contribute to the research world. WONCA Seoul boosted my dedication towards the path of Family Medicine with the illuminating confidence from the senior Family Physicians and encouragement from my fellow YDM members.