Trauma training course: innovative teaching models and methods for training health workers in active conflict zones of Eastern Myanmar

Abstract

BackgroundMyanmar has struggled through decades of internal conflict, which has negatively impacted the country’s health outcomes. Recent government changes have brought hope and reduced conflict. The ethnic minority groups have suffered the brunt of the health consequences and reside in regions that lack health infrastructure, resources, and providers. Due to the chronic lack of healthcare providers within conflict areas, health workers (HWs) have been trained in an effort to fill the void. Research has shown that these non-physician clinicians positively impact health outcomes in developing countries. These HWs are supported by community-based organizations in collaboration with foreign non-governmental organizations. Started in 2000, the trauma training course was developed to meet the educational needs of these HWs.MethodsEssential procedures for HWs in conflict zones were identified, and teaching methods were adapted to develop models that were simple, reproducible, cost effective, and able to facilitate effective learning within the limitations of these challenging environments. This paper presents simulation models developed to teach trauma injury evaluation and management in resource-limited settings to HWs.ResultsMaterial and construction of the models described include breathing, chest, cricothyroidotomy, circulation, wound repair, fracture/dislocation, splinting, fasciotomy/amputation, and an animal model. In 2013, a pre/post test and post-training evaluation were completed, which demonstrated an increase in understanding of the material and satisfaction with the training.ConclusionsThe simulation models described engage the HWs in clinical skills practice specific to injury management, which builds upon the HWs existing knowledge and facilitates an increased understanding of life-saving procedures. Through observation of the HW performance and HW feedback, these simulation models have increased the understanding of trauma management. Limitations include lack of a graduated learning system for the HWs, logistics, and time constraints. Despite the barriers faced, we feel that this is a necessary program that has reduced morbidity and mortality due to traumatic injury in the geographic areas that the HWs serve. With the changing political environment in Myanmar and the development of peace agreements between the government and the ethnic minority groups, these HWs can be integrated into Myanmar’s evolving health system.

Comparison of trauma care systems in Asian countries: A systematic literature review

“…However, the trauma care systems were not fully described. The studies on the other LMICs such as Sri Lanka, Myanmar and Cambodia were focused on rehabilitation, injury surveillance, education for capacity building for trauma care rather than trauma care system contents . We could not include the countries in the study.…”

Integrating community health volunteers into non-communicable disease management among Syrian refugees in Jordan: a causal loop analysis

“…11 Studies have shown positive impact of community health workers on NCD management in low-income and middle-income settings. [13][14][15][16][17][18] However, limited guidance exists on the specific role community health volunteers (CHVs) might play in delivering care to refugees living with NCDs in protracted displacement settings. Since 2011, the International Rescue Committee (IRC) has administered Jordan's largest CHV programme, serving both Syrian refugees in non-camp settings as well as uninsured Jordanian patients.…”

Status of Emergency Signal Functions in Myanmar Hospitals: A Cross-Sectional Survey

“…23 Since 2000, several organizations have implemented the trauma training course (TTC) program with non-physician clinicians (called health workers) in Eastern Myanmar. 24 The program comprises various skills for carrying out the initial treatment of trauma, taught through simple simulations and feedback. The findings indicated that survival rates improved significantly among major trauma patients following the implementation of this program.…”