NeuroAccess – Lusaka, Zambia 2016

Dr Michael Bonello & The Walton Centre NHS Foundation Trust, Liverpool, UK

Dr Michael Bonello, ST7 Neurology

The Walton Centre NHS Foundation Trust, Liverpool, UK

NeuroAccess is a project supported by The Encephalitis Society and run by Drs Benedict Michael and Sam Nightingale which aims to improve the care of patients with Encephalitis and other neurological problems in sub-Saharan Africa through improving education in clinical neurology. The project is funded by courses in neurology for UK undergraduate and postgraduate medics, and by grants from The Encephalitis Society and the Association of British Neurologists.

I would like to thank the ABN for funding my application to travel to Lusaka, Zambia between the 22nd October till the 6th November 2016. I was involved in the provision of neurological teaching as part of NeuroAccess.

NeuroAccess started in 2013, an idea of Dr Benedict Michael and Dr Sam Nightingale, where a yearly two-week course was set up to provide neurological education to general medics in the sub-Saharan African countries of Mozambique and Zambia.

Visit

For two weeks the day started at 07:00 with a two-hour morning teaching session delivered to the seventh year (1st week) and fourth year (2nd week) medical students in which we covered a set neurology curriculum trying to build up basic concepts like localisation to explain more complex pathology such as stroke, movement disorders and epilepsy. This was normally followed by a two-hour small group teaching session delivered to fifth-year medical students were a hands-on approach was used to highlight the concepts of the neurological history and examination. An hour session of bedside teaching with the sixth year medical students would follow. Junior Doctor teaching would be next on the agenda and this included a wide variety of teaching styles and topics. This varied from interactive lectures e.g. on neuroradiology, grand round style sessions on cerebellar disorders and spinal cord disorders, to more bedside tutorials presenting patients with Brown-Sequard syndrome and Motor Neurone Disease. A video bank of clinical signs has proved essential in making the sessions as interactive as possible. The afternoons were spent seeing inpatient referrals under the supervision of Dr Siddiqi as well as preparing the sessions for next day.

Wednesdays proved a change from the routine as after the morning 7 am lectures we made our way to the weekly neurology clinic where we would join Dr Siddiqi and Dr Kvalsund seeing patients who could have been waiting for hours and who would have travelled hundreds of miles to seek a neurology opinion. We normally used to be joined by medical students in clinic resulting in it being a teaching clinic. The feedback received for all teaching sessions was very good. Tendon hammers and pen torches were handed out to the most involved students and doctors promoting interaction. A quiz at the end of the two weeks consolidated concepts we covered all week and a diagnostic set was given to the winner.

Future plans

NeuroAccess aims to slot into a permanent program of post-graduate neurology that is currently being developed by Dr Omar Siddiqi to train a local team of Neurologists that can take forward and improve neurological care in Zambia. Its aim is to build on a strong record of teaching in the UK were faculty, teaching on the successful NeuroPACES course, have the chance to teach on the NeuroAccess course.

The programme is supported by an open access eLearning resource in neurological infection that has been developed (www.braininfectionsuk.org/neuroid_elearning) to allow future reading for junior doctors and consolidation of further knowledge. We aim to return next year to provide continuing neurological education and to build on the previous year’s teaching.

NeuroAccess is a project supported by Encephalitis International and run by Drs Benedict Michael and Sam Nightingale which aims to improve the care of patients with Encephalitis and other neurological problems in sub-Saharan Africa through improving education in clinical neurology. The project is funded by courses in neurology for UK undergraduate and postgraduate medics, and by grants from Encephalitis International and the Association of British Neurologists.