Building Castles: Sudanese-Irish Collaboration on Doctor Migration Challenges

Dr Abobakr Shadad, lecturer in medicine at NUI Galway, welcomed participants to the Migration of Sudanese Doctors: Dynamics & Opportunities Conference in Galway, Ireland on June 9, 2012 with the Irish saying ‘Tri na cheile a Thogtar na Caisleain’ – We can only build a castle if we work together. This conference was the first Irish conference of the Sudanese Medication Association (of UK and Ireland), and took place over the course of 3 days in both Galway and Dublin. Dr Shadad’s phrase set the tone of the event with many speakers focusing on the theme of collaboration. In particular, Mr. Bahar Idriss Abugarda, Sudan’s Federal Minister of Health (FMOH), echoed these sentiments, stating that he wanted to take the opportunity to “encourage and welcome collaboration and bilateral agreements with Ireland”.

Why Collaborate?

Why is collaboration so essential to tackling doctor migration issues? Is there much value in such partnerships, or is it simply all rhetoric? Currently there’s a large deficit of doctors in Sudan as many emigrate. As Dr Elsheikh Badr (President of the Academy of Health Sciences FMOH Sudan) reported, in 2005 approximately 60% of Sudanese-trained doctors emigrated, and the trend appears to be increasing. Destinations often include the Gulf countries, UK, Ireland, and more recently Libya. Ireland is a country that relies heavily on foreign-trained doctors; Sudanese-trained doctors are increasingly important for the Irish health system.

Collaborative efforts allow Ireland’s government and research institutes to develop a clearer picture of current training needs in Sudan and act on these needs. Overall, partnerships between Sudan and Ireland – through research as well as direct bilateral engagement – aim to help manage doctor migration in the hopes of maximising benefits for both countries.

Methods of Collaboration

Speakers at the conference suggested several ways Ireland and Sudan may collaborate on issues of Sudanese doctor migration.

1.      MOU/bilateral partnership

On June 9 the conference proceedings were temporarily interrupted for the signing of a Memorandum of Understanding (MOU). Sudan’s Federal Minister of Health (FMOH), the Academy of Health Sciences, the School of Nursing and Midwifery at NUI Galway, and the Sudanese Medical Association took part in the signing – a significant step forward in building a bilateral partnership between the two countries.  Such collaboration aims to bring about mutual benefits and protection for professionals against possible exploitation.

2.      Training exchange/twinning

Several presenters focused on the need for training exchange and hospital/medical centre twinning. Ms Helen Burke, an advanced nurse practitioner in diabetes, discussed the pairing of the Diabetes Day Centre, University Hospital Galway. The centre ran a small training exchange programme that brought two diabetes nurses from Sudan to Ireland. She reported a positive overall experience, with the nurses being able to take ideas back to their own centre. With a strengthened skill-specific training curriculum, it may be possible to develop similar, larger-scale programmes in other specialties.

Mr Eric O’Flynn of the Royal College of Surgeons in Ireland (RCSI) reported on the RCSI collaboration with the College of Surgeons of East, Central, and Southern Africa (COSECSA). A ‘college without walls’, COSECSA is currently in 9 countries. It is a growing and evolving training programme focused on e-learning and distance exam administration. COSECSA is unique because it is Africa-centred. The Sudanese Association of Surgeons has applied to join; Mr O’Flynn stated that he is delighted to be working with Sudanese colleagues and he ‘thinks the future is very bright for this’ and other capacity-building initiatives.

Twinning of hospitals is another means of collaboration that received significant attention at the conference. In February 2012, Ireland joined the ESTHER Alliance – a network of governments working to tackle major diseases and healthcare issues by twinning European hospitals to those in developing countries. At the conference Dr Mohamed Eltom of Portiuncula Hospital, Ireland gave a presentation on ‘Saving Mothers’ Lives’ in which he briefly shared the experience of the Omdurman Maternity Hospital’s collaboration with Irish universities from 2000-2009. He stated that such “collaborations…have proven to be effective in the past” and should similarly be pursued now and in the future.

Dr Ruairi Brugha of RCSI discussed practical training for Irish-trained medical students and doctors in Sudan. He and several colleagues suggested that a programme for a short training in Sudan (perhaps a month or two) would allow doctors trained in Ireland to give back to Sudan and also help them to gain practical training in certain areas, like tropical medicine.

3.      Continuing open dialogues

Several speakers noted the importance of the conference itself as a forum for engaging on challenging topics. Keeping an open dialogue between medical professionals, academics, and policy makers in Sudan and Ireland is crucial for moving forward on key issues. This will help encourage compliance with the World Health Organization’s Global Code of Practice on the International Recruitment of Health Personnel, which is not only about ethical recruitment, but also includes regulations for health system development, health system management, and fair treatment of health workers. Continuing the dialogue on this topic between the two countries gives Ireland the opportunity to identify pressing training needs in Sudan on which Ireland can collaborate. Given the volume of Sudanese doctors in Ireland, it is important to ask what Ireland can be doing to build  capacity that would “help meet the health needs of Sudan and help those doctors who want to return to Sudan”, as stated by Dr Brugha.

It is an exciting time for Sudanese-Irish collaborations around the issues of doctor migration and training. These initiatives must remain truly two-way in nature, as each country has experience and expertise to share with the other. It is only through partnership and working together that they will build castles – or rather, policies and collaborative initiatives that benefit both countries.

Ashton Porter

Key Correspondent

Email: [email protected]

This article was written as part of a series of articles written by the Key Correspondent Team (KC Team) covering the Migration of Sudanese Doctors: Dynamics & Opportunities Conference.

For more information on the KC Team go to: www.keycorrespondents.org