Child health front line

After learning about an opportunity to contribute to a growing relationship between the Health Frontiers-supported Paediatric Training Program and the University of Melbourne Department of Paediatrics, University of Melbourne alumnus Dr Amy Gray decided to head to Laos to make a contribution to child health in an area that desperately needed paediatric training expertise.

Laos has been ranked 135th out of 177 countries on the United Nations Development Programme (UNDP) Human Development Index, ranking the lowest among all its south east Asian neighbours. Although child mortality rates are improving, there is still a real need for targeted services to improve health and education in the small, landlocked country.

As part of her PhD, Dr Gray has been working with Lao paediatricians to translate, adapt and distribute the World Health Organisation (WHO) Pocketbook of Hospital Care for Children so that it can be effectively used by health staff in hospitals all over the country. The booklet contains guidelines for the management of common illnesses among children where there are limited resources. Although it was published in many languages and distributed to various countries, there was no version written in Lao, the official language of Laos.

“There was a lot of work involved in advocacy for the translation of the book into Lao. However we ended up receiving some financial support from the WHO, which was extremely helpful” Dr Gray says.

The work she has put into the project has certainly paid off, with hospitals around the country requesting the booklet and other organisations now interested in supporting the Pocketbook activities.

“The work we have done has now reached far outside my research, which is great. As a result of what we have done, local paediatricians are now equipped with an essential resource to train other health staff and improve care” Amy says.

Amy studied medicine at the University of Melbourne before starting her paediatric training at the Royal Children’s Hospital. She then spent some time working in Vietnam at the National Hospital of Paediatrics, where she developed her interest in international health.

“There is a lot that is taken for granted in Australia, especially good quality clinical care and education. It’s just not a given in these countries. Working in Vietnam (and now Laos) really gave me the opportunity to develop a broad interest in international child health” she explains.

Amy’s supervisor, Professor Trevor Duke, the Director of the Centre for International Child Health (CICH), has had years of experience working in developing countries and is sensitive to the difficulties faced by health workers everyday in under-resourced settings.

“Most countries with high child mortality rates have not until recently had a focus on the quality of health services so many health services struggle with very limited resources. Hospitals are often under-utilised or conversely unnecessarily overcrowded, have high rates of preventable complications, and their staff feel unsupported and morale is often low” he says.

Professor Duke is very supportive of Amy’s work, particularly as it is focused on sustainable capacity building and long term change.

“In Lao, for example, this is the first ever local-language-translated guide for paediatric care. There is a strong sense of local ownership and achievement in producing and using the guide and it has become an integral part of a new health culture” he says.

Amy plans to come back to Melbourne by the middle of this year. However, the project she initiated will continue, thanks to her dedication and the support from all the different partners involved. For example, the relationship with the University has led to an Australian-based mining company, Minerals and Metals Group, committing to support continuing medical education for Lao paediatricians for the next 5 years. As a result, paediatricians in Laos will be better equipped and will have access to more resources than they ever have before.

“There have been enormous benefits in having the support of the University with this project and the doctors of Laos see the benefits and the connection as valuable too” she says.

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