Dr Jeanne Frossard is a retired anaesthetist who continues to work at University College London Hospitals. She is now a trustee of the Primary Trauma Care Foundation (PTCF) having volunteered to help the charity for the last ten years.
I actually wanted to be a vet but I wasn’t clever enough and thought I should still do something in medicine. I think I’d still quite like to be a vet!
There was no great calling. After my house jobs I didn’t really know which path to follow so I did my FY2 in New Zealand for a year. I spent three months in anaesthesia and quite enjoyed it. I then went travelling in Asia and nearly decided on a career in tropical medicine but settled for anaesthetics instead.
I’ve always enjoyed voluntary work abroad – when I came back from New Zealand I spent 3 months working with Médecins Sans Frontières in Afghanistan. It was actually quite quiet – we were stationed in a little backwater town and most of our work load involved cases of malnutrition or dietary problems. Occasionally people came in with shot wounds which were mainly tribal issues!
I worked with a team of orthopaedic surgeons in Sarajevo during the war conducting mainly pre-planned surgery. We took a lot of equipment with us but the supplies often ran out and we just had to get on with it.
I then met anaesthetist Mike Dobson who was working with the PTCF and was soon on my way to my first trip to Rwanda in 2005. Since then I have helped set up courses in Gaza, West Bank, Jordan, Lebanon, Iraq, Rwanda, Namibia, Malawi, Madagascar and China.
The PTC course is an amazing, sustainable trauma management course that can be adapted to low income settings where trauma management is very poor due to lack of infrastructure and training. It is run by volunteer trainers who give their time and skill for free but it desperately needs funds to move forward, update and improve.
The developed world has trauma management courses such as ATLS and a good infrastructure for managing trauma. The developing world has none of this. The PTCF worldwide network offers proven, adaptable training using local resources to reduce mortality and morbidity in these countries. UK doctors frequently work abroad in developing countries. It is very important they know about PTC training and support it both as volunteers and financially.
I wasn’t surprised by it. The first courses are normally in stable environments, with preferably young but influential people. We run ‘2-1-2’ courses which means we train the local doctors for two days, we run a teaching course for one day and then we watch them teaching the course for two days. I have found it so rewarding after five days leaving about 40 trained people, 12 of which are instructors with the skills and confidence to teach trauma management in their countries and start a cascade.
The success of the course is very dependent on the local people. If you’ve got one person who is completely fired up and wants to push it, then it works. They really have to take the opportunity and grab it. I’ve just been to Madagascar and one of our contacts there is a guy I had previously taught in Rwanda so that was brilliant – he knew what was required and has a good influence over his peers locally.
We do face some challenging situations of course – being in war zones can be stressful but the most difficult aspect is normally just navigating the logistics of African travel! Delays at airports and on roads can be frustrating when there’s work to be done.
There are always some eye-opening moments. I’ve seen goats slaughtered to be used as training props with the trainees practising putting in chest drains using a goat thorax! One of my colleagues once organised a course for 20 people and 150 turned up!
We are now able to gather a massive amount of data to show that the courses are effective. While hard statistics are always going to be difficult to generate, we regularly receive reports from doctors in natural disaster and conflict areas who tell us our work is making their lives easier. The training has given the chance for doctors and nurses to give patients the best possible outcome with limited resources.
A doctor in Pakistan reported that our training had really helped his team to cope with the consequences of terrorist bombing. Similar news came from doctors in Sri Lanka who had dealt with the aftermath of the Tsunami and most recently, from those working in Nepal at the time of the earthquake.
The PTCF course now runs in 65 countries, has been translated into 12 languages and the entire charity is run by only three staff!
If you are inexperienced, you have everything to gain by volunteering and actually little to give. You will learn about different diseases, different practices and possibly most importantly, different cultures.
It makes you think about how to cope with limited resources, how to adapt in diverse situations and to manage colleagues. Working in developing countries makes doctors more aware of what they have and what they don’t have. I’ve certainly become less tolerant of people complaining about the NHS and particularly if patients are unhappy with a 20 minute wait!
For senior doctors, volunteering can help refresh skills or keep you on your toes – I always learn something from the younger trainees.
I’m going to Uganda in September to co-direct an annual course which gives Western doctors an idea of what to expect when working abroad.
I think retired doctors life myself seem to be even busier because our lives are so varied. In fact we have always been this busy, working very long hours, but now we take on the work that we enjoy so we take on lots of different roles.
I have no intention of giving up work and it’s easier to continue if you incorporate a teaching element within your workload.
I like to relax by walking and will shortly be going on a walking holiday to Bavaria with friends. And I’m rather spoilt in that I have an Everyman Cinema next door!
Don’t complain about things, just get on and do it. There will always be an excuse why you won’t do something. Just make it happen.