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NeuroAccess

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.

If you are a neurology registrar or consultant and would like to be involved in NeuroAccess teaching courses, either in the UK or overseas, please contact Benedict Michael and Sam Nightingale on neuroaccess@encephalitis.info

Drs Michael and Nightingale are Clinical Research Fellows with the Liverpool Brain Infections Group and neurology specialist registrars working at the Walton Centre and Royal London Hospital respectively.

You can follow the project on Twitter follow @neuroaccess         

Mozambique - June 2014

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Report – NeuroAccess, Mozambique, July 2014. 

Drs Benedict Michael and Sam Nightingale visited Beira Public Hospital in Mozambique between 16-27th June, 2014.  

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The hospital:

Beira Hospital is the second biggest hospital in Mozambique. The hospital facilities are very basic, for most of their time at the hospital there was no running water. The supply of medications is limited, and the hospital only has regular access to a single anti-epileptic medication. Infectious diseases, including Encephalitis and meningitis are a major problem. Around 20-30% of the local population is HIV positive; in the hospital around 80% have HIV. Multi-drug resistant TB is prevalent - most of the doctors and students wear protective masks on the medical wards. 

Beira Hospital is staffed mostly by local doctors, but there are also doctors from Cuba, the USA and Europe. The hospital has a single neurologist from Cuba, however he is on a temporary contract and does not do any clinical teaching. The medical students and junior doctors are taught neurology by non-specialist residents. The level of theoretical knowledge of neurology amongst students is good, but their practical skills need some improvement.

Although the public hospital in Beira is extremely basic, the medical school is well set up. The first doctor has just completed a PhD, supported by a University in Germany. Her project was investigating using urine dipsticks on CSF to diagnose brain infections. As laboratory facilities are very basic this simple bedside test is very useful clinically. 

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Teaching:

Ben and Sam taught medical students and junior doctors a daily morning session on the theory of neurological examination and diagnosis. They followed this with 4 small group bedside teaching sessions. 

On the Saturday they ran an additional session at the medical school. It started with interactive cases of Encephalitis and other neurological infections. The session was completed with a neurology quiz - the winner of which received an ophthalmoscope.  

The written feedback from these sessions was universally positive. Themes for suggested improvements included a request for more learning resources - eg. handouts, videos etc. 

 Future directions:

Ben and Sam would like to support the pre-clinical undergraduate neurology teaching at the medical school which happens around April every year. 

Another useful project, would be to provide videos demonstrating neurological clinical signs. On their next visit, Ben and Sam aim to record good quality footage of this and make it publicly available.

Students found the NeuroID e-learning modules useful and Ben and Sam are keen to build on this resource. 

Overall, it was another successful trip. Ben and Sam are keen to continue their work, and have even more ideas for the future on how the project can develop and be more beneficial than ever! 

You can take a look at the photos from their latest journey in our media centre here.

Zambia - November 2013

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Pilot Trip

November 2013

In November 2013 Ben and Sam undertook a pilot visit to Zambia where they completed two weeks of clinical neurology teaching at the University Teaching Hospital in Lusaka. They saw that the burden of Encephalitis and other neurological disease was enormous in this setting, and learnt that the greatest need for teaching is for the junior doctors in General Medicine (Internal Medicine Residents). In the majority of cases they had not received clinical teaching from someone with a special interest in neurology before. At medical school the neurology teaching was provided by general medics and there ?was no postgraduate neurology teaching. Many of the Internal Medics found that they now had to provide the undergraduate?teaching, having received inadequate teaching on this subject?themselves.

“The best teaching session 
we’ve ever had! More please!”

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During the 2 weeks Ben and Sam taught the following groups:

• Undergraduate medical students / Year 5 – 5 sessions / Year 6 – 4 sessions / Year 7 – 6 sessions / Interna lmedicine residents–6 sessions / Psychiatry residents–3 sessions? / Psychiatry specialist nurses–3 sessions / Clinical Officers (a sub-doctor grade responsible for much of the medical care delivery in Zambia). – 2 sessions

In addition they gave a Grand Rounds presentation on Encephalitis at a District Hospital and attended neurology clinics and ward rounds, with a focus on cases of neurological infection.

In all they taught over 300 students, doctors and clinical officers. The teaching was very well received. Feedback from doctors and students was unanimously positive. Most found the bedside teaching particularly helpful.

“Very interesting to hear the 
latest insights in managing 
patients with neurological 
infections, like Encephalitis”

With Ben and Sam we aim to expand this project during 2014. We hope to visit two further countries in sub-saharan Africa – Malawi and Mozambique - raising awareness, delivering education, and ultimately saving the lives of people affected by Encephalitis and other neuro-infectious conditions. We will also aim to provide Neuro-Kits, which are essential for the neurological examination.

If you would like to support this project please get in touch with us on mail@encephalitis.info.

The Encephalitis Society is the operating name of the Encephalitis Support Group which is a registered Charity and Company Limited by Guarantee.

Registered in England and Wales No. 4189027. Registered Office as above. Registered Charity No. 1087843.