The NHS Global Health Research Group in Health Technology Project India

OBJECTIVE

  1. Research in technologies to make Minimally Invasive Surgical care possible in rural India
  2. To develop a model for surgical care in rural India

BACKGROUND

The National Health Service in UK has a program and initial funding to develop a research program to meet the needs of rural surgical patients in Sierra Leone and rural India. The preliminary proposal is to meet the need in both places which are management of fractures and wounds in Sierra Leone and Minimally Invasive Surgeries in rural India.
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THE PLAN

  1. DEVELOPING THE NODAL CENTER: This nodal center could be used for clinical research and training programs. The center would also double as a referral center
  2. DEVELOPING THE RESEARCH CENTER: This Indian research center would provide the engineering and academic background and would work in relation with the University of Leeds on a variety of research programs related to Minimally Invasive Surgeries especially GLLS [Gas Less Lift Laparoscopic Surgeries]
  3. DEVELOPING RURAL CENTERS: These rural centers would work together to provide surgical care to the rural population to develop a model that could be replicated in other rural areas

THE TARGET POPULATION

After a lot of deliberations, Arunachal Pradesh was chosen as the geographical target area for the project for the nodal and may be for the rural centers also. The proposal is to develop the following in Arunachal Pradesh

  1. A training center where the local doctors could be trained for MIS especially the GLLS and other MIS. The Tomo Riba Institute of Health and Medical Sciences [TRIHMS] at Naharlagun in Arunachal Pradesh was chosen for the nodal center. This place was chosen as the State Government is very keen to develop this place as a Medical College and the senior staff are interested in using the project to take their dream of Medical College forward. Dr. Moji Jini the Director of Health Services in Arunachal Pradesh is the primary contact person there.
  2. The small Hospital at Bhalukpong at the Arunachal Pradesh and the nearby rural health care facilities at Arunachal Pradesh or Nagaland covering a population of about 100,000 would be the target area for the project. Dr. Jumsung Sidisow is the contact person at Bhalukpong

THE LANCET CoE IN SURGICAL INNOVATION AT KARUNYA UNIVERSITY

The Lancet Secretariat in India established the Lancet CoE at Karunya University and the PGSSC (Program in Global Surgery and Social Change) of Harvard University supports the work there with some seed funding for the projects there. The University has the Deemed to be University status and hence has its own academic council and is authorized to give degrees and diplomas as well as certificates that are legally valid in India.

THE PROPOSED ACTION PLANS

  1. TEACH GLLS AT TRIHMS: The team from SEESHA could visit the TRIHMS every month to train the local doctors and other interested doctors to learn GLLS.
  2. SELECTION OF THE 100,000 TARGET POPULATION: It is possible to do this selection during the Association of Rural Surgeons of India [ARSI] conference at Dimapur in Nagaland in November this year. One of the sessions during the conference is earmarked for Surgical Care Planning in Northeast India.
  3. OFFERING TRAINING PROGRAMS: These could be offered jointly by the University of Leeds team and the Karunya University and many of the contact programs could be arranged at the TRIHMS. Contracts or MOU [Memorandum of Understanding] could be signed between the concerned institutions namely University of Leeds, Karunya University and the TRIHMS. Such an arrangement could give national and international validation for the training programs.
    1. The training programs could be in
    2. GLLS
    3. Urology for rural surgeons
    4. Anesthesia for rural doctors
  4. OFFERING HEALTH CARE TECHNOLOGY AND RESEARCH COURSES: These could be joint courses between the Universities namely the University of Leeds and Karunya University. Student and faculty exchange programs could be worked out for these courses between the Universities
  5. BASELINE SURVEY AND DATABASE MANAGEMENT: Baseline survey of the 100,000 population [SOSAS] and telephonic and health care facility walk through surveys designed by the Harvard PGSSC for the WHO could be used for the survey of other health care facilities in Arunachal Pradesh and other areas
  6. STARTING MUTUALLY BENEFICIAL RESEARCH PROJECTS: These could be between the Lancet CoE and the University of Leeds and some of the following could be considered
    1. Developing a low cost camera for GLLS
    2. Developing hand instruments for GLLS using the technology developed by University of Leeds [like the pneumatic joystick controls for hand instruments, special bowel retractors, special abdominal wall lifting methods, magnetically operated controls for instruments]
    3. Clinical trials on low cost endoscopy unit developed by University of Leeds
    4. Low cost vacuum therapy units and low cost external fixator systems for fractures developed by ARSI
    5. Colorectal surgeries with GLLS technique. Has the advantage of not having gas leaks especially if perineal resection is required and could be carried out under spinal anesthesia or the physiological changes associated with insufflation. The clinical trials could be carried out at the TRIHMS
  7. FORMATION OF PROJECT MANAGEMENT COMMITTEE FOR INDIA: This could have representations from stakeholders like University of Leeds, SEESHA, TRIHMS, Karunya University, Lancet India Secretariat, and Harvard PGSSC
gnanaraj Dr. J. Gnanaraj MS, MCh [Urology], FICS, FARSI, FIAGES is a urologist and laparoscopic surgeon trained at CMC Vellore. He has been appointed as a Professor in the Electronics and Instrumentation Engineering Department of Karunya University and is the Director of Medical Services of the charitable organization SEESHA. He has a special interest in rural surgery and has trained many surgeons in remote rural areas while working in the mission hospitals in rural India. He has helped 21 rural hospitals start minimally invasive surgeries. He has more than 150 publications in national and international journals, most of which are related to modifications necessary for rural surgical practice. He received the Barker Memorial award from the Tropical Doctor for the work regarding surgical camps in rural areas. He is also the recipient of the Innovations award of Emmanuel Hospital Association for health insurance programs in remote areas and the Antia Finseth innovation award for Single incision Gas less laparoscopic surgeries. During the past year, he has been training surgeons in innovative gas less single incision laparoscopic surgeries.

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This entry was posted in Primary Care, Primary Care Featured 2, Surgery and tagged , , . Volume: .

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