International public health expert Dr. Peter Barss endorses AMSF approach of funding 'low budget and high impact practical training"

How one day at lunch in Toronto took me to Angola and around the world

by Dr. Peter Barss, MD ScD MPH DTM&H FRCPC FACPM

Peter Barss

Dr. Peter Barss, 2012, Harvard Alumni Association website

One day as a new intern at the Toronto General Hospital, I was sitting alone having lunch at the cafeteria. A resident doctor joined me and introduced himself as Bill Milligan. He had recently returned from working in Angola, and enthusiastically described his experiences working with Dr George Burgess at Dondi Hospital, which was supported by the United Church of Canada.

This led to my searching for a similar job with various organisations such as CUSO and others, including the United Church. The great attraction of Angola was the opportunity to provide and learn good health care by working with dedicated senior colleagues. And so eventually my wife and I opted for Angola and spent a couple of weeks being tutored in Portuguese. We stored our worldly belongings in a friend’s barn before departing from Canada. We touched down en route in Luanda and flew onwards in a small plane, landing at a remote airport on the central plateau of Angola. No one was there to meet us and the one antiquated rotary phone didn’t work. We managed to find a ride to a small town and waited most of the day in the sun for a bus and later a car out to the remote hospital in Chissamba. There we were greeted with great joy by Dr Betty Bridgman and many African staff. Word of our long voyage to join their work had never reached them from Canada.

Chisamba

Standing L-R: Edith Radley, Rev Joyce Myers, Alice Moreira, young Neil Burgess, Mary MacDougall, Dr George Burgess
Sitting L-R: Martha Barss, Nandondi Barss, Dr. Peter Barss, Dr. Betty Bridgman, Evelyn Swan, Rev. Amy Schauffler, Phyllis Burgess Circa 1974, Chissamba , Angola Burgess photo collection

We worked for two and a half years at Chissamba and Dondi Hospitals, with many visits to even more remote health centres. Our first daughter Julia, known locally as Nandondi (“born at Dondi”), was born there by the light of a lantern, as the generator was off at night. The work load was enormous and included high-risk obstetrics, surgery, clinic work, public health, teaching and training. It was clear that the work of a few Canadian doctors and nurses and the many African male nurses and female nurses and midwives trained over the years in the rural nursing schools was renowned throughout the land. Patients endured long bus trips even from the capital to get to the remote bush hospitals where they were treated with love and human touch, compassion and competency. There was simple accommodation for relatives, who helped feed and care for patients. Those requiring prolonged treatment for leprosy and tuberculosis lived in small adobe dwellings with an opportunity to grow their own food and raise chickens.

Dondi Hospital
Dondi hospital housing for out-patients and families of in-patients. 1960s. Burgess photo collection

After further training in Toronto and London, England, I was sent by CUSO to head up a remote provincial hospital in Papua New Guinea. Building upon my experiences in Angola, I was able to help develop a simple low budget government hospital and associated health centres, with a food budget of about 10 cents per patient per day, which gradually rose to 20 cents. Previously unheard of and initially greeted with considerable skepticism by government bureaucrats were simple village style residences of natural materials located a short walk from the hospital. Women awaiting a complex birth and patients requiring surgery or a boat home to their remote islands could stay there, along with relatives. Our staff planted nutrition gardens on the hospital property to demonstrate protein growth foods such as groundnuts and beans. We collaborated with local churches, government builders, and the Canadian embassy to construct dormitories and classrooms for the hospital phase of the churches’ trainee community nurses.

So the influence of the Angolan rural health system and training funded by Canadians touched the other side of the tropical world. Indeed, when my family and I were departing six years later, the local hospital staff in Papua New Guinea had heard of the Angola work. They managed to persuade Dr Burgess and his wife Phyllis to travel around the world to complete the work I had begun, as his last long-term mission, after the Angolan hospitals had been devastated during the long civil war.

With these historic traditions of supporting low-budget and high impact practical training in Angola, and by example elsewhere, the Angola Memorial Scholarship Fund deserves serious consideration. For some years during the long civil war in Angola, the fund concentrated on sending small numbers of professionals abroad for advanced training. In order to make the most of limited resources where they are most needed, the fund now concentrates on basic education and training within Angola so that many students and trainees can benefit from even modest donations. As an experienced public and international health professional, I supported and continue to support such an approach.

Note: Dr. Peter Barss is a clinical faculty member with the University of British Columbia School of Population and Public Health. He is an international expert in injury prevention and has received many awards including a national citation from the Canadian Red Cross for the many lives saved by research-based prevention of water-related injuries. Dr. Barss received the 2001 Harvard Ig Noble prize for his work on addressing the dangers of falling coconuts and falling out of coconut trees, a public health issue in the tropical countries he has worked in.

Coconut Injury

Dr. Peter Barss discussing his injury prevention work in relation to falling coconuts and falling out of coconut trees Photo from http://www.improbable.com/2008/06/01

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