The Case for Optimism: Health Partnerships in an Era of COVID-19

By March, the grim implications of coronavirus were hitting home. International travel for NHS staff volunteering in our antimicrobial stewardship programme was cancelled on the 2^nd as people turned their attention back to their institutional and Whitehall responsibilities. Travel for THET staff stopped on the 9^th. Each decision was made reluctantly; each decision felt like a hammer blow to THET’s vision of encouraging the free exchange of expertise and learning across borders. Clearly this was not the time to expect our friends across the UK health community to be prioritising international work.

And then the messages started arriving. A WhatsApp from Lisa Kelly, Chief Operating Officer at Nottingham University Hospitals NHS Trust: “The anxiety and challenge in the hospital is quite honestly the most difficult thing I’ve experienced. Can’t imagine how our colleagues across the globe are going to respond. Is there anything we can do as a THET community to support?” An email from Dr Kathrin Thomas, a GP in North Wales: “We are wondering here if there is anything we can do for partners in Africa, who are facing this pandemic with far fewer resources than we are.”

I found those messages inspiring. They spoke to all that we most value in the Health Partnership community – a generosity of spirit and professional fellowship expressed even in the face of heavy domestic challenges.

By April, THET had recovered its stride. We launched our Health Worker Action Fund and on the 25^th we hosted our first truly international conference, ‘Partnerships in a time of COVID-19’, attracting participants from across 54 countries as well as the World Health Organization. ‘Partnerships in a time of COVID-19’ was no substitute for face-to-face contact, but it unequivocally showed how technology could be used to sustain relationships built up over time, to make new friendships, and facilitate the rapid and low-cost exchange of views and advice.

The conference was also an opportunity to champion the Health Partnership approach with our friends at DFID, DHSC and elsewhere. And in April and May we added to our understanding by surveying almost 70 Health Partnerships. Clear patterns emerged about the kind of activity taking place such as these, supported through the HWAF:

• The provision of Personal Protection Equipment (PPE): ‘Ugandan partners requested that funds go for PPE, specifically scrubs. The aim has been to minimize infection within the hospital, particularly among staff in priority areas.’ – The Kampala–Cambridge partnership.
• Remote training and guidance on safety: ‘Over the two-day workshop, participants gained an understanding of COVID-19 disease epidemiology and pathology, referral pathways and criteria for patient admission to hospital/treatment centres.’ – King’s College London-Hargeisa Group Hospital.

• Mentoring and Peer Support: ‘Psychosocial support training is encouraging calmness by reinforcing active and positive coping skills that enable health workers to better manage their emotional and psychological reactions while managing patients with COVID-19.’- Peace Hospice Adjumani (PEACHOA) and Cairdeas International Palliative Care Trust.

A new-found fluency in the use of virtual technology has emerged to support these exchanges, something we have long talked about but never fully embraced.

‘Armchair’ volunteering, for example, is coming in to its own. Arguably, this has always been an important part of Health Partnerships: the small hours of the morning spent writing the emails or preparing materials to share after a long day of work. However, COVID-19 has inspired us to take the next step. For THET, this means taking our partnership with Health Education England to a new level by launching a Virtual Volunteering programme. This will see us recruit at least 25 English NHS volunteers, each supported by our overseas Directors and with access to a modest budget for activity and training costs. They too will be able to provide vital assistance to our partners as they respond to COVID-19 whilst developing professionally and benefiting their work in the NHS.

International volunteering, conferences and learning-exchange will never be quite the same, and nor should they be. Made urgent by COVID-19 and inevitable by climate crisis, our ambitious use of virtual technology is transforming our expectations, not least by allowing us to listen even more closely to the views of our partners overseas.

Working virtually must reduce, but never entirely replace, our use of travel. There is a downside which Dr Tom Bashford, a veteran of Cambridge Global Health Partnerships, expressed lucidly in a recent email: “We have a strong partnership and good friendships, but I have the vague sense we are living on relationship credit. Trust, friendship, a genuine sense of partnership and shared goals, a mutual understanding of the realities facing our partners – these are hard to enrich and further using online communication.”

In time, travel will resume. But until it does we at THET salute what the Health Partnership community is achieving. We will keep working hard to share the news of your achievements, for example at this year’s conference. We will continue to do all we can to ensure further funding flows to support your work. The challenge presented by COVID-19 in LMICs is increasing and will continue to do so. Health Partnerships have a crucial role to play.

“The way forward is solidarity”, argued Dr Tedros earlier this year. “Solidarity at the national level and solidarity at the global level.” We agree. And I for one, never cease to be inspired by the many expressions of this by those involved in Health Partnerships.