Cooperating on Care

From Taiwan Review 2018-04-12
A pediatrician attends to a patient at National Taiwan University Hospital in Taipei City. (Photo courtesy of NTUH)

A pediatrician attends to a patient at National Taiwan University Hospital in Taipei City. (Photo courtesy of NTUH)

Taiwan’s foremost foreign aid organization is boosting public health and medical training in partner nations across the globe.


Nebie Boubie, a health official and midwife from Burkina Faso in West Africa, spent three months from March to June last year receiving on-the-job instruction in modern procedures and technologies at a medical facility in eastern Taiwan’s Hualien County. According to the 40-year-old, the training program, implemented by Hualien Tzu Chi Hospital in collaboration with the Taipei City-based International Cooperation and Development Fund (TaiwanICDF), greatly strengthened his clinical knowledge and skills, while offering an up-close look at the nation’s advanced health information infrastructure.


“What impressed me most was the humanistic, caring and holistic approach to patient care adopted by the devoted and qualified medical staff,” he said. “Taiwan’s health care system is very efficient and well structured. Its National Health Insurance system provides most people with access to health care and is worthy of being implemented in low-income countries.”


Boubie has worked for the Burkina Faso Ministry of Health for 17 years and recently joined medical missions to Ethiopia and Sudan organized by the international humanitarian organization Doctors Without Borders. He said that pregnant women and newborns in his country struggle to gain access to quality medical care due to the “three delays”—delays in deciding to seek care; delays in reaching care; and delays in receiving adequate treatment—as well as financial constraints and insufficient supplies of safe blood.


Taiwan is working with the African nation to address these challenges, Boubie noted. In addition to offering instruction for medical professionals at local hospitals, TaiwanICDF, the nation’s foremost foreign aid organization, is implementing projects in Burkina Faso to improve facilities and clinical skills. These efforts, he said, have already helped reduce maternal and infant mortality rates.


Medical personnel from Burkina Faso receive on-the-job instruction at Hualien Tzu Chi Hospital in eastern Taiwan’s Hualien County under the Healthcare Personnel Training Program organized by the International Cooperation and Development Fund. (Photo courtesy of International Cooperation and Development Fund)

Long-Term Commitment


Boubie is among 358 professionals from 31 countries who participated in TaiwanICDF’s Healthcare Personnel Training Program between its launch in 2005 and the end of February this year. The initiative provides foreign medical workers with up to three months of clinical instruction at one of 33 hospitals across Taiwan. When they return home, graduates become seed teachers, passing on their newly acquired knowledge and skills to colleagues.


“We tailor our projects to meet pressing needs in partner countries by holding discussions and conducting feasibility studies,” explained Cathy Wang (王宏慈), director of TaiwanICDF’s Humanitarian Assistance Department. “Our projects are also designed to capitalize on the strengths and resources of Taiwan’s health care system as well as concur with the U.N. Sustainable Development Goals [SDG].”

In line with the SDGs, TaiwanICDF is focusing its international medical cooperation on four fields: child and maternal health; prevention and control of noncommunicable diseases; the prevention and treatment of HIV/AIDS, tuberculosis and neglected tropical diseases; and the promotion of health information systems. In recent years, the organization has also expanded its overseas medical programs from offering short-term mobile medical missions to administering three- to five-year projects centered on capacity building and facility upgrades.


“The implementation of prevention, early detection and treatment strategies can save lives and significantly reduce medical spending,” Wang said. “So, we’ve been working to establish cooperative relationships between Taiwan hospitals and partner countries to advance such efforts.” The director added that she has been impressed by the enthusiastic participation of local medical institutions.


Improving Outcomes


Dr. Shyu Ming-kwang (徐明洸‬), director of the Obstetrics Division at National Taiwan University Hospital (NTUH) in Taipei, is spearheading a new TaiwanICDF project to improve maternal and infant health outcomes in Guatemala, a diplomatic ally of the Republic of China (Taiwan).


A doctor from NTUH, second left, visits a neonatal intensive care unit at a hospital in Guatemala. (Photo courtesy of NTUH)

The physician, who specializes in areas including high-risk pregnancies, prenatal diagnosis, breast-feeding and breast cancer screening, went on a fact-finding mission to the Central American nation in November last year. He said the warm welcome afforded to him by first lady Patricia Marroquin and officials from the Ministry of Public Health and Social Assistance highlighted the importance of the project as well as the commitment on both sides to ensuring its success.


According to Shyu, maternal deaths in the country, which stand at 60-100 per 100,000 live births, about 10 times the rate in Taiwan, often result from a lack of facilities at public hospitals. Better-equipped private medical institutions are prohibitively expensive for many citizens.

“Our task is to achieve maximum efficiency by making the best use of limited resources,” he said. “Through applying our expertise and experience, we’re confident we can help identify problems, determine priorities and develop solutions.”


Based on Shyu’s findings concerning the lack of equipment, TaiwanICDF is assessing the feasibility of installing cost-effective diagnostic tools at public hospitals, such as fetal monitors and vital signs machines, to help reduce intrapartum stillbirths and manage life-threatening pregnancy complications. Plans are also underway to educate personnel in the use of these devices, with several doctors and nurses scheduled to come to Taiwan this year to participate in a three-month training program at NTUH.


“By providing a little assistance, we can have a big impact on the well-being of local people,” Shyu said. “A doctor’s duty is to save lives. I’m glad to be involved in work that transcends national borders and to use my expertise for the betterment of people in need.”


A local participant in a TaiwanICDF project in Burkina Faso meets elementary school students to teach health and sanitation concepts. (Photo courtesy of International Cooperation and Development Fund)

Prevention Strategies


Dr. Peng Yu-sen (彭渝森), director of the Internal Medicine Department at Far Eastern Memorial Hospital in New Taipei City, is similarly devoting his time and expertise to promoting health care development in overseas communities. He has visited Belize, also an ROC diplomatic ally, four times since 2013 to help plan and implement a capacity building project for the prevention and treatment of chronic renal failure.


The kidney specialist used to believe that infectious ailments were the primary sources of medical problems in developing nations. However, after visiting Belize, he discovered that the major causes of illness are chronic noncommunicable diseases like diabetes and hypertension related to lifestyle factors such as physical inactivity and unhealthy diets. Belize faces serious shortages of medical professionals—renal specialists in particular—and treatment devices like hemodialysis machines, he said, adding that these issues have resulted in high mortality rates and placed a heavy economic burden on the nation.

In addition to training doctors and nurses from Belize at Far Eastern Memorial Hospital, Peng and fellow team members have organized public awareness campaigns in the Central American nation and cooperated with community medical workers to encourage healthy behavior. The major task ahead, the physician said, is to carry out a national screening program for chronic diseases—a fundamental tool of modern public health and preventive medicine vital to the formulation of effective health promotion strategies.


Peng noted that the central government, local communities and medical personnel in Belize have given their full support to TaiwanICDF-initiated projects. “It’s a great feeling to work hand in hand with the [Belize] government toward a common goal and know that my skills are serving a greater good,” he said. “I hope our assistance projects can promote Taiwan’s strength in medical care as well as enhance bilateral ties.”


Tseng Ching-ping, left, deputy director of the Information Technology Department at Taipei City-based Cathay General Hospital, and colleagues meet with hospital staffers in Paraguay as part of the TaiwanICDF-initiated Health Information Management Efficiency Enhancement Project. (Photo courtesy of International Cooperation and Development Fund)

Using Information Systems to Strengthen Health Care Delivery


Health information systems (HIS), which facilitate data collection, processing, analysis and dissemination, can significantly improve medical service quality while promoting the formulation of effective disease prevention strategies. Internationally recognized for its HIS expertise, Taiwan is using this knowledge to help partner countries achieve greater efficiency in health care delivery.


Among the nation’s ongoing overseas HIS initiatives is the 2016-2019 Health Information Management Efficiency Enhancement Project in Republic of China (Taiwan) diplomatic ally Paraguay. Administered by the Taipei City-headquartered International Cooperation and Development Fund (TaiwanICDF), the program is jointly funded by the ROC Ministry of Foreign Affairs, Paraguay Ministry of Public Health and Social Welfare and Taipei-based Cathay General Hospital.

Tseng Ching-ping (曾景平‬), deputy director of the Information Technology Department at Cathay General Hospital, is responsible for the design and implementation of the project. He said that the current handwritten documentation process used at many Paraguayan hospitals is a major cause of poor operational performance and service quality.


According to Tseng, Taiwan is ideally placed to help address these deficiencies given the rapid development in its health information and management systems since the implementation of hospital accreditation and certification in 1988 and the launch of the National Health Insurance system in 1995. “We can help close gaps in primary care delivery by sharing our experience and know-how.”


Under the project, Tseng and his team are assisting in the establishment of HIS infrastructure at public hospitals in three regions of Paraguay, namely Alto Parana, Canindeyu and Guaira, while also training staff in the use of such systems. As of the end of last year, eight engineers and managers had visited Taiwan to attend a two-month training program at Cathay General Hospital on computer programming, e-learning course design and systems administration.


“Decades ago, foreign missionaries made significant contributions to the development of modern medical services in Taiwan,” Tseng said. “Now that I’ve got the opportunity to participate in humanitarian aid missions, I feel I have a duty to provide assistance.”