Working with health profession students, Sudan launches country’s first Project ECHO telementoring programme to treat patients with COVID-19 at home

-New partnership builds on campaign led by Sudanese American doctors to reduce COVID-19’s toll on communities and support overwhelmed hospitals and clinics
 

An initiative that deploys volunteer medical students in Sudan to treat COVID-19 patients in their homes will get a boost from a new partnership comprising Project ECHO, the global telementoring initiative based at the University of New Mexico Health Sciences Center in Albuquerque; the University of Nebraska Medical Center (UNMC); the Sudanese American Medical Association (SAMA) and Sudan NextGen (SNG), which are both part of the Coalition of Sudanese Organizations against COVID-19 (the coalition); and the Sudanese Federal Ministry of Health (MoH).

The existing Community Medical Response Team (CMRT) programme, set up during the height of COVID-19 in 2020, will use the ECHO telementoring model to connect medical students, graduates, and trainees with highly experienced providers and other experts in virtual learning communities that share best practices and support for treating patients with COVID-19 in their homes. This will help reduce the virus’s toll on local communities while alleviating the pressure on hospitals and care centers struggling to deal with Sudan’s worsening crisis, which the Ministry of Health has described as “dire.”

“We are privileged and excited to help reduce sickness and suffering in Sudan, where COVID-19 is challenging an already weakened health system, overwhelming the capacity of hospitals and doctors to care for patients,” said Sanjeev Arora, M.D., founder and director of Project ECHO.

“When COVID-19 was declared a worldwide pandemic, my thoughts immediately went to Sudan,” said Nada Fadul, M.D., an infectious disease physician at University of Nebraska. “We had to do something. Today, we are thrilled to be part of a vibrant movement that leverages the passion and energy of medical students and young doctors to help their communities through this terrible time.” 

Dr. Fadul and other Sudanese physicians living overseas—including in Ireland, Canada, Australia, and the United States—began working with the coalition in 2020. The coalition’s efforts during the first wave of the pandemic covered everything from training healthcare providers on proper use of personal protective equipment (PPE) to pregnancy care during the pandemic, as well as efforts to provide PPE and other medical supplies. The second wave saw a major need for community interventions, so Dr. Fadul and her colleague Reem Ahmed, M.D., from Emory University, co-founded Sudan’s COVID-19 CMRT programme. Over the past four months, they have worked with other Sudanese physicians, including Mohamed Khogali, M.D., in Saudi Arabia, and trained more than 120 medical and healthcare students in over 50 Sudanese neighborhoods to manage patients with COVID-19 in their homes. The CMRT trainings focus on the principles of home management for mild to moderate cases; home isolation and quarantine methods; and identifying life-threatening symptoms that require immediate medical attention.

“Since the start of the COVID-19 pandemic, medical schools in Sudan have been closed, so many students were just sitting at home,” said Dr. Fadul. “They wanted to do something, but they didn’t know what to do or how do to it safely. In addition to the impact they’re having on patients, students benefit from pursuing their learning in a hands-on way. When they return to their classrooms, they will be better equipped to take on new challenges.”

The CMRT ECHO will build on these early efforts. During phase one of the roll-out, students will be able to join ECHO learning sessions at six sites throughout Sudan that have internet connectivity. Students unable to go to these sites can join the sessions through their smart phones and other personal digital devices.

"I've told these students, if you've made an impact on one person, and helped manage that patient at home and prevent him or her from going out and spreading the disease, within a month you've prevented 400 patients from getting COVID-19,” added Dr. Fadul. The students have so far engaged in visits to local schools, local mosques, and women’s group gatherings, and sent messages via WhatsApp to spread the word about the CMRT programme and COVID-19 prevention.

Beyond the immediate response to COVID-19, phase two of the project will expand Project ECHO’s Sudan network and add needed programs to help revitalize the country’s healthcare system, including programs in healthcare safety and quality management, research monitoring and evaluation, reproductive health, midwifery, and cardiology.

Prior to the recent revolution and transition of power in Sudan, only 2% to 8% of the country’s Gross Domestic Product went to health care, leaving the healthcare infrastructure weak and vulnerable. The transitional government is working to rebuild the country toward democracy but was left with an under-resourced healthcare system.

“The COVID-19 pandemic has made an already difficult situation even worse,” said Nuha Ibrahim, M.B.B.S., project manager for UNMC ECHO and part of the leadership team of SAMA and SNG. “With the recent lifting of sanctions against Sudan from the United States, we have an opportunity to contribute our knowledge and expertise to support a response led by Sudanese medical personnel and students who know their communities and are respected by them.”

“We’re confident that Project ECHO will enhance our ongoing programs in Sudan and significantly increase SAMA’s ability to share the knowledge and expertise of specialists with healthcare providers across the country to improve patient care and health outcomes,” said Dr. Nahla Gadalla, Executive Director of SAMA.