When Sandy Holt-Wilson, a retired ophthalmologist, was recently asked to visit Gondar Medical School in Ethiopia, he was hesitant. With less than two months to go before Christmas, his 800-bird turkey farm in Wales was going to suffer. But seasonal commitments aside, Sandy was enthusiastic to put his other professional hat on and return to Gondar. With funding from the Tropical Health and Education Trust (THET), and armed with a Topics in International Health CD-ROM on trachoma, Sandy had previously travelled to Gondar as a consultant ophthalmic surgeon, to teach a group of health officers. The THET was keen for him to return to get feedback from the students.

Gondar College of Medical Sciences in northern Ethiopia is one of only two medical schools in the country outside Addis Ababa. It serves a target population of about seven million people. Gondar has a serious problem with its medical staff – in the last three years alone, 25 specialists and general practitioners have been lost to private clinics and foreign employers. The problem is exacerbated by the lack of infrastructure within the health service. Most of the population is spread across rural countryside, with no means of access to hospitals. Healthcare delivery is very much dependent on senior nursing professionals – called health officers – who run health centres in rural areas.

There are between 750 000 and 1 million blind people in Ethiopia, at least 40 per cent of whom are treatable; 35 per cent of cases could have been prevented. Trachoma, the leading cause of preventable blindness worldwide, is the cause of a third of cases in Ethiopia. Trachoma is caused by Chlamydia trachomatis, a bacterium spread from person to person or via flies. Without treatment, repeated infection can occur during childhood, causing scarring of the conjunctiva. In severe cases, the eyelashes turn inwards (known as trichiasis) and rub on the cornea – this can lead to white scarring and blindness. Surgical correction of trichiasis prevents blindness and can be carried out by suitably trained health officers.

The THET, which aims to facilitate links between universities in the developing and developed world, has helped to fund this training of health officers. The training is based at Gondar, which benefits from a well-equipped computer centre run by Voluntary Service Overseas volunteer Andy Schofield. Within the computer centre, formal lectures given by ophthalmologists like Sandy, and practical teaching on eyelid surgery are supplemented by sessions using the Trachoma CD-ROM.

In Sandy’s opinion, the students relished the opportunity to use this distance-learning material. “They worked together in small groups and a wonderful air of inquisitiveness and questioning arose as they debated approaches and issues. The material on the CD-ROM was of great benefit as it reinforced their lecture notes. With an instructor on hand, the students were able to progress at their own pace but had access to help when required. This provided for a more productive and directed tutoring, and kept the tutor more involved and enthusiastic.”

Andy Schofield concurs. “It stimulates an interest in further learning and background reading, and aids the comprehension of complex or dry material from lectures or textbooks. It brought an enthusiasm to learn, which is always of benefit. The self-directed learning process should enable a more effective use of students’ and instructors’ time so we look forward to trying out the other Topics in International Health CD-ROMs. Sandy has brought some more out – these include HIV/Aids, Nutrition, Malaria, TB, Leprosy and Schistosomiasis, which we hope will be evaluated by the staff in the very near future.”

Dr Shitaye Alemu, Assistant Professor of Medicine at Gondar, explained that the Trachoma CD-ROM is also used in a wider capacity within the medical school – house officers, medical students and nursing students alike all use it as an adjunct to their teaching, as a revision method, or to make up for missed classes. “It’s more fun than conventional teaching methods and very easy to use and to take in,” she says. “It has stimulated the school to look for other CD-ROMs on topics like surgery, anaesthesia and orthopaedics.”

See also

• Topics in International Health CD-ROMs Produced by the Tropical Medicine Resource

External links

• Gondar College of Medical Sciences in northern Ethiopia
• Tropical Health and Education Trust (THET): Charity helping to train healthcare workers in developing countries
• Voluntary Service Overseas: International development charity