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Global Health Econ Sustain Decolonization of health care

advice through regular virtual meetings and WhatsApp mainly in low- and middle-income countries (LMIC).
consultations, attended by clinicians from various regions This area was deemed a low priority by the former colonial
of Tanzania. We have received requests to expand these administration.
discussions into neighboring countries. The Tanzanian As African physicians who helped to coordinate this
Ministry of Health has also engaged in further efforts to joint venture, we would say that our experience with this
improve care for people with MSK disease in Tanzania. collaboration has been great. We successfully secured
Our collaborative effort is especially focused on addressing support to train 20 staff members in research methods
deficiencies in the provision of MSK care and support. We and the management of MSK conditions. In addition, we
recognize that it is essential that these initiatives not only established a clinic for these patients, as our capacity and
target doctors but extend to all health-care workers who confidence in identifying, diagnosing, and treating patients
play a huge part in providing clinical care, especially in the was enhanced by working in tandem with our Global
community. We presented our findings and experiences North collaborators. We conducted several in-country
at the first East African regional NCD conference, which multistakeholder meetings to gather recommendations
enabled us to raise awareness among stakeholders beyond for improving MSK care in Tanzania, which led to the
Tanzania. concept of developing training videos. Our Global North
The provision of MSK care in East Africa is worse than collaborators sought to understand our needs, offering
anywhere else on the continent. Although educational clinical and personal developmental support whenever
courses in rheumatology are available online, they are necessary and feasible. All activities were initiated and
heavily focused on presentations of patients from the supervised by African health-care providers, resulting in
Global North and are not context specific. Many of the significant capacity building on our part.
investigations and therapeutic interventions described The Royal College of Physicians (RCP) in London
and proposed, while scientifically sound, are simply facilitated the establishment of the East, Central, and
not appropriate for, or available within, an East African Southern African College of Physicians (ECSACoP) in
setting. Tanzanian clinicians seek advice and support 2015, recognizing the longstanding presence of the West
from clinicians working in the Global North who respond African College of Physicians. ECSACoP includes six
to locally identified needs. Tanzanian physicians are best countries: Kenya, Malawi, Tanzania, Uganda, Zambia,
placed to define the deficiencies in our clinical service and and Zimbabwe. One of its main aims is to improve
determine which patients require assistance. Therefore, we and harmonize postgraduate medical training in these
can seek targeted and patient-specific support from our countries. The RCP, in collaboration with East African
northern colleagues as and when required, enabling us to colleagues, also supported the medical training and
maintain control over the clinical agenda. In requesting fellowship program. This initiative, funded by the East
clinical support, quality takes precedence over quantity, African Development Bank, aimed to provide training
and the collaboration dynamics feel both constructive and in neurology and oncology in Kenya, Rwanda, Tanzania,
appropriate. and Uganda from 2016 to 2020 (Walker & Eastin, 2021).

Our colleagues from the Global North share our vision Courses were jointly developed between UK and African
of developing an independent, sustainable clinical service colleagues, with an emphasis on sustainability and local
in East Africa. Several other programs are designed and capacity building. The majority of the faculty comprised
developed to support knowledge exchange between the African professionals, and the training approach prioritized
Global North and East Africa. One such program is the methods such as the “train the trainer” model.
International Postgraduate Medical Training Scheme, Volunteering abroad can also provide real benefits
which primarily focuses on physical health. It enables for NHS staff. Health Education England (HEE), the
overseas doctors, through arrangements with international organization providing this opportunity, states, “It can
governments, to undertake full specialty training to UK give them a fresh perspective, new skills, and approaches
standards. This comprehensive training takes doctors that can be applied to their work in the health service and
from entry to the Certificate of Completion of Training help them and the wider health service improve the quality
and recognition in the General Medical Council specialty of care we provide.” We have been involved in the HEE
register in England before they return home to practice as initiative and can confirm the benefits experienced by UK
consultants in their chosen field. Another initiative, this trainees in learning from local culture and customs, which
time in the field of mental health, is the Mental Health Gap reflect on the colonial biases that everyone must overcome
Action Programme, which supports scaling up services when partnering with Africa. Change only occurs when
for mental, neurological, and substance use disorders, individuals shift their mindsets, and learning from the

Volume 2 Issue 2 (2024) 4 https://doi.org/10.36922/ghes.2299