Project Dove 2023

Having just arrived in Jaffna, Sri Lanka, Dr Cristelle Chow spent her first day in the city visiting the Teaching Hospital Jaffna. A consultant general paediatrician and the director of Children's Complex and Home Care Services in KK Women’s & Children’s Hospital, she is one of four faculty members part of Project DOVE 2023, a Duke-NUS student-led initiative which aims to bring global health awareness to a higher level.

That evening, she gathered with the other participants of Project DOVE 2023 to reflect on the day’s takeaways. During the session, many students pointed out the stark contrast between the healthcare systems of Singapore and Sri Lanka, just four hours apart by flight.

“In Sri Lanka, patients have their ailments recorded down in health booklets, which they are responsible for bringing to doctor appointments,” observed 2^nd year Duke-NUS medical student Edina Tan. “In Singapore, if a patient forgets their NRIC, everything is still accessible via the hospital’s digital system.”

Duke-NUS medical students and faculty at Teaching Hospital Jaffna

Duke-NUS medical students and faculty at a polyclinic in Ariyalai

One might wonder if, in a world that is driven by technology, a country can provide an uncompromised level of medical aid when their healthcare system is only beginning its process of digitisation.

But the visit to the Teaching Hospital Jaffna showed that it is entirely possible. It seemed that they were even able to do more with less.

“In fact,” said Project Co-Director and 2^nd year Duke-NUS medical student Lee Yixuan, “a medical officer could remember every single one of her patients and their ailments, providing for even more efficient healthcare."

Under the auspices of the SingHealth International Collaboration Office and its local partners, Project DOVE 2023 was made possible by the generous accommodations of the faculty of the University of Jaffna.

“Many students who are interested in global health use Project DOVE as an opportunity for a deeper immersion into global health issues,” said Dr Courtney Davis, Clinical Assistant Professor at Duke-NUS and Co-Lead for the Education Core at the SingHealth Duke-NUS Global Health Institute. “It often becomes a ‘stepping stone’ activity for them to become more involved in global health – be it in future research, service or practice.”

 

“One of the key themes that showed up in our reflections is the acknowledgement that the community knows their problems and needs best”

Tan Yu Bin, Project Co-Director
Project DOVE 2023

Duke-NUS faculty member Dr Ho Shu Fang and medical student Noah Yeo at a school health screening programme

This trip to Sri Lanka marks the first of many to come for Project DOVE, helping to lay the groundwork for sustainable, long-term collaboration with the University of Jaffna, which has also been identified as a partner in the formation of SDGHI’s Regional Collaborating Centres.

Over four days, faculty from the University of Jaffna hosted various workshops, talks and visits to a variety of healthcare facilities across different levels of care. Duke-NUS students had a chance to speak to patients and doctors alike, and had stimulating discussions with healthcare professionals on a variety of topics that ranged from technical to sociocultural. Dinner conversations and fireside chats with University of Jaffna faculty helped them gain a deeper insight into the Sri Lankan medical system. Students also assisted the healthcare teams on the ground during school, village, and polyclinic healthcare screenings, joining the local doctors in providing comprehensive and efficient healthcare services.

“I really liked the opportunity to observe both the big picture and the individual aspects of Jaffna’s healthcare system,” said 2^nd year Duke-NUS medical student Ian Xu, echoing the grateful sentiment that was shared amongst his tripmates. “Through our 4 days of attachments, we were exposed to many aspects of Jaffna’s healthcare system across all spectrums, from primary to tertiary healthcare. This enabled us to understand how healthcare management is contextualised and localised.”

“We saw how the medical professionals in Jaffna made use of existing solutions in the community to help solve other problems,” said 3^rd year Duke-NUS medical student Laura Yang. For example, young women were hired as healthcare assistants to assist doctors with home visits to the elderly. This simultaneously solved manpower issues, the concerns that elderly were not able to travel to hospitals due to their lack of mobility, and advocated for women empowerment by providing them with an income and sense of purpose. “The people within the community know what the community needs, and thus are able to serve the people better.”

With this in mind, students also acknowledged the need to respect the healthcare models and systems that have been put in place.

“One of the key themes that showed up in our reflections is the acknowledgement that the community knows their problems and needs best,” mentioned Project Co-Director Tan Yu Bin, a 2^nd year medical student. “It’s important that we collaborate with local community health services, local NGOs, and the villagers themselves when we plan out the next project.”

This highlights one of the core considerations of global health, which students were well aware of before they embarked on the trip.

Duke-NUS medical student Laura Yang assisting with measuring blood pressure at a community health screening programme in Kilinochchi

Duke-NUS medical students taking part in a community-oriented primary care clinic

“Thinking about the future of Project DOVE, it is important to keep in mind that each trip won’t be a touch-and-go kind of thing,” said Yu Bin, underscoring the need for a partnership that emphasised knowledge exchange and mutual learning.

Upon returning to Singapore, participants of Project DOVE aim to distil what they have learnt into various proposals for action in order to plan for the next trip to Jaffna, where students hope to assist in targeted healthcare improvement programmes informed by their deeper understanding of the community and healthcare systems of the region.

In the field of global health, improvements need not be expensive or technologically advanced to make an impact – in fact, the smallest of changes can make the biggest of differences. It’s all about thinking out of the box. Having seen how resources are maximised for greatest effect, the Project DOVE participants have been exposed to innovative ways of work outside of the Singapore healthcare system.

“It’s different,” Edina summed up. “But it got me thinking, ‘is it necessarily a bad different?’”