Clinical partnerships – commitment in the Global South

Partner: Faculty of Dental Medicine, University of Medicine, Tirana.

Contact: Prof. Dr. Florian Beuer, Department of dental prosthetic, geriatric dentistry and functional training Courses.

Description: At the core of the clinical partnership is the exchange of ideas relating to current prosthetic concepts and modern therapeutic approaches. The methods implemented at Charité in digital dentistry will be established and further developed at the University of Tirana. Other than fixed and metal free dental prosthetic, the project deals in particular with digital full sets as well. In Albania, there is a high demand for these kinds of prosthesis. As a result, the University of Tirana wishes to implement a Master program for dental prosthesis in cooperation with researchers at Charité.

Partner: Princess Christian Maternity Hospital, Sierra Leone; Holy Family Virika Hospital, Uganda.

Contact: Prof. Dr. Gundel Harms-Zwingenberger, Institute for tropical medicine.

Description: When it comes to giving birth, Sierra Leone represents one of the most dangerous country in the world with a maternal mortality of 1,360 deaths for every 100,000 births. At the same time, the often-poor obstetrical care of this country has further languished during the Ebola epidemics towards the end of 2015. Furthermore, the number of safe deliveries in health facilities decreased significantly due to a lack of capacity as well as a decay of trust from mothers-to-be in the public health services. Because of this, a partnership was set up between the Institute for Tropical Medicine and International Health of Charité – Universitätsmedizin Berlin and the Princess Christian Maternity Hospital, in Freetown, Sierra Leone. This clinical partnership aims to improve the quality of the obstetrical care in Sierra Leone and in particular in hindsight of the Ebola epidemic. The partnership is based on Sierra Leone’s national health care strategy and runs in close cooperation with the project “health care system reinforcement and epidemics prevention” of the local health program GIZ. In addition, within the framework of this clinical partnership, a south-south cooperation will be set up with the Virika Hospital in Uganda which should enable an exchange program of the African partnership concerning the project “Ebola Outbreak Preparedness”.

Partner: Hôpital Régional de Faranah.

Contact: Prof. Dr. Titus Kühne, institute for Imaging Science and Computational Modelling in Cardiovascular Medicine.

Description: In Guinea, the lack of health care staff and the precarious state of health infrastructures inhibit many people from accessing public health facilities. Consequently, there exists a strong dependence on international aid. This clinical partnership aims to create communication infrastructures in the field of medicine. The goal of this project is to also establish a Satmed platform that would build a modern patient data management platform in Guinea. Satmed already operates in several African countries and is available via e-health apps in an independent and safe environment for committed doctors, nursing staff, midwives and Community Health Workers. This platform also offers tools for simple and efficient cooperation, for conferences, e-Learnings and for data transmission. Charité is a competent partner in the field of telemedicine and teleradiology as well as offering a wide spectrum of clinical specialties. In the long term, the access and the quality of public health service should improve in Farunah and in the whole country too.

Partner: Ministry of Health of the State of Eritrea/ Gash Barka Referral Hospital Barentu, Eritrea.

Contact: Dr. Carolin Meinus und Dr. Katharina Marggraf, Department of Pediatric Pneumology and Immunology - Intensive Care Medicine.

Description: in cooperation with the group ARCHEMED - Ärzte für Kinder in Not (Doctors for Children in Distress) – and with the Eritrean Ministry of Health, Charité has since 2012 supported the Gash Barka Referral Hospital in Barentu, Eritrea. This project seeks to build clinics in neonatology, obstetrics and pediatrics as well as an improvement in the care of mothers and children, particularly premature infants. An advanced training of Eritrean colleagues through bedside teaching (for instance, hygiene, heat regulation, food), training (among others, in the areas of newborns-reanimation and the establishment of standards for frequent diseases) as well as professional discussions with Eritrean colleagues is high on the agenda. Since 2018, this project has concentrated on the work of the clinic’s emergency department. The adequate provision of a room for the care of the children, refining the definition of treatment standards and training of the emergency room personnel should improve the initial care and treatment of pediatric patients. Together, with our Eritrean colleagues on the ground, we aim to provide a significant contribution to the reduction of child and maternal mortality in the region of Gash Barka.

Partner: University Teaching Hospital of Butare, University of Rwanda.

Contact: Prof. Dr. Frank Mockenhaupt, Institute for Tropical Medicine.

Description: since March 2007, an ESTHER-partnership exists between the clinical university Butare (Centre Hospitalier Universitaire Butare, CHUB) and the Institute for Tropical Medicine in Berlin. The goal of this clinical partnership aims to improve the quality of patients´ treatment at the CHUB: This partnership exists through the following tasks:

• The development of reference guidelines (which are based off national guidelines) for clinical and diagnostic way of proceeding with HIV-patients.
• Increase in HIV relevant levels of knowledge and expertise on CHUB and ITM through exchange between personnel.
• Implementation of pilot programs for the improvement of hands disinfection in the clinical area.
• Knowledge management, publications and public presentation of scientific findings at both a national and international scale.
• Research tasks in the field of parasitic infections, hospital-acquired infections and other diseases.

Partner: Université Hassan II, Casablanca.

Contact: Prof. Dr. Jalid Sehouli, Clinic for Gynecology with the Center for oncological Surgery at Charité CVK and CBF.

Description: Breast cancer and cervical cancer are the most common forms of cancer in women.  Although the prevalence of breast cancer in Morocco is lower than in the western industrialized countries, nonetheless cases are on the rise. Each year, around 2.000 women in Morocco develop cervical cancer. Within the framework of a national plan aimed at enhancing cancer prevention, the Ministry of Health has put in place various measures in collaboration with the foundation Lalla Salma to improve cancer prevention and treatment nationwide and to increase the patients’ quality of life. Thanks to the partnership with the University of Hassan II in Casablanca, in cooperation with the foundation Lalla Salma, the quality of treatment in Morocco should rise. The focus is on communication and quality assurance processes such as tumor conferences, interprofessional communication and SOPs as well as patient-oriented communication and care. In the long term, a nationwide dialogue with all universities is sought.

Partner: Department of Psychiatry, Medical University of Hanoi, Vietnam.

Contact: Dr. Thi Minh Tam Ta, clinic for Psychiatry and Psychotherapy CVK.

Description: The establishment of a clinical partnership in 2017 seeks to guarantee a long term and flexible cooperation between the clinic of Psychiatry and Psychotherapy at Charité CBF, the Department for Psychiatry of the medical university of Hanoi and the National Institute of Mental Health in Vietnam.  In accordance with the fundamental principles at the core of Charité (healing, teaching and research), this long-term cooperation should improve the psychiatric care in Vietnam and for Vietnamese migrants in Germany also.

• Clinic: In a first step, the target group will be doctors, psychologists and already qualified psychiatrists. In the long term, this would lead to more skilled labour, resulting in significant improvements in the under-provision of such professionals in Vietnam as well as improving quality and quantity of mental health services whilst at the same time reducing the “Mental Health Treatment Gap.
• Advanced Training: In addition to the exchange of psychiatric seminars focusing on adapted knowledge transfer, improvement of continuing education in psychiatry and modern psychiatric multimodal therapies, these establishments will aim to raise the standard of psychiatric specialist and basic education to a high standard.
• Research: within the stipulated terms, common research projects and PhD programs are planned with Charité CBF. By embedding these in three mutually reinforcing areas, a sponsored clinic partnership can contribute in the long term to the internationalization and modernization of psychiatry in Vietnam, but also provide new impulses for German-speaking psychiatry.

Partner: Université Evangélique du Cameroun, Cameroon.

Contact: Prof. Dr. Andrej Trampuz, Center for Musculoskeletal Surgery (CMSC).

Description: in developing countries, post-op and hospital-acquired infections are very common. Particularly in countries such as the Cameroon, where patients must bear the health costs themselves, such post-op infections may lead to dramatic consequences for patients and their families. It will lead to longer and more expensive hospital stays, to a longer loss in employability and possible to job loss, disability and in the worst-case scenario, premature death. On the other hand, many infections are clearly treatable and avoidable thanks to greater understanding.  Regarding the clinical partnership with the Université Évangélique du Cameroun and the Hôpital Protestant de Mbuou, the nursing staff and medical students will be trained in the prevention, diagnosis and treatment of post-op and musculoskeletal infections Furthermore, infections and cases of resistance will be closely monitored. Hygiene plans will be developed and new methods in diagnostics and treatment will be introduced. In the long term, the project should contribute to the development of a national strategy in this area. The project is supported by a grant from the PRO-IMPLANT foundation.

Partner: Kandy National Hospital, Sri Lanka

Contact: Prof. Dr. Kai-Uwe Eckardt, PD Dr. Philip Enghard

Sri Lanka has been struggling with an increase in kidney disease for several years. The cause, in addition to known kidney diseases, is the accumulation of chronic kidney disease of unknown origin. This kidney disease of unknown origin, or CKDu for short, manifests itself primarily among poor rice field workers in some areas of Sri Lanka and has placed a significant burden on the local healthcare system. Our partner clinic in Kandy is one of the largest clinics in the CKDu risk area and the main care provider for affected patients. In order to provide optimal treatment to patients with end-stage renal disease, the hospital in Kandy operates a large dialysis facility and has established an impressive kidney transplant program. However, the increasing number of patients and the introduction of kidney transplantation has brought new needs to the hospital that are not currently being met. Currently, there is no digital file system and records in outpatient clinics are kept in notebooks that patients keep themselves. Given the increasing number of patients and also more complex transplant cases, a digital patient record system is to be introduced in the nephrology department in Kandy as part of the hospital partnership. In addition to a digital file system, our colleagues from Kandy have lamented the lack of basic immunological testing for the diagnosis and monitoring of kidney and renal transplant patients. Therefore, as a second goal, an immunological laboratory is to be established in Kandy within the framework of our hospital partnership, with corresponding training of the staff in Germany and on site in Kandy.

Partner: Mental Health Center of Tbilisi State Medical University, Georgien

Contact: Prof. Dr. Meryam Schouler-Ocak

Psychological disorders are highly stigmatised in Georgia. Around half of all affected people do not undergo the required medical treatment. Psychiatric care in Georgia was established following the existing structures of the Soviet Union, and treatment options have only been slightly expanded since the political transformation and 1991. As there are hardly any outpatient facilities for social psychiatric care, patients are usually only treated with medication. In general, patients with chronic schizophrenia are treated with the available psychotropic drugs. Furthermore, other therapies such as psychotherapy, occupational therapy and social therapy, as well as a social psychiatric approach in the outpatient sector in the Caucasus, have not been available up to now. This means that the recovery and social inclusion/participation of people with psychological disorders in Georgia is very limited.
The partnership between the Psychiatric outpatient clinics (PIA) of the Psychiatric University Hospital Charité at St. Hedwig Hospital in Berlin and the Tbilisi Mental Health Center, Central University Hospital, aims to close these gaps in care. The two partners are working to establish and implement an interdisciplinary, multi-professional treatment strategy for working with patients with psychological illnesses. In an initial workshop in June 2019, the partners worked together to determine the specific needs in the Georgian outpatient treatment system. Building on this, they will develop a social psychiatric-oriented training approach, which will be imparted to eight staff members from various health professions through interactive workshops. This involves the transfer of strategies, skills and knowledge. The Georgian specialists (doctors, psychologists, psychiatrists, nurses and social workers) will then deepen their new skills by each taking part in a one-week placement in Berlin. The partnership project will be evaluated on an ongoing basis. The results are to be presented and discussed at a final conference with the expert public and politicians in Georgia.

‘We are thrilled with this great partnership’, said Prof. Meryam Schouler-Ocak, Project Manager on the German side. Her multicultural team in Charité travels to another country every year for a few days and has expert discussions and shares ideas with the local colleagues in order to broaden their own horizons. When the 2016 visit to the psychiatric ward in Tbilisi took place, both partners confirmed that this would be a good basis for future, meaningful cooperation.

The Georgian-German clinic partnership also plays a relevant role in the governmental approach to psychiatric care in Georgia. The strategic development programme for 2015–2020 aims to balance out the psychiatric sector, shifting from a purely medication-based field to the incorporation of a biological-psychological-social approach. As the treatment strategies developed by the project partners include work in this area, the hospital partnership can push this national process to serve as a model project.

Partner: EVEX Klinik und Institut für Neurologie und Neuropsychologie, Tiflis, Georgien

Contact: Prof. Dr. Tengis Gloveli

The partnership between Charité Universitätsmedizin Berlin in Germany and the EVEX hospital as well as the Institute for Neurology and Neuropsychology in Tbilisi, Georgia, aims to improve neurosurgical interventions and post-operative care in the Georgian hospital. Problem: In Georgia, there are no neurosurgical treatment options for epilepsy, although neurosurgical interventions can offer good chances of recovery for forms of epilepsy that cannot be treated with drugs and are also cost-effective. Main activities: A neurosurgery programme for epilepsy patients is to be established and a high-precision cutting instrument (microtome) used to cut sections. Professionals will share knowledge and experience both online and during project trips. There is to be technical monitoring of activities in Georgia undertaken by German experts, while Georgian professionals are to carry out on-site hospital visits in Germany. Short-term results: Neurosurgical epilepsy care is to be made possible and will create new diagnosis and treatment prospects in Georgia. Nerve tissue removed during surgery can be analysed. Long-term results: The percentage of epilepsy patients who are resistant to treatment is to be reduced.

Partner: Chapidze Emergency Cardiology Center, Tiflis, Georgien

Contact: Dr. med. Uta Liebers

The partnership between Charité Universitätsmedizin Berlin and the Chapidze Emergency Cardiology Center in Tbilisi aims to improve the early detection of chronic obstructive pulmonary diseases and enhance the understanding of these diseases among patients in Georgia. Problem: In Georgia, mortality rates are high as a result of non-communicable diseases (NCDs). There are few national prohibitions on the use of tobacco, a limited understanding of respiratory tract diseases and limited access to drugs, all of which contribute to the high mortality rates. Main activities: Firstly, staff of each partner will visit the other to share knowledge about lung function tests. Then, Georgian doctors will attend workshops and a symposium on testing and treatment methods. Courses on NCDs will also be held for patients. Short-term results: The newly acquired knowledge of respiratory tract diseases will be passed on to other regions in Georgia through a collaboration with the Georgian Respiratory Association. The workshops serve as basis for support groups of patients. Long-term results: This project will foster the early detection of respiratory tract diseases and increase knowledge about these diseases in several Georgian regions. This will enhance the survival rates of patients with NCDs.

Further Information

Partner: KEM Hospital Research Centre in Pune, Indien

Contact: Maximilian von Heyden

The partnership between the Institute for Sexual Science and Sexual Medicine at Charité Universitätsmedizin Berlin, Germany, and the KEM Hospital Research Centre in Pune, India, focuses on treating paedophiles so as to prevent child abuse. Problem: In India, about half of all children are survivors of one or more sorts of child abuse. Child abuse can have life-long impacts on the physical, mental, social and sexual health of survivors. One preventive measure, which has not hitherto been used in India, is to work with the individuals who risk abusing children. Main activities: Therapists are to receive further training and to work as multipliers. Materials on paedophilia and hebephilia are to be produced and disseminated via social media to raise awareness. An online manual and an online test to use when diagnosing and treating patients are being produced in local languages. Short-term results: Treatment and the quality of care for paedophiles is to be improved. Long-term results: Cases of child abuse are to be prevented.

Partner: Provincial Fourth People’s Hospital in Chengdu, China

Contact: Prof. Dr. Thomas Penzel

The partnership project between the Charité - Universitätsmedizin Berlin and the Provincial Fourth People’s Hospital in China aims to improve the quality of care in sleep medicine among patients in partner hospitals. Problem: Sleeping disorders are widespread in China and can seriously impact the health of the Main Activities: During the partnership project, a polysomnographic device has been acquired to better diagnos sleeping disorders. Medical personnel and therapists receive training and further education regarding the implementation and analyses of polysomnographic results. individual as well as the general population. Due to lacking training in sleep medicine among doctors, specializd care is very limited. Short-Term Effects: Patients with sleep disorders can obtain accurate diagnoses and therapies at the Provincial Fourth People’s Hospital. Long-Term Effects: Diagnoses and therapies for sleeping disorders should be ensured long-term at multidisiplinary health centers.