The Cambridge-Yangon Trauma Intervention Project

The Cambridge-Yangon Trauma Intervention Project

Tom Bashford¹, Rowan Burnstein¹, Rikin Trivedi¹, Peter Hutchinson¹, Mu Mu Naing², Myat Thu²,
Thinn Hlaing².

1. Addenbrooke’s Hospital & University of Cambridge, Cambridge, United Kingdom
2. University of Medicine 1, Yangon, and Yangon General Hospital, Yangon, Myanmar

The Cambridge-Yangon Trauma Intervention Project (CYTIP) has run since 2015, supported predominantly through UK Aid and administered by Cambridge Global Health Partnerships. Initially linking Yangon General Hospital (YGH) in Myanmar and Cambridge University Hospitals in the UK, it has expanded to include their affiliated universities; the University of Medicine 1 (UM1) and the University of Cambridge respectively. In addition, it interfaces with a range of other partners, including the Rangoon General Hospital Reinvigoration Trust, the Tropical Health and Education Trust, and the NIHR Global Health Research Group on Neurotrauma (GHRGN).

The ultimate aim of CYTIP is to improve the care of trauma patients at Yangon General Hospital. It is constituted of seven semi-autonomous partnerships working on pathology services, anaesthesia & intensive care, nursing, physiotherapy, medical education & simulation, orthopaedic surgery, and neurosurgery. The work of these partnerships is coordinated and integrated, and involves both operational improvement and academic research.₁ As an example, the neurosurgical partnership has to-date supported postgraduate neuroanatomy teaching delivered at YGH by Cambridge neurosurgeons, support of UM1 cadaveric programmes, epidemiological research, health systems research, and long-term nursing volunteer placements.₂ Myanmar is a partner country of the NIHR GHRGN and this has supported neurosurgeons from YGH to participate in international research projects and present at international neurotrauma conferences.

YGH occupies a significant position within the Myanmar heath system. As a result, some of the work of CYTIP has been to support national efforts in partnership with the Myanmar Ministry of Health & Sports – particularly with respect to planned increases in Intensive Care capacity across the country. CYTIP has worked in partnership with UM1 to support national capacity assessments, curriculum design, and a model for Intensive Care delivery in Myanmar over the coming decade. From a neurosurgical perspective, the current focus of CYTIP is to support an integrated approach to trauma at YGH. This is intended to draw on the existing epidemiological and health service research projects, and will be enabled by the development of a new elective neurosurgical hospital in Yangon and consequent redesign of neurosurgical services at YGH.

1. A systems approach to trauma care in Myanmar: from health partnership to academic collaboration. Bashford T, Myint PPN, Win S, Thu M, Naing MM, Burnstein R, Hlaing TT, Brealey E, Hutchinson PJ, Clarkson J. Future Healthc J. 2018 Oct;5(3):171-175. doi:10.7861/futurehosp.5-3-171.
2. Management and outcomes following emergency surgery for traumatic brain injury - A multi-centre, international, prospective cohort study (the Global Neurotrauma Outcomes Study). Clark D, Joannides A, Ibrahim Abdallah O, Olufemi Adeleye A, Hafid Bajamal A, Bashford T, Bhebhe A, Biluts H, Budohoska N, Budohoski K, Cherian I, Marklund N, Fernandez Mendez R, Figaji T, Kumar Gupta D, Iaccarino C, Ilunga A, Joseph M, Khan T, Laeke T, Waran V, Park K, Rosseau G, Rubiano A, Saleh Y, Shabani HK, Smith B, Sichizya K, Tewari M, Tirsit A, Thu M, Tripathi M, Trivedi R, Villar S, Devi Bhagavatula I, Servadei F, Menon D, Kolias A, Hutchinson P; Global Neurotrauma Outcomes Study (GNOS) collaborative. Int J Surg Protoc. 2020 Feb 28;20:1-7. doi: 10.1016/j.isjp.2020.02.001. eCollection 2020.

Figure. Faculty and participants “Delivering Trauma Intensive Care” course, Yangon, 2018.