Who are we?

Child Health International (CHI) is a registered charity based in Winchester, UK. Founded in 1992, our aim is to improve the standards of healthcare of children, in particular those with cystic fibrosis, in countries, which can benefit from our experience.

What do we do?

CHI works by establishing collaborative projects with groups in countries where resources are limited. We deploy suitable UK volunteer health professionals to work with the group. Usually we also organise a reciprocal visit to UK for appropriate personnel – typically specialists in respiratory medicine, physiotherapists and dieticians, but also health policy-makers and representatives of parent support groups. Ongoing interaction is an important part of ensuring a successful project.

We prefer to work in partnership with a local organisation or national CF association. We concentrate on children with CF, partially because it is possible to offer a low cost and effective treatment regime within the means of most countries.

How have CF projects begun?

Roy and Dorothea Ridgway, who lived in Winchester, had a son with CF, who died at the age of 29. On a visit to Moscow in 1991, they paid a visit to the Republican Children’s Hospital to see how children with CF were treated. They talked with Russian Doctors and offered help. So CHI (then known as the International Integrated Health Association) began.

With the break-up of the Soviet Union, there were UK Government and EU funds available for health and social welfare programmes in Russia. Dr. Chris Rolles of Southampton General Hospital led a programme of exchanges of medical personnel. Solvay Pharmaceuticals played a very significant role in providing supplies of the enzyme Creon and financial help with antibiotics. After 4-5 years, we believe we helped to transform the system of CF care in the Russian Federation. Today there are two Centres of CF excellence in Moscow and St Petersburg and 22 other regional CF centres. The lifespan and quality of life of children diagnosed with CF has improved significantly as a result.

Dr. Mark Rosenthal examines a child in Lviv, Ukraine

Help to Southern Ukraine (Odessa) from the mid 1990s onwards was mainly funded by an EU programme. A major project began in Western Ukraine in 2002. This was as a result of a grant from DFID, a UK Government Department, and with a partner charity in Lviv, called Dzvin.

Projects in Serbia and Lithuania have taken place after CHI received direct requests for help and have been funded by the charity.

A new project in India is underway as a result of liaison between Southampton General Hospital and the All India Institute of Medical Sciences and has been supported by CFW and by Solvay Pharmaceuticals.

CHI does not have a fixed format for organizing projects. Each is grown in a way appropriate to the specific conditions and existing groups within the country.

What form does the British medical expertise take?

Physiotherapist and the team at work

We regard a “team approach” as vital. The cystic fibrosis team consists of:
• a paediatric specialist consultant in respiratory medicine and/or CF,
• a physiotherapist,
• a dietician and
• an administrative nurse, who has a key role in the interface between the hospital/ clinic and the affected families with deep knowledge of both medical factors and the social welfare provisions

This is the ‘core’ team. If possible, an individual with advice on the role of parent support groups may be included; parent support and support groups are an essential part of the treatment and must be covered by someone in the team. We usually need the help of interpreters with a good knowledge of medical terminology.

Within CHI, our medical adviser is Dr. Chris Rolles, a retired paediatric specialist in cystic fibrosis from Southampton General Hospital. The project teams themselves are drawn mainly from the Royal Brompton Hospital, London (which also contains the (British) National Lung Centre) and Southampton General Hospital. The individuals give their time as volunteers and are not paid.

The low cost treatment option

Treatment in the UK costs about £20,000 per child per year, of which the costs of enzymes and antibiotics are significant – and mostly unaffordable to families in many countries of Central and Eastern Europe and in India. Many simple things make a huge difference at a much lower cost:

• Earlier and accurate diagnosis of CF,
• Improvements in managing the problem such as maintaining records of child weight and height and regular monitoring of the child, even when he/she is ‘well’,
• Good physiotherapy techniques, taught both to professional physiotherapists and to parents; plus advice on nutrition.

Mobilising parent support groups makes a difference – and we encourage local and national health policy makers to take CF seriously and fund all aspects of a CF service – including the supply of Creon. Our medical teams are pleased to form a twinning link with local CF clinics/ hospitals so that continuing exchanges of experience and problems can be shared. This can lead, too, to collaborative research projects of mutual benefit.

Who pays?!

Tony Wolstenholme

Medical teams are not paid for their time and skills but, when they go overseas, CHI pays for their travel, accommodation and subsistence. We have had good support from the British Government and from the EU, as well as from many generous individual supporters. We gratefully acknowledge valuable help from Solvay. We carefully consider any request for help and do whatever we can. We are also grateful for any offer of support – whether it be financial or experience-related.

CHI Contact Details:

www.childhealthinternational.org

info(at)childhealthinternational.org

Child Health International, 44 Richard Moss House, St. Peter’s Street, Winchester, Hampshire SO23 8BX, United Kingdom. [Registered Charity No 1014734]

[click here]
for a printable version of this article