An interview with SMP member James Moore, Royal College of Physicians and Surgeons of Glasgow

Originally trained as a nurse, James went on to complete the RCPSG Diploma in Travel Medicine, and the London School of Hygiene and Tropical Medicine Diploma in Tropical Nursing. He has worked around the globe as an expedition medic. More recently Jame’s completed an MSc in Global and Remote Medicine, has been part of the team initiating the RCPSG Diploma in Expedition Medicine in Glasgow and has created a peer-to-peer Covid support programme via zoom between consultants in the UK and Malawi.The group offers a great opportunity to offer support and share learning.

[Image, Top Left: Dr Simon Pattern, James Moore, Dr Jess Fox. Bottom Left: Dr Cathy Chambani Magombo and Tom Hunt - Medic Malawi].

How has Covid affected you and your partners/ friends in Malawi?

Malawi appeared to escape the first wave compared with what happened across the EU. However, it became clear in the latter stages of 2020 that the second wave was likely to be far worse, which it has been and continues to be. It has affected many parts of the country, including the healthcare professionals working with limited resources and opportunities for improvement.

Could you share a little about yourself with us?

I live in a little village just outside Exeter in the Southwest of England, with my wife Sarah, and two kids - Josh (15) and Olivia (13). We’re blessed to live in an amazing part of the UK and enjoy everything the outdoors has to offer. I grew up in a seaside village in North Devon where I spent most of my childhood surfing. Both Josh and Livi have taken on a love for that sport and we’re in the water all year round, either surfing, paddle boarding or kayaking. I love to travel and have done so ever since Sarah and I had a gap-year many years ago, and travelled and worked our way around the world (including 3 months in Malawi and Zimbabwe).

Tell us about your background?

I trained in Bristol as a nurse, where I began a career working in Emergency Departments. Alongside this I had a passion for travel and my career path naturally deviated into the world of Expedition Medicine, a kind of sub-speciality in areas such as pre-hospital care, tropical medicine and General Practice and travel medicine. Whilst enjoying an Emergency Department career, I completed the RCPSG Diploma in Travel Medicine, and the London School of Hygiene and Tropical Medicine Diploma in Tropical Nursing, before stepping out of the NHS and starting my own independent travel clinic. During this time i’ve worked across the globe as an expedition medic. More recently I completed an MSc in Global and Remote Medicine, and set up the RCPSG Diploma in Expedition Medicine, with my colleague and great friend Dr Jon Dallimore, hence my close ties with the Royal College in Glasgow.

How did you come to work with Medic Malawi?

A couple of my expeditions involved travelling to Malawi and working with a school and hospital in the remote town of Mtunthama. The school and hospital are supported by a local school in Devon where I’m a Governor, and over the years my clinic has been able to help with this support. Most recently, a good friend became the charity Director, moving out to Malawi with his wife and family. We’ve been in contact on a weekly basis since they arrived.

What are you hearing from your colleagues at Medic Malawi at the moment?

It’s tough, really tough. I think it’s very difficult to understand healthcare delivery in sub-Saharan Africa unless you have walked in those shoes. The things we take for granted (PPE, basic medicines, oxygen masks, oxygen) are just some of the things that are in short supply. The country's oxygen demands are outstripping supply, with most rural hospitals not enjoying the luxury of piped oxygen, whilst bottles cost £70 to fill. This, coupled with the huge toll placed on the medical staff, is pushing an already broken system closer to the brink.

What are you currently working on?

Recently, Medic Malawi launched an oxygen fund to try and provide some help for the local hospitals. Everyone realised this is a very short-term solution and plans are now in place to maximise the use of oxygen concentrators. These don’t deliver huge amounts and are reliant on a stable electricity supply. Connecting two of these together does provide a good flow, enough for some of the sicker patients.

As I mentioned earlier, it’s difficult to appreciate the situation the medics are facing from an icy corner of Devon. However, we have recently started a peer-to-peer support programme via zoom. We have linked up one of the Consultants in our local Nightingale Hospital, a GP, myself and some Doctors and nurses in Malawi. During our on-line sessions there's a great opportunity to offer support, share learning and establish if there is anything we can do from here in the UK.

I know the Malawi team are incredibly enthusiastic to know more about this disease, how we manage cases here in the UK and if there are any new, simple measures that are transferable. I feel it is important to note, the clinicians in this country are very aware of the differences in healthcare systems, and that a listening ear may be the only thing we can offer. However, just knowing you’re not battling this illness on your own can provide comfort. I also feel there are things we can learn from other countries' practice that could be implemented here in the UK. A lack of resources can sometimes drive innovation in ways we don’t always appreciate, so I’m hoping the learning will be a two-way process.

How did you come to find The Scotland Malawi Partnership

I was investigating some career options and a colleague mentioned the Scotland-Malawi Partnership. So finding you was not directly related to my work with Medic Malawi. However, this is a small field and we soon realised we had much in common.

The SMP's core values are underpinned by mutually beneficial partnerships and friendships between our two nations. How does your work, and partnership with Malawi, reflect this?

As I mentioned earlier, learning in these situations should flow both ways. High income countries don’t have all the answers, and we often over complicate situations through unnecessary bureaucracy and processes which are just not present in other parts of the world. It is refreshing to also chat and learn from colleagues exposed to clinical conditions we see only rarely during our careers. There is so much to learn.