21 Oct 2009

GEORGIA / PRIMARY HEALTHCARE

Georgia is embarking on an ambitious reform program for its health care system. With help from international donors, including the World Bank, Georgia is providing specialized training to hundreds of doctors and nurses, and revamping its primary health care facilities. WORLD BANK

Posted at: October 21, 2009 4:00 pm

Duration: 02:58

Available in: SD

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STORY:  GEORGIA / PRIMARY HEALTHCARE
TRT: 2.58
SOURCE: WORLD BANK
RESTRICTIONS: NONE
LANGUAGE: ENGLISH / GEORGIAN / NATS

DATELINE: AUGUST 2009, GEORGIA

SHOTLIST:

AUGUST 2009, AJARIA AUTONOMOUS REGION, BATUMI, GEORGIA

1. Various shots, doctor with baby
2. Med shot, clinic waiting room
3. Wide shot, doctor leaving clinic
4. Various shots, doctor with old woman
5. SOUNDBITE (Georgian) Dr. Mzevinar Bolkvadze, Primary Care Physician:
"I did the emergency training a week and a half ago, and I have already had a case where I badly needed it. "
6. Wide shot, doctor on village road

AUGUST 2009, BATUMI, GEORGIA

7. Various shots, training course for nurses and physicians
8. Med shot, clinic where courses are taught
9. SOUNDBITE (English) Dr. Tamar Mkhatvari, Family Medicine Expert, Ministry of Labor, Health and Social Affairs of Adjarian Autonomous Region:
 "They are very interested to improve their skills, knowledge and attitudes."
10. Med shot, clinic waiting space
11. Med shot, doctor examining young girl
12. SOUNDBITE (Georgian) Dr. Leila Jikhashvili, Primary Care Physician: 
"I learned better skills and up-to-date information."
13. Various shots, doctor examining boy
14. SOUNDBITE (Georgian) Dr. Mzia Surmanidze, Primary Care Physician: 
"I had cases where a patient died and I had trouble telling the relatives. I let emergency workers do it."
15. Various shots, doctor examining boy's chest
16. Wide shot, doctor in mountain village
17. SOUNDBITE (Georgian) Dr. Mzevinar Bolkvadze, Primary Care Physician:
 "It's very important for us to have training.  Even if it were every month, I would move heaven and earth to get there."
18. Med shot, doctor with young patient

STORYLINE:

The only physician in her village, Mzevinar Bolkvadze sees patients like this cranky baby all day.

The waiting room of the newly built and newly equipped walk-in clinic is often full.

In the evening, she makes house calls on foot despite a bad leg, clocking over ten kilometers up and down mountains.

She checks on an 85 year old patient she persuaded not to give up on life.  Doctor to 1,600 people, she needs a smattering of training in geriatrics and more.

She took a six-month family medicine course to better serve her many kinds of patients.

And she just completed a course in emergency medicine.

SOUNDBITE (Georgian) Dr. Mzevinar Bolkvadze, Primary Care Physician:
"I did the emergency training a week and a half ago, and I have already had a case where I badly needed it. "

The training will be essential for saving lives this winter, when this high mountainous region is cut off from the rest of the world for up to six months.  It's at those times that Dr. Bolkvadze, like many other village doctors, is forced to rely only on herself.

The emergency medicine course taught at this Family Medicine Training Center in Western Georgia is one of the first in the country.

It is part of an overhaul of primary care that includes intensive retraining of physicians and nurses supported by the World Bank.

Courses of all kinds have been designed.  These nurses are learning hands-on how to care for patients at home.

As part of the reform, instructors were trained.  Buildings were renovated and equipped.

Training centers outside the capital make it easier for doctors in remote or rural areas to attend.

SOUNDBITE (English) Dr. Tamar Mkhatvari, Family Medicine Expert, Ministry of Labor, Health and Social Affairs of Adjarian Autonomous Region:
"They are very interested to improve their skills, knowledge and attitudes."

Better doctors and nurses with new equipment will provide better healthcare to patients.

This clinic was renovated with state and local funds.  Equipment and re-training was provided by the World Bank.  The clinic's three doctors are taking the emergency training in stages.  Dr. Jikhashvili went first.

SOUNDBITE (Georgian) Dr. Leila Jikhashvili, Primary Care Physician: 
"I learned better skills and up-to-date information."

Her colleague hopes retraining will make her more independent.

SOUNDBITE (Georgian) Dr. Mzia Surmanidze, Primary Care Physician: 
"I had cases where a patient died and I had trouble telling the relatives. I let emergency workers do it."

When asked what other training she would like, she says cardiac care.

Up in the mountains, Dr. Bolkvadze agrees.  She says cardiology training is crucial.

SOUNDBITE (Georgian) Dr. Mzevinar Bolkvadze, Primary Care Physician: 
"It's very important for us to have training.  Even if it were every month, I would move heaven and earth to get there."

She hates to be away from her patients who are free to call her day and night but says retraining has made her feel like a new doctor.

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