Using simulation to improve outcomes for babies in Myanmar

Ram Nataraja
Mr Ram Nataraja training surgeons at Yangon Children’s Hospital

A Monash University researcher has used simulation to teach local Myanmar surgeons how to treat a common yet life-threatening condition affecting babies.

Mr Ram Nataraja, from the Department of Paediatrics, trained surgeons at the Yangon Children’s Hospital to treat intussusception – a condition where the bowel ‘telescopes’ in on itself which causes it to block off its own blood supply – using a simulator he designed of a baby with a synthetic bowel.

On average, approximately 100 babies are affected by paediatric intussusception each year at the Myanmar hospital. As in many low-and middle-income countries, the majority of these cases require surgical intervention. In Australia, treatment of paediatric intussusception involves the use of an air enema to put air pressure into the colon to reverse the condition, which is much less invasive and is highly successful.

Together with colleagues from Monash Children’s Hospital, Mr Nataraja conducted a simulation-based medical education (SBME) workshop for local surgeons to teach them the air enema technique and enable its use in clinical practice.

Mr Nataraja conducted a clinical evaluation and compared the outcomes of 178 babies with paediatric intussusception in the 12-months preceding the implementation of the technique and the 12-months post implementation. The study found that the number of babies requiring surgical intervention significantly decreased, from 82.5 percent to 58 percent, in the year following its introduction.

Mr Natarja said that by conducting a simple simulation workshop to train others, showed how low-cost educational activities could help a whole country to improve the quality of care that they provide to babies and children.

“It prevents babies from having operations so that positively impacts them, their families and also the healthcare system, as they require less care and stay in hospital for a shorter amount of time. And that's a great outcome for everyone."

The findings of the study have been published in Simulation in Healthcare.

Mr Nataraja is also the Director of Surgical Simulation at Monash Children’s Hospital and Myanmar Project Lead, Monash Children’s Hospital International (MCHI).