When you think about the devastating consequences of cuts to UK aid, you might not expect that Britain’s National Health Service (NHS) would be one of the institutions to suffer.
Why would slashing billions from the budget used to tackle extreme poverty abroad have consequences for the work of our doctors, nurses, and midwives at home?
However, the cruel reality is that the cuts have a far-reaching impact — and some NHS staff have come out to argue that, at a time when COVID-19 cases are rapidly rising in the UK once more, these cuts are making their crucial work more difficult.
They are doctors, nurses, midwives, pharmacists, surgeons, and anaesthetists from hospitals based all over the country, affiliated with the Tropical Health and Education Trust (THET), an organisation that connects NHS staff to health workers in Africa and Asia for training.
There are more than a billion people who will never encounter a qualified health worker across their whole lives. That’s why, in the past nine years, THET has partnered with 130 NHS Trusts, Royal Colleges, and academic institutions to reach over 100,000 health workers across 31 countries.
Our amazing doctors and nurses within the NHS are right at the centre of all this astonishing work — 2,000 NHS staff have volunteered 95,349 days of their time in the past four years alone to help train health workers in some of the world's poorest communities, according to THET.
It works through grants of varying sizes: THET offers funding for specific NHS institutions, like trusts or universities, to partner with health institutions in low- and middle-income countries, like hospitals and training colleges. They share knowledge with one another, and as part of the grant, UK staff will often visit the partner organisation abroad to learn new skills, and offer practical expertise — with overseas staff visiting the UK to share their knowledge too.
Love the NHS? Reverse #UKAid cuts 💙
— Global Citizen UK (@GlblCtznUK) July 6, 2021
Learn more about how aid cuts have made the work of doctors and nurses in the UK more difficult: https://t.co/U0W8qgmU4z@THETlinkspic.twitter.com/4FCqhUpoI3
Well-trained health workers abroad mean stronger health systems around the world, which in turn means a more resilient NHS. Take the pandemic, for example: if cases fall in every country, it becomes far less likely that a vaccine-resistant variant of the virus will emerge.
THET is just one of many organisations that has seen their work decimated by UK aid cuts. Although five years of funding was approved for their project — called the UK Partnerships for Health Systems — in 2019, it was cancelled by the Foreign, Commonwealth, and Development Office (FCDO), in April 2021.
In total, £48 million in aid funding was lost, £28.5 million of which would have allowed NHS staff to train 78,000 healthcare professionals in low and lower-middle income countries, projected to help more than 430,000 patients.
The NHS staff that spoke to Global Citizen insisted it was a two-way street: the training programmes taught them how to work with patients from different cultures back home; opened their eyes to new perspectives; encouraged knowledge-sharing by opening them up to new ways of working; and helped them develop fresh skills, like maximising the effectiveness of resources.
Indeed, Sarah Davidson, who worked in a Winchester intensive care unit during the pandemic while three months pregnant, told Global Citizen that she often learns more from doctors abroad than they learn from her. “The NHS needs the most efficient use of resources to solve problems,” Davidson says. “And that’s the skill you get taught working overseas.”
Without these incredible humans within the NHS, the pandemic would have overwhelmed the UK. But without aid funding, it’s more likely that health systems abroad will succumb to that fate — making the NHS weaker as a result. Everything is connected.
Here they talk to Global Citizen about the work they’ve been doing through THET partnering with health care workers in vulnerable countries, and describe the devastating effects of the aid cuts on their everyday lives.
Natasha Soliman
What’s your day-job?
I’m a midwife working in a busy hospital in east London.
Where do you help train staff abroad?
Somaliland.
Tell us about the work you do there.
During a pandemic babies are still born, and women still very much still need us.
I shared my skills and knowledge with midwives in Somaliland … I was so proud to be part of this project, this is crucial work. Without well trained and motivated nurses and midwives, good health care cannot be achieved for all. Much like the UK during this pandemic, we could not have done without our nurses and midwives.
How have the aid cuts affected you?
What I would say to Boris is please reverse your decision, because it would devastate the world’s poorest communities. We’re at risk at undoing all the progress that has been made.
Chris Lavy
What’s your day-job?
I’m a consultant spine surgeon in Oxford.
Where do you help train staff abroad?
I’ve been involved in training surgeons in 14 countries in Africa for the past 20 years, including in Malawi and Zimbabwe.
Tell us about the work you do there.
Our health partnership work has been lifesaving and life changing.
We’ve heard from health professionals we’ve trained who’ve been able to systematically assess injured patients and provide life-saving treatment where previously they didn’t have the skills to do so. We meet the families of children, who instead of facing a lifetime of disability, are able to go to school, and run and walk, because they’ve been treated for club foot, or other limb deformities.
How have the aid cuts affected you?
The aid cuts make it hard for us to continue to develop these health partnerships that support health care colleagues working in often very isolated settings. It means less training opportunities in parts of the world where there was already a massive shortage of trained health workers.
I call on the Prime Minister Boris Johnson to reverse the decision to cut aid to the poorest communities, as it will impact opportunities to develop health care provision for some of the world’s most vulnerable people.
Sarah Davidson
What’s your day-job?
During the first wave of the pandemic, I was actually three months pregnant. However as an anaesthetist [in Winchester], I wanted to continue to contribute my skills. So I worked in one of the intensive care units that became an outpost for the elective cancer surgery that couldn’t be delayed.
Where do you help train staff abroad?
Bangladesh.
Tell us about the work you do there.
We’re just at the start of building our formal partnership on the back of the personal working relationship of two professors of surgery — one in the UK and one in Bangladesh.
We have provided contextually appropriate equipment for bedside testing of haemoglobin and disseminated these along with teaching on the use of them.
How have the aid cuts affected you?
The lessons I’ve taken home that I’ve been able to use in my governance work in the UK are immeasurable. The cuts to UK aid has just stopped it. We can’t proceed.
Claire Brandish
What’s your day-job?
I’m an antimicrobial pharmacist in Buckinghamshire — deployed at an intensive care unit during the COVID-19 pandemic.
Where do you help train staff abroad?
Uganda.
Tell us about the work you do there.
We looked to raise awareness of antimicrobial resistance in the Wakiso district of Uganda … to strengthen the capacity of infection prevention and control measures in these communities.
We were struck by the number of similarities we share in this global challenge … as we prepared to work in intensive care units, it was really encouraging to watch handwash facilities being delivered by boat to the remote Bussi and Zinga Islands on Lake Victoria.
How have the aid cuts affected you?
We’re deeply saddened by the news that all FCDO funds have been cancelled. This is a huge blow to all involved in health partnerships who work so diligently and with compassion to strengthen health systems and provide health care that should be a basic human right.
The proposed aid cuts are incredibly short-sighted, and not in keeping with the government's commitment to tackle antimicrobial resistance … We should be investing more in the health of Global Citizens, and not less. This is an opportunity for the UK to be a world leader.
Chris Carter
What’s your day-job?
I’m a critical care nurse — and a senior lecturer at Birmingham City University.
Where do you help train staff abroad?
Zambia.
Tell us about the work you do there.
To support and strengthen the emergency trauma and critical care nursing response.
It also gives us an opportunity to get new ideas and get fresh perspectives. I know that I certainly have used my experiences of working internationally to help me, as a critical care nurse and an educator on the front line of the NHS.
How have the aid cuts affected you?
COVID-19 has taught me it often affects some of our most vulnerable people in our communities and societies, and it doesn't matter wherever we are in the world.
With the sudden and unexpected cuts to the aid budget, this has affected our future partnership activities — and left us uncertain about funding.
Joanna De Souza
What’s your day-job?
Lecturer in nursing at King’s College London.
Where do you help train staff abroad?
Somaliland.
Tell us about the work you do there.
We work with our Somaliland colleagues to strengthen the health services there. People are running the courses to train nurses, doctors, dentists, laboratory technicians, and pharmacists. We’ve been upskilling them in modern-day teaching.
How have the aid cuts affected you?
So much of our work is going to have to stop through this lack of funding.
We would really hope that those cuts could be reevaluated. There’s value to their systems — but also to our own systems, with the shared learning that takes place.
Chris Bumstead
Where do you normally work?
The NHS Foundation Trust in London, as an international partnerships program coordinator.
What do you do to help train staff abroad?
Tanzania.
Tell us about the work you do there.
The focus of our work has mainly been on training staff in mental health and substance use to open up a specialist addictions unit at the hospital — and training staff that had formerly never had training so they’re equipped to deal with the needs of their patients.
How have the aid cuts affected you?
It’s not all one-way. We in the NHS have actually learned a lot through the work we’ve done in Tanzania — in terms of understanding the religious and cultural beliefs of people with mental health problems, and how they might present when they’re seen by our services in London.
The absence of the program now is actually a very small cost when you think about all the extra benefits that would have been available for us in the NHS and for our partners. So I’m hoping it will be reinstituted.
Emma Mitchell
What’s your day-job?
I’m a consultant geriatrician in Bristol.
Where do you help train staff abroad?
Myanmar — and a little bit of work in Tanzania.
Tell us about the work you do there.
I’ve run two quality improvement projects in Yangon, Myanmar … designed and delivered a communications skills course for a medical membership examination … and got funding for a research project which concerns ageing individuals in Yangon.
How have the aid cuts affected you?
The proposed aid cuts really concern me. Predominantly, funding streams will be severely compromised … The benefits from working internationally will also be compromised.
From an individual level, there’s so much I’ve learned about myself and others. It’s a great platform for sharing ideas, for questioning the way you do things, for fostering creativity and a space to innovate. I really think it really helps with mutual progressional development.
I hope the decision to proceed with the aid cuts is reversed. If COVID-19 has taught us anything, it’s that it disproportionately affects certain groups of people. Now really is the time to be looking outwards, not just inwards.
Satyan Rajbhandari
What’s your day-job?
I’m an NHS doctor working in the north-west of the UK.
Where do you help train staff abroad?
Nepal.
Tell us about the work you do there.
Like everyone in the NHS, we had extra shifts, took personal risks in treating patients. This has exhausted me both physically and mentally. Thank god we are seeing the tail end of COVID-19 in the UK ... However everyone in the world is not that lucky.
The charity provides clinical and educational support to Nepal, suffering a lot from COVID-19. Everyday I hear news about someone, whom I know personally, dying due to COVID-19. We did what we could to help by sending essential supplies and arranging training. Our work has saved some lives but there is a need to do more.
How have the aid cuts affected you?
I feel betrayed with the recent UK government decision to reduce international aid. We all live in a global village. It is not right for us to enjoy all prosperity when people in the world are dying due to lack of basic needs such as vaccines, clean water, and medicines for preventable diseases.
My personal message to Boris, please do not do this. These aid cuts will have minimal impact to the UK economy but will have a devastating effect on the poorest of the poor in countries like Nepal. Reverse your decision. All of us can live happily in our global village.
Sonia Akrimi
What’s your day-job?
I’m a senior registrar in anaesthetics.
Where do you help train staff abroad?
Zambia.
Tell us about the work you do there.
We work together to support the development of safe anaesthesia and critical care in Zambia through training, quality improvement, and research.
I feel so proud of the resilience, adaptability, and humanity that has been shown within this partnership … Despite being separated by distance and despite everybody involved having such significant pressure and stress and challenge in their workplace at that time, we were still all working together to support each other in our role.
How have the aid cuts affected you?
I’m so concerned about the impact that this is going to have on health systems in low-and middle- income countries, like Zambia … I’m worried that the abrupt loss in this funding, without the time to mitigate the risks, means that these health systems will regress.
I’m also very concerned about the impact this will have on the pandemic itself. In order for cases of COVID-19 to remain low in the UK, we need every country in the world to be able to effectively manage outbreaks and case numbers. For this to happen, we need every country to have resilient health systems.
More details are emerging about the UK aid cuts all the time, so follow Global Citizen UK on Facebook and Twitter to stay up to date. Take action with us to raise your voice in support of UK aid by emailing your MP.