The capacity-building approach was successful in the start-up process of the first HSCT center in Iraqi Kurdistan

I Majolino; A Rovelli; M Vacca; M Verna; M Canesi; V Conter; D Othman

doi:10.1038/bmt.2017.202

Initial Results of Peripheral-Blood Stem-Cell Mobilization, Collection, Cryopreservation, and Engraftment After Autologous Transplantation Confirm That the Capacity-Building Approach Offers Good Chances of Success in Critical Contexts: A Kurdish-Italian Cooperative Project at the Hiwa Cancer Hospital, Sulaymaniyah

Journal of Global Oncology ◽

10.1200/jgo.17.00101 ◽

2018 ◽

pp. 1-8

Author(s):

Ignazio Majolino ◽

Dereen Mohammed ◽

Dastan Hassan ◽

Francesco Ipsevich ◽

Chra Abdullah ◽

...

Keyword(s):

Stem Cell ◽

Capacity Building ◽

Peripheral Blood ◽

Peripheral Blood Stem Cell ◽

Autologous Transplantation ◽

Iraqi Kurdistan ◽

Cell Mobilization ◽

Cooperative Project ◽

Initial Results ◽

Site Training

Introduction At Hiwa Cancer Hospital (Sulaymaniyah, Iraqi Kurdistan) after the center was started by a cooperative project in June 2016, autologous transplantation was developed. Patients and Methods To develop the project, the capacity-building approach was adopted, with on-site training and coaching of personnel, educational meetings, lectures, on-the-job training, and the implementation of quality management planning. Results Here, we report initial results of peripheral-blood stem-cell mobilization and collection of the first 27 patients (age 12 to 61 years; 19 males and 8 females; multiple myeloma, n = 10; plasma cell leukemia, n = 1; Hodgkin lymphoma, n = 12; non-Hodgkin lymphoma, n = 3; and acute myeloid leukemia, n = 1). Only three (11.5%) of 26 patients experienced a failure of mobilization. A median of 6.1 × 106/kg CD34-positive cells per patient were collected (range, 2.4 to 20.8), with two apheretic runs. Twenty-four patients underwent autologous transplantation. All but one transplantation engrafted fully and steadily, with 0.5 and 1.0 × 109/L polymorphonucleates on day 10.5 (range, 8 to 12) and day 11 (range, 9 to 15), respectively, and with 20 and 50 × 109/L platelets on day 13 (range, 10 to 17) and day 17 (range, 2 to 44), respectively. More than 95% of patients are projected to survive 1 year after autograft. Conclusion These data are the result of an Italian effort to establish in Iraqi Kurdistan a leading center for hemopoietic stem-cell transplantation. The capacity building approach was used, with on-site training and coaching as instruments for the development of provider ability and problem solving. With future limitations for immigration, this method will be helpful, especially in the field of high-technology medicine.

Download Full-text

An Innovative Integrated Capacity Building Project for Stem Cell Transplantation in the Southern Lazio Region

Blood ◽

10.1182/blood-2018-99-115406 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 5845-5845

Author(s):

Francesca Saltarelli ◽

Alessandro Andriani ◽

Vincenza Martini ◽

Roberta Sala ◽

Laura De Padua ◽

...

Keyword(s):

Stem Cell ◽

Stem Cell Transplantation ◽

Capacity Building ◽

Cell Transplantation ◽

Conflicts Of Interest ◽

Continuous Process ◽

Quality System ◽

Training Phase ◽

Lazio Region ◽

Start Up

Abstract Autologous stem cell transplantation (ASCT) is a standard treatment for many hematological disorders. Since ASCT needs technical and professional skills, a start-up process should imply the application of a specific methodology to reduce time and costs, and to optimize the results. We describe here an innovative and integrated process leading to the start-up of a transplant activity in the Hematology Unit of the general hospital of Frosinone, southern Lazio, Italy. The method had previously been employed successfully by one of us in a critical context (Mediterr J Hematol Infect Dis. 2017 Apr 15;9). Since 1996, the Hematology Unit in Frosinone gained experience in treating malignant and non malignant disorders, but HSCT could not be performed so patients were referred to other institutions in the country with remarkable costs and discomfort. The innovative aspect of our project is the application of a capacity building methodology aimed at establishing a quality system prior to the initiation of the clinical transplant activity. Capacity building is a continuous process addressed to individuals, organizations and institutions aiming at developing abilities and achieve objectives. A preliminary step was to check sustainability,ie whether the institution was suitable to support an ASCT activity, and to assess the level of expertise of the medical and nurse staff involved in the process. In fact, our Hospital was lacking some of the facilities required to perform ASCT, such as apheresis and stem cell manipulation. To overcome the obstacle, an agreement with the close Latina Hospital that has consolidated experience in ASCT was established, gaining access to their facilities and expertise. In June 2018 we held a first training course addressed to physicians and nurses that covered different aspects of ASCT. A scientific advisor led the process of editing clinical protocols and procedures. Simultaneously a quality system was built based on clinical guidelines that follow the international FACT-JACIE standards. In this phase, the document management system, the outcome indicators and the main rules of the transplant program were created. In order to improve the educational program we planned a second training phase based on on-site coaching. To better accomplish the task, physicians and nurses are now asked to highlight the practical aspects of the process that require further development trough a simple questionnaire. During this second training phase, selected physicians and nurses with experience in transplantation will undertake an open discussion about the aspects requiring further evaluation. The goal is to perform our first autologous transplant within four months since the start of the project. We believe that the capacity building process through on-site training and coaching represents an innovative effective method for developing autonomous skills needed to conduct a sustainable HSCT program. Disclosures No relevant conflicts of interest to declare.

Download Full-text

The start-up of the first hematopoietic stem cell transplantation center in the Iraqi Kurdistan: a capacity-building cooperative project by the Hiwa Cancer Hospital, Sulaymaniyah, and the Italian Agency for Development Cooperation.

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2017.031 ◽

2017 ◽

Vol 9 (1) ◽

pp. e2017031 ◽

Cited By ~ 4

Author(s):

Ignazio Majolino

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Capacity Building ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Development Cooperation ◽

Hematopoietic Stem ◽

Start Up ◽

Transplantation Center

We describe the entire process leading to the start-up of an hematopoietic stem cell transplantation center at the Hiwa Cancer Hospital, in the city of Sulaymaniyah, Kurdistan Iraqi Region. This capacity building project was funded by the Italian Agency for Development Cooperation, and implemented with the support of the volunteer work of Italian professionals, either physicians, nurses, biologists and technicians. The intervention started in April 2016, was based exclusively on training and coaching, and led to a first autologous transplantation in June 2016 and to an allogeneic transplantation in October. At the time of reporting, 9 months from the initiation of the project, 18 patients have been transplanted, 15with an autologous and 3 with an allogeneic graft. The center at the HCH represents the first transplantation center in Kurdistan and the second in wide Iraq. We conclude that international development cooperation may play an important role also in the field of high-technology medicine, and contribute to improved local centers capabilities through country to country scientific exchanges.

Download Full-text

Neurosurgery in Iraqi Kurdistan: An Example of International Neurosurgery Capacity Building

World Neurosurgery ◽

10.1016/j.wneu.2016.04.088 ◽

2016 ◽

Vol 92 ◽

pp. 108-112 ◽

Cited By ~ 2

Author(s):

Rimal Hanif Dossani ◽

Steven Carr ◽

Gene Bolles ◽

Razvan Balata ◽

Bharat Guthikonda

Keyword(s):

Capacity Building ◽

Iraqi Kurdistan

Download Full-text

Start-Up Business Camp TDA Wilayah Jakarta

Jurnal Pemberdayaan Masyarakat Universitas Al Azhar Indonesia ◽

10.36722/jpm.v3i2.549 ◽

2021 ◽

Vol 3 (2) ◽

pp. 47

Author(s):

Bambang Eko Samiono ◽

Hanny Nurlatifah

Keyword(s):

Capacity Building ◽

Start Up

Komunitas Bisnis Tangan Di Atas (TDA) adalah komunitas wirausaha terbesar di Indonesia, wadah bergabungnya para wirausahawan di Indonesia. Beberapa program banyak dilakukan untuk meningkatkan capacity building anggota TDA tersebut. Namun, sebagian besar program masih belum terstuktur dan tersegmen untuk level tertentu. Sehingga hal ini menyulitkan untuk pebisnis pemula untuk mendapatkan pelatihan dalam satu paket yang tepat. Selain itu, terlihat bahwa banyak sekali pebisnis pemula mengikuti berbagai macam pelatihan secara berulang karena masih belum paham bagaimana menerapkan materi pelatihan yang didapat. Tim pengabdian masyarakat yang telah lama bekerjasama dengan divisi edukasi Internal TDA Jakarta Selatan dan Jakarta Timur bekerjasama sebagai kontribusi untuk memberikan solusi terhadap permasalahan yang dihadapi mitra yaitu berupa 1) Memberikan Program Workshop series dalam bentuk Camp, 2) Penyediaan mentor yang sesuai dengan bidangnya yang mampu memberikan pembekalan secara praktis dan sistematis serta 3) Memberikan materi praktis berupa lembar kerja sebagai template untuk memulai bisnis sehingga bisa di gunakan secara praktis. Pelatihan Start Up Business Camp ini di jalankan dalam 4 sesi selama 2 kali pertemuan dengan 10 orang peserta bisnis pemula dari TDA Jaksel dan Jaktim. Di akhir pelatihan diperoleh evaluasi adanya tingkat kepuasan terhadap peaksanaan pelatihan ini sebesar 96%.Kata kunci: Bisnis, Wirausaha, Pendampingan, Start up, Pelatihan

Download Full-text