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Reflection #4: A Call for Help – The Africa Connection

by Helen Fosam

With a decade of experience behind me as a medical writer and four years into my freelance medical writing business, a request for help landed in my inbox from an address I did not recognize. I almost missed it, ready to hit delete. By that time, I learned that avoiding unexpected emails, especially those with tantalizing headings, increased my time on paid freelance work. But this email caught my attention. I guess it was the subject description – someone in Nigeria was looking for guidance on developing a continuing medical education (CME) program. CME was my bread and butter. What I did day in day out. I was confident that I could provide valuable input. So I responded to the email. But let me first share my experience during the first 4 years of freelancing.

After losing my dream job — the one with what I thought was akin to a corner office, complete with a couch to relax whenever I needed a break — freelancing presented itself. The freelance opportunity came precisely 2 days after I received my termination notice. My first client was purely accidental, or was it fate? My former boss from a company I had worked with many years prior. A lesson right there — do great work wherever you are, even for a company or with people you don’t particularly like. The new company she joined had a time crunch on a project and wanted to know if I could help out. I told her that I would check my calendar to see if I could fit in the work, knowing full well that my calendar was completely blank! That first client and the few more that followed gave me the confidence I needed, that I could actually do this. To survive as a freelance medical writer. Here’s why. For each project with each client, I gave more than was asked, I always delivered on time. I said “yes, I can” to every project. “Yes, I can” to projects on diseases and drugs I could not even pronounce, let alone know what they caused or treated. “Yes, I can” to educational designs that sometimes left me scratching my head. But, it was my job to do the research and write about them as an expert. 

The tagline for my business was “On Time, On Target, On Budget.” Repeat business sustained me. In fact, I’ve been working on and off with that first client and several others for almost 10 years! Whenever a client moved on, I gained a new client because they would reach out to me to help support their work. Indeed, I had a client job-hop 5 times in the space of 2 years, and I gained 5 new clients! I will not lie. It was hard work. But your reputation follows you, and with that, recommendations. I will also not lie; some clients want you to work for nothing because they assume you don’t have a choice as a freelancer. In my case, I had a client for whom I worked the same hours as their full-time employees but for a fraction of the pay and no benefits. They thought they had a great deal, and they did, but they, and the few others like them, had no idea of the agenda behind my free service. I needed to build my portfolio, gather as much experience as I could, and at the same time get to know their clients because it may come in handy one day. Then move on. And that’s exactly what I did. Today, my resume as a freelancer includes experiences that cover the gamut from A to Z. I ask for LinkedIn connections and endorsements from KOLs and decision-makers in pharma and non-pharma companies I’ve worked with. With this background, I felt ready to respond to that email that landed in my inbox and start giving back to my ‘village.’

That opportunity came literally out of the blue. John, not his real name, had posted a request in a forum I belonged for advice on organizing a medical education event in Nigeria. I gave John my candid feedback, thought nothing further, and proceeded with my life and deadlines. A few months later, John approached me again, this time seeking help to develop a sustainable medical education program in Nigeria. As justification for the program, John narrated a personal story that basically concluded that many patients were dying needlessly from preventable or manageable conditions, and those with the resources sought medical treatment outside Nigeria. In some cases, doctors lack opportunities to keep up to date with new knowledge and skills, sometimes decades after graduating from medical school. My experience in the United States told me otherwise. The practice of medicine is a journey of continuous learning. CME is central to this journey and mandatory for all physicians to maintain their licensure to practice. I assumed that the same mandated requirement applied in other countries.

I decided to do some research. Several published studies like herehere, and here confirmed what John told me. Access to CME to support continuing professional development can be difficult for many healthcare professionals in Africa. Given the challenges of managing infectious diseases and the increasing prevalence of non-communicable diseases like diabetes, ischemic heart disease, and stroke, access to current and relevant medical information becomes critical for optimal patient care.

Working with John and his various contacts, we set out on a mission to assemble a formidable team of talent from the United States, India, and Nigeria. The plan was to develop telemedicine CME programs for healthcare professionals in Nigeria. So, with my experience in planning, developing CME, and writing grants, I got down to work. This was the opportunity I was looking for. To start giving back. But things went pear-shaped and soon fell apart. I guess it was not meant to be. But the thought that I had connected with people interested in using my experience was already planted deep in my grey matter. No matter how much I tried to forget the failure and move on, the idea would not leave me alone. So I tried again.

Helen Fosam is the founder of the Missing Link to Improved Health Outcomes (MiLHO) Initiative. The initiative focuses on creating online continuing medical education courses for healthcare professionals in Africa. We are currently beta-testing our pilot course on type 2 diabetes. Click here https://milho.net/subscribe/ to subscribe and to access the free diabetes course.

A medical writer focusing on continuing medical education, Helen has roots in pre-clinical research, in academia as a faculty member, and in the healthcare sector as an R&D adviser. She holds a Ph.D. in Physiology from Sheffield University, UK, MSc in Biochemistry from Sussex University, UK, and BSc in Biochemistry from Kent University, UK.

The MiLHO Initiative emerged from a combination of a personal medical emergency, the role CME played in that emergency, and the realization that healthcare professionals’ access to and participation in CME is critical to evidence-based patient care and their optimal health outcomes. The mission of the MiLHO Initiative is to support healthcare professionals in Africa to access relevant and affordable CME in their local settings. Join us. Together, we can make a difference. Click here https://milho.net/subscribe/ to subscribe, and then forward the link to your contacts.