Anesthesiology in Africa
SCCM Contributes to Enhancing Education
Most who undergo surgery would expect a skilled anesthesiologist or nurse anesthetist to be involved with their care. These skilled professionals are tasked with keeping the patients asleep, pain free and alive during the experience. But, surgical and anesthetic care in Africa, where countries are considered fortunate to have one anesthesiologist per million people, is often considered a luxury. Entire countries function without anesthesiologists, leaving the responsibilities to nurses or other healthcare professionals who lack specialized training. The consequences are often so dire that the surgery itself can be much more dangerous than the condition that it is meant to correct.
The World Federation of Anesthesiology Societies and the Kenya Society of Anesthesiologists are taking a leading role in providing anesthesia education in Africa. The Society of Critical Care Medicine, serving as a partner with The Johns Hopkins Hospital Anesthesiology and Critical Care Medicine Department, is supporting these efforts in part through its participation in the 4th All Africa Anesthesia Congress, held in September in Nairobi, Kenya. The meeting brought thousands of participants from throughout Africa’s 54 countries to learn how to improve the practice of anesthesia and critical care medicine.
Former Society president Charles G. Durbin, MD, FCCM, was among those invited to present during the meeting, held every four years. Durbin spoke on protective lung ventilation as well as lessons learned from the Surviving Sepsis Campaign, an important topic as African hospitals begin efforts to implement the initiative. He also led a problem-based learning session on thoracic surgery issues, a particularly well-received course as educational methods using case studies and small group discussions were new methods for most participants.
“Making new friends and connecting with people from other continents and cultures are very rewarding experiences, and I think useful for them,” Durbin said. “I’ve cultivated a few ongoing communications with the people I met there, and maintaining these relationships is very important.”
Patients requiring anesthesia and surgery in Africa desire and deserve the same opportunity for survival as patients in other parts of the world. Often it is not expensive machines and advanced medications that have the most impact in patient survival, but rather the simple interventions such as hand washing, cleanliness and a methodical approach that have the greatest impact in decreasing preventable death in African operating rooms.
These collaborative efforts will go far in improving the care of operative patients throughout Africa and ensuring robust education in anesthesiology. The ongoing reward of these efforts will be improved safety and a decrease in the number of preventable, surgery-related deaths.
Durbin, along with course co-director Marie Baldisseri, MD, FCCM, and others, also served as faculty for a two-day Fundamental Critical Care Support Course (FCCS) held as part of the 4th All Africa Conference. The Society donated the FCCS course license and books to accommodate the physicians and nurses seeking to enhance their critical care knowledge. Gaining from a curriculum suited to meet local needs, several students from the FCCS course became instructors, ensuring the course will thrive in the region and be led by local healthcare professionals.
The Society of Critical Care Medicine has taken a strong role in bringing its wealth of knowledge regarding the basic fundamentals of life-saving medical practice to the anesthesiologists and nurse anesthetists who practice throughout Africa. The Nairobi course marks the twenty-sixth international FCCS course of 2009. Additionally, for several years the Society has sponsored grant-funded courses in African countries such as Eritrea, Kenya, Tanzania and Zambia, underlining the importance of disseminating critical care education worldwide, particularly to those most in need. FCCS also is well-established in Egypt at Dar Al-Fouad Hospital in Giza, and numerous licensed courses have been held throughout South Africa.
