Anaesthesia symposium spreads the word at the foot of Kilimanjaro

Radboud University Medical Centre (UMC) in the Netherlands has been working with the Kilimanjaro Christian Medical Centre (KCMC) in Tanzania for a number of years, offering support and education. Clinicians from the UMC department of anaesthesia have been developing the provision of anaesthesia at KCMC, as well as a programme to teach staff about its applications.

The orthopaedics department in KCMC had virtually stopped performing any surgical procedures, because the limited use of anaesthesia was leaving patients in a great deal of pain for several days at a time. The protocol for general anaesthesia at the hospital was quite outdated, with a much lower use of opioids than is now common, and there was also no formal provision of pain control.

Paediatric anaesthetist Dr Luc Tielens visited KCMC and started to grow a new department around the single resident anaesthetist in place. “There was no sense in just providing short-term relief and then leaving again; it was important to establish a long-term plan and education programme to help build up the anaesthesia service,” explained Dr Tielens.

One of the first priorities was to establish an effective pain protocol and regional anaesthesia was an important component of this. The anaesthetic resident – followed soon by a second colleague – spent three months at UMC learning how to perform regional anaesthesia and, since then, the technique has been widely adopted for all kinds of pain control. Three years ago, the doctors would perform an occasional local block, now they carry out 40 to 50 a week.

In partnership with anaesthetists from the UK and America, new education curriculums have been developed for those specialising in anaesthesia. The nurses’ course is being changed from one year to three and will hopefully be recognised with a diploma upon completion, giving it far more status.

In 2018 it was decided to organise the Tanzania Regional Anaesthesia Symposium, a local meeting about regional anaesthesia. “However, for this type of technique, hands-on training is by far the best way to learn and one of the largest challenges we faced was how to get additional ultrasound systems to KCMC for the workshops,” continued Dr Tielens. Fujifilm SonoSite stepped in and offered four machines on loan that could be packed into luggage. “We were able to travel with the systems, probes and everything required to give live screening demonstrations and workshops straight from the Netherlands to KCMC.”

Delegates including 13 of Tanzania’s 17 anaesthetists came from all over east Africa, including Congo, Kenya and Rwanda. Another symposium is planned for 2020 and there have been discussions about starting a group for local anaesthetists.

Pictures: Fujifilm SonoSite has played an important role in the establishment of an anaesthesia symposium and hands-on training at KCMC.

Published on page 11 of the October 2019 issue of RAD Magazine.