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International Outreach | ‘Out’ in Africa: Anesthesia in Tanzania by John McDowell, CA-3 |  I recently traveled to Mwanza, Tanzania, located on the southern shore of Lake Victoria, to teach student nurse anesthetists. I received the Society for Education in Anesthesia (SEA) traveling fellowship and worked through Health Volunteers Overseas (HVO), which gave me the opportunity to visit for one month in this area desperately underserved by healthcare workers.
In Mwanza, Bugando Medical Centre sits atop the highest hill and serves as a regional referral hospital for a large surrounding area. It contains 80 beds and 5 operating rooms where some 30-40 surgeries occur daily. They do many types of operations including general surgery, OB/Gyn, urology, pediatric, and some thoracic. My challenge was to help teach and train 22 student nurse anesthetists, providing them with lectures, quizzes, and in-operating room (OR) teaching. As might be expected, there are minimal resources available for anesthesia in Tanzania. The main drugs and equipment used are those that would have commonly been found in the average 1950s US ORs. The key drugs were ether, halothane, and thiopental. The machines were EMO and OMV vaporizers. Having said all this, I truly had a great experience being in Tanzania. I feel I was able to make a big contribution to the education of the student nurses, and that I was able to learn quite a lot myself.
The nurses had just begun their one-year of training when I arrived, so I lectured on pharmacology basics, anesthesia machine basics, and physiology. In the OR, I instructed them on the setup and use of a modern anesthesia machine that was available, gave pointers on intubation and the use of different anesthetics. My clinical teaching extended into the post-anesthesia care unit (PACU); there I assisted with extubating patients. The students were very eager to learn, with some having a very good background of medical knowledge, while others needed much more assistance and teaching of basic medical concepts. I learned a great deal by teaching the students. It helped me to reevaluate my own understanding of anesthesia and exposed me to different ways of being an effective anesthesia provider, including learning how to deliver an ether anesthetic.
Overall, my month in Mwanza was one of the best experiences I have ever had. I will never forget the people or places, and will take this with me for the rest of my career. I hope I am able to continue to serve as an anesthesia provider in other underserved areas in the future, including back in Africa. I highly recommend any anesthesia provider take the time to make one of these trips—no matter where you are in your career. It can only make one more grateful for what we have in the US, in addition to making one a better healthcare worker.
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(View Dr. McDowell's PowerPoint Presentation)
| |  Medge Owen, M.D., Associate Professor of Obstetric Anesthesia has traveled extensively to improve childbirth conditions for women in developing countries. Worldwide, nearly 600,000 women die during childbirth each year. Most of these deaths occur in developing countries and could be prevented. Photo shows Medge Owen teaching new-born resuscitation class in Ghana Africa
| In 2001, Dr. Owen established a non-profit organization, Kybele, Inc., to promote education in obstetric anesthesia and neonatal resuscitation. “Kybele” was the goddess of childbirth in ancient Anatolia, now modern day Turkey. Owen was a Fulbright Scholar in Turkey (1997-1999) and helped establish an obstetrical anesthesia service at Uludug University. In September 2004, Owen will return to Turkey with a delegation of 8 obstetric anesthesiologists from prestigious universities throughout the U.S. and U.K. to teach regional anesthesia for childbirth. She is also co-authoring the first textbook of obstetric anesthesia to be published in Turkey, scheduled for release in late 2004. In addition to her efforts in Turkey, Owen has taught neonatal resuscitation in Brazil, Croatia, and Ghana. She also chairs the Committee on International Outreach for the Society of Obstetric Anesthesia and Perinatology (SOAP). | Pain Research. The Pain Mechanism Research Laboratory, under Jim Eisenach’s leadership, is a hotbed of international collaboration and exchange in both clinical and laboratory studies. There are always a number of foreign anesthesiologists and research fellows in the lab, each spending 1-2 years of research before returning to his or her country, usually to join the clinical faculty. Currently the lab has 8 such individuals: Carine Dalle (France), Dongping Du (China), Kenichiro Hayashida (Japan), Hideaki Obata (Japan), Alfonso Romero (Spain), Edgar Sandoval (Spain), Tao Yan (China), and Yong Zhang (China). | Ralph Bethea, MD, CA-III resident achieved numerous accolades for representing us as the SEA-Katz Health Volunteers Overseas educator in Tanzania. His report of the experience was published in Anesthesia Education - The Newsletter of the Society for Education in Anesthesia 2004;22(1):1,14,15 (with permission). Bethea delivered “Turning Back Time: Anesthesia Practices in Third-World Africa, with Board Review of Relevant, but Unfamiliar Gases and Equipment” at Wednesday Morning Case Conference. Dr. Bethea's PowerPoint presentation at Case Conference (13MB). | |  Operation Smile. Two of our pediatric faculty volunteer with Operation Smile, an international group providing free surgical services to people in the U.S. and 18 countries who have cleft lips and palates, burns, and more severe craniofacial deformities, as well as limb deformities. Those involved, Jim O'Brien (Ecuador, Peru) and Doug Ririe (Ecuador, Panama, China, and Peru), travel to these destinations as part of a medical team and provide anesthesia and perioperative care for patients having these surgeries. Photo shows Doug Ririe with Operation Smile in Bolevia
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