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Registrar and Anaesthesia Liaison for ICU
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‘When news of Zambia’s first Covid-19 positive patients broke, we tried hard to carry on as normal, while also trying to prepare ourselves for a surge in cases as we moved along the curve. The work environment had an underlying current of anxiety at all levels as we didn’t know what to expect in terms of case load and presentation, whether or not we would have enough protective equipment for staff or if we had enough drugs and equipment to provide adequate patient care.
As it became evident that we had established community transmission the majority of elective cases were put on hold and in the department the focus shifted to optimising both staff and equipment to ensure we would be able to launch a response to a huge surge in cases. This included rotas of work and rest weeks for the doctors. As we have gained an understanding of the pattern of disease in our population – the majority of patients have had asymptomatic or mild disease, this has helped ease anxiety among members of staff, who have adapted to a work environment with increased attention of infection prevention. We are starting to reintroduce elective lists and have a plan in place for the management of Covid-19 suspected or confirmed patients, both on ICU and in theatre, though adequate availability of PPE does remain a point of anxiety.
Despite having to withdraw in-country trainees, GADP has provided continuous support throughout: sharing experience and information from managing Covid-19 patients in the UK and other LMICs; supporting staff wellbeing; regular teaching to support exam preparations; and the procurement of essential PPE.’
Read more about the GADP Health Worker Action Fund project here.
Chief Anaesthetic Officer
Wisdom Musonda Chelu is a Chief Anaesthetic Officer at the Ministry of Health in Lusaka, Zambia. He is part of the Brighton-Lusaka Anaesthesia project in partnership with the Ministry of Health (Zambia), Lifebox Foundation, Brighton-Lusaka Health Link and Primary Trauma Care Foundation. The partnership aims to improve delivery of safe anaesthesia through capacity building of health workers and to implement (Brighton-Lusaka Anaesthesia Project) the training programme of Bachelor of Science Degree in Clinical Anaesthesia in partnership with Levy Mwanawasa Medical University.
As a young boy, I read medical related books and lived around medical doctors. I would watch as they were called out to homes to see someone who was sick, and the work seemed very thrilling and important. I did a three year training programme as a Clinical Officer General with a Diploma in Clinical Medical Sciences at the College of Health Sciences in Lusaka. I had a keen interest in surgery, and whenever I was in theatre, I assisted the Clinical Officer Anaesthetist. I learnt about anaesthesia through that process and then decided that I would specialize in clinical anaesthesia.
Obstetric anaesthesia is associated with higher risk than routine care, and requires specialized training for healthcare professionals to enable them to work safely and efficiently with the patients. THET supported the Ministry of Health to train anaesthetic providers in Safe Obstetric Anaesthesia with WHO Surgical Check List. I have been organising and coordinating SAFE- Anaesthesia Courses through Education supported by THET, Zambia and Lifebox Foundation and so far about 150 anaesthetic providers have been trained and 125 pulse oximeters donated to needy hospitals.
I recall a particular case with a patient who had a bad obstetric history, her newborns used to die upon delivery due to severe fetal asphyxia. Due to the training I had received, when I saw this patient, I knew that I was to give her spinal anaesthesia and put her in left lateral position to avoid aortal caval compression to lessen the distress. I administered her oxygen by mask for her to breathe to improve oxygen saturation in blood (intrauterine fetal resuscitation). After three minutes from the start of surgery, the male baby was extracted and immediately after giving oxytocin, the newborn was resuscitated. Later, as I monitored the mother, she was in tears and told me that is the first time she has heard her own baby cry. I was humbled.
The courses add value to our work as anaesthetists, we are able to learn and develop knowledge and skills through sharing with others from different hospitals. I have seen and experienced that partnerships are key in developing and improving the provision of safe anaesthesia in Low-Middle Income Countries. We need partnerships to help in anaesthesia human resource development.
Biomedical Engineer Technician (BMET)
Received a Diploma in Biomedical Engineering Technology at NORTEC, Ndola (Supported by THET).
“I chose to do a Biomedical Engineer Technician (BMET) Diploma because I love engineering and the combination of that with the medical side is very interesting. It is difficult being a BMET especially because in the hospital, when the first machine breaks down staff just put it aside, and the same thing happens when the second one breaks, finally when the last one breaks down they will bring it to us and say ‘fix this’ we don’t have anything to use now. So I feel a lot of pressure but the training has really helped and now I feel as if I help to save lives.
I have been working at Chongwe District Hospital as part of the Medical Equipment Uptime Project for almost six months now. I took an inventory when I started and found 120 items of equipment here but once I begun to show staff I could fix equipment, more broken equipment began to appear (equipment that had previously been hidden or locked away during the inventory).
I remember discovering that there was only one suction machine used for all the operations in the hospital, of course this is a huge risk as when this the patients airways cannot be cleared of fluid during the operation causing patients to suffer further. After seeing that the broken suction machines had very simple problems like damaged power cables or connections I fixed them and made sure that every ward had one.
I was also able to keep oxygen concentrators, which two patients depended on, running while the power grid was switched off for the connection of solar back-up (for about 30 mins).
At the beginning of the Project the hospital had just 73% of equipment working now we have 90% working. Within the project, I also hear about what happens in the other project hospitals, and learn how to be more effective, especially with who to report issues to, and how to work with hospital administration.
Looking to the future I would love to gain higher qualifications in electronics, after all if you improve on that, you can research problems better than just the troubleshooting. It would also be great to move to a bigger hospital, of course it’s nice when you know it’s only you, but in a bigger hospital you get to have more experience and more exposure – the bigger the better.”
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