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Principles of Practice: Providing paediatric anaesthesia training in South Africa 

31 January 2018


The World Federation of Societies of Anaesthesiologists (WFSA) and the South African Society of Anaesthesiologists (SASA) are partnering with THET through the Africa Grants Programme to build essential anaesthesia skill in South Africa.

Today 5 billion people have no access to safe and affordable anaesthesia when needed, resulting in increased disability and huge numbers of deaths annually. This global health crisis has often been overlooked but is now beginning to receive more attention from national governments, the global health community, and the media[1]. As more is now being done to tackle issues around safe surgery and anaesthesia, it is essential that strong international partnerships are formed with a joined-up solution-based approach to improving surgery and anaesthesia globally.

Hence the focus of the Africa Grants Programme which has funded Safer Anaesthesia From Education (SAFE) Paediatric Anaesthesia courses[2] as part of this essential collaborative approach to surgical scale-up and development. The aim of the course is to provide refresher training for both physician and non-physician anaesthetists in the essentials of paediatric anaesthesia. It is not intended to be a comprehensive training course in paediatric anaesthesia, but rather emphasises the principles of safe care for children, in particular, assessment, vigilance and competence in essential skills.

“Safe surgery is not possible without safe anaesthesia so it is essential to improve the knowledge and skills of anaesthesia providers at all levels,” explained Julian Gore-Booth, WFSA CEO.

“Understandably we find that providers are especially keen to access training related to ensuring that children can access safe anaesthesia. The SAFE paediatric course will provide the knowledge and skills that anaesthesia providers need to treat paediatric patients for common conditions such as open fractures after road traffic accidents and appendectomies’,” he added.

There are only approximately 250 anaesthetists serving the 42 million people using public sector healthcare services in South Africa. Although the health system has some world-class skills, it remains tremendously under-resourced, with existing resources centralised in the more metropolitan centres of the country, which is insufficient for the needs of the population.


29% of South Africa’s population are under 15 years old. The main causes of death for this age group are non-communicable diseases and trauma both of which often require surgical treatment[3], so access to trained paediatric surgery and anaesthesia providers is essential. However, there are few specialist surgeons and anaesthetists in some areas of the country, with paediatric procedures often provided by general physicians in rural areas who have a limited level of anaesthesia training, and paediatric anaesthesia training specifically.

Recognising the need for these skills, SASA and WFSA have long collaborated on delivering the SAFE Paediatric Anaesthesia course and other SAFE programmes in areas of need on the African Continent, but none have yet been delivered within South Africa. To address these issues this project will support the provision of the much needed SAFE programme in the rural areas of South Africa, while also further building the training skills available to the continent as a whole.

Dr Tirunesh Busha who took part in the SAFE Paediatrics training in Ethiopia speaks of the confidence the course has given her in treating and anaesthetising children:

“A case I remember specifically where my SAFE training was helpful was that of a five year old girl who came in with a full thickness face burn, and where mouth opening was a big problem for intubation as part of airway prophylaxis. I was able to stabilise her and she stayed in our ICU for about two weeks before being referred to a burn centre in Addis Ababa for some reconstructive surgery.”

Successes such as the one Dr Busha explains above illustrate the vital need for the SAFE training in areas of the world where simple anaesthesia training is often neglected. As we begin the project in South Africa we are excited to learn of the important impact the training will have through this project for both the patients and the health workers involved.


[1] http://docs.wixstatic.com/ugd/346076_713dd3f8bb594739810d84c1928ef61a.pdf

[2] SAFE is a three-day course in paediatric anaesthesia developed by the Association of Anaesthetists of Great Britain and Ireland (AAGBI) and the World Federation of Societies of Anaesthesiologists (WFSA), and endorsed by the Society of Paediatric Anaesthesia (SPA).

[3] https://data.worldbank.org/indicator/SP.POP.0014.TO.ZS?locations=ZA

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1 Comment

  • Lamin Fofanah
    05 Oct 2020 11:41
    I am a nurse anaesthetist with a BSc in anaestesia. I am planning to pursue a postgraduate studies in paediatric anaesthesia, what is involved? I am from sierra leone, west Africa where nurse anaesthetists prove 99% of all surgical interventions

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