Journeys

Road traffic accidents in Uganda are frequent and brutal.  Two years ago, the anaesthesia community at Mulago Regional Referral Hospital, the largest in the country, lost several of its own when a minibus carrying anaesthetic SHOs to a funeral was swiped off the side of the road.

Treatable injuries became fatal ones: the same infuriating story we heard many accounts of over the next few weeks. No drugs; no staff; no electricity; no efficient transport.

“In a country that has only 0.6 anaesthetic providers per 100,000 population (unlike the UK which has 20) this is a huge blow,” wrote Dr Sarah Hodges, Head of Department of Anaesthesia at the CoRSU Rehabilitation Hospital in Kisubi.

The World Health Organziation, which launched a Decade of Action for Road Safety in May, estimates that road traffic accidents will be the fifth leading cause of death by 2030.

As we crammed into a mutatu, cab, for the 300km journey down to Mbarara, suitcases strapped to the roof, squaring up to oncoming traffic and picking up speed along torn up and dusty roads, it was easy to believe.

Improvements in infrastructure over the last few years have certainly made cross-country journeys easier, but thunderstorms on the Monday before our training course began had swamped potholes and slowed travel.  The participants, stationed in hospitals and health centres as far north as Abel, by the border with South Sudan and west, across the Rwenzori Mountains, travelled hundreds of kilometres to get to Mbarara in the south.

Many who had left their posts before dawn were still arriving, wet and tired, the following morning.

This is Khasitsi Khalayi – a 40 year old anaesthetic officer at a Health Center 4 in the Mbale district, in Eastern Uganda.

“Since here are so many patients – sometimes you have shortages, sometimes you are alone – of drugs, of materials, staff.  Sometimes because of these shortages you are overworked, and patients are many.  You encounter some problems,” she explained.

Khasitsi left her home the day before, traveling by bus to Kampala where she boarded another bus to Mbarara, arriving at 2am.  She got on a boda boda, a motorcycle, and met Dr Stephen Ttendo at the University.

“He said I should not miss the pulse oximetry session.”

Advertisements

Anaesthesia in Uganda

Anaesthesia providers in Uganda lack access to almost everything that we take for granted in developed world practice: basic drugs, monitoring equipment, support staff, continuous learning. And every week they treat a nightmare caseload: ruptured uteruses, road traffic accidents, severe burns.  Ambulances bump across 60 kilometers of potholed road, stiff blankets and stretchers are carried on foot across the mountains, patients stumble in on foot, requiring urgent surgical attention at all hours.

There are only about 300 anaesthetic officers in the entire country, treating a population of more than 31 million.  Lifebox has been working with the Ugandan Society of Anaesthesia (USoA) to support their activities.

In June and July of this year we spent two weeks at the Mbarara University of Science and Technology in southern Uganda, running training in pulse oximetry, the WHO Surgical Safety Checklist, and obstetric anaesthesia.

Thanks to your generosity we were able to donate 80 Lifebox pulse oximeters to the USoA.  These were presented to anaesthetic officers from facilities that lack access to even a single pulse oximeter.

Over the next few weeks we’ll share their stories with you.

Hello world!

Lifebox is a not-for-profit organization saving lives by improving the safety and quality of surgical care in low-resource countries. We are doing it with a straightforward first step: Ensuring that every operating room in the world has a simple, essential device that can save tens of thousands of lives – an oxygen monitor.

More than half the hospital operating rooms in low-income countries lack an oxygen monitor (also known as a pulse oximeter), crucial for helping front line clinicians prevent fatal oxygen starvation in patients during anaesthesia. Millions of people undergo surgery without this basic safety measure because they have no choice. They need surgery for bleeding and broken bones after a road traffic accident, for appendicitis and strangulating hernias, for emergency caesarean sections. Lifebox works to make sure these hospitals get access to this vital equipment.

On this blog we’ll share stories from the field, feedback from Lifebox users and other uplifting stuff related to safer surgery and anaesthesia.