Never a day at the beach

The Togolese Republic stretches narrowly north 600 km into West Africa, with Burkina Faso at its head and the Bight of Benin swirling at its feet in the capital city of Lomé.

But it’s never a day at the beach for the staff at Centre Hospitalier Universitaire (CHU) in Lomé city centre.

The sprawling CHU complex has two obstetric theatres that perform 12 caesarean sections a day.  Patients travel from miles around, emergency cases that seem to be driven right up to the door.

Recovery areas, scattered throughout the complex, “suffer with a lack of patient monitoring,” reported a British doctor who traveled there for recently.  But as you’ll see below, some exciting developments and some even bigger plans, we hope that this dangerous reality won’t be the case for much longer…

The British team was in Togo for a workshop hosted by Mercy Ships and led in collaboration between U.K. anaesthetist Dr Keith Thomson and Mrs Aicha Bissang, president of the Association National des Techniciens en Anesthesie du Togo (ANTART, the anaesthesia technicians association).  137 delegates, mostly anaesthetic technicians from hospitals all around the country, traveled to Lomé for the two-day workshop.

Delegates broke into small groups, taking shelter from the Togo sun (humid!) –

– and went through the tutorial, workshop and discussion of the Lifebox education programme, which is so crucial to the solid understanding and communication that builds long-term change.

Mercy Ships had also purchased 22 Lifebox pulse oximeters, which were distributed to attendees from hospitals without access to a single monitoring device.

This is just the beginning.  Lifebox is coming back to Togo for a workshop later this year, this time aiming to meet the oximetry need in all the ORs in the country. We can’t wait.

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Just so splendid

You might remember Benson Nfon Tanjong, president of the Cameroon North Westerner’s Association of Anesthetics (CAMNOWAA), from the photo below.  It was taken last year in front of the available monitoring equipment at his hospital – none of it functioning:

Lifebox sent an oximeter and the hospital found funding to buy some additional units. But Benson told us some very difficult stories about his anaesthesia practice, and we knew that these few units wouldn’t be enough to keep patients safely monitored in the operating rooms across the region.

That was back in October.  Coming on for a year later, we prefer to picture Benson from the photos below: behind the camera, in dappled sunlight, coordinating a workshop that has put 37 pulse oximeters into 19 hospitals across the north west region of Cameroon!

Benson introduced Lifebox to a congress of anaesthetists in May, in the port city of Douala. He reported that a significant number of operating rooms were without pulse oximeters, and that anaesthesia providers were eager – and impatient! – to put together a plan for a thorough needs assessment, workshop and rollout.

So things moved quickly.  The date was fixed, and Benson spent several days traveling across the region to confirm invitations (the only time that pulse oximetry and party planning converge), the oximeters were shipped, local faculty secured, and after a brief tussle with customs clearance the CAMNOWAA Bamenda workshop was underway.

35 participants and five faculty arrived at the CBC Women’s Union from miles around, many taking precious time away from work to stay overnight in Bamenda and attend the workshop.

The faculty ran through the Lifebox education programme – tutorials exploring everything from the physiology of oxygen transport to how to clean a pulse oximeter probe, and clinical scenarios where anaesthesia providers were free to talk through the many different types of cases they needed to be able to handle on a daily basis.

“The education materials were just so splendid, especially the clinical scenarios which were very interactive,” Benson told us happily.

“The workshop registered a huge success, and I am very grateful about that,” he continued, a few days later.  “It was really exciting.  I am having so much pressure from other provinces as to when they will have their own oximeters.”

For more information about Lifebox workshops, and how you can get involved, please visit www.lifebox.org – we couldn’t say it better than Benson, your support would be just so splendid!

Challenge Accepted!

When we first heard about the Boston Lifebox Challenge earlier this year, we knew better than to get caught in the crossfire!  We watched as ideas, enthusiasm and events ricocheted across the city, and are thrilled to duck and share, with our thanks, the below article  straight from the website of one of the challengers:

“When BIDMC Anesthesiology Residents heard a presentation about how the lack of a simple monitoring device was leading to patient deaths in third world countries, they were inspired to end this problem.

After hearing Alexander Hannenberg, MD, Associate Chair of Anesthesiology at Newton-Wellesley Hospital, speak about his involvement with Lifebox, the residents rallied to action. Lifebox provides clinical staff in developing countries with pulse oximeters. These devices measure a patient’s blood-oxygen level and are considered a standard of care in the United States.  Lack of pulse oximeters in operating rooms and recovery areas in the developing world can lead to unnecessary complications.

“Patients can suffer complications or even die if they are not being monitored by a pulse oximeter,” Brian O’Gara, a BIDMC Anesthesia resident said in an interview. “We call this avoidable mortality.  We saw this as an opportunity to save lives and thought it would be a great project.”

Dr Brian O’Gara and Dr. Neesann Marietta, Lifebox Challenge heavyweights

A friendly competition among Anesthesia Residency programs at Boston hospitals ensued in the winter of 2011 through Spring 2012. BIDMC’s residents held bake sales, hosted a breakfast event and organized a charity golf tournament to raise funds. Six months later, they were deemed the winners of the “Lifebox Challenge” having collected nearly $6,000. But O’Gara knows the real winners are the patients who will benefit from ORs stocked with pulse oximeters.

Putting for pulse oximeters

“I worked in Ecuador and Tanzania in medical school and I know what the needs can be,” O’Gara says. “I am grateful for the support from our department leadership because they gave us the time and financial support to make this project a success.”  Resident leadership for the Lifebox Challenge came from Drs. Ann Hau, Neesann Marietta, and Brian O’Gara.  Important contributors and volunteers included Drs. Pete Panzica, Yunping Li and Kristen Telischak as well as CRNA Arpana Bachireddy.

O’Gara says other departments also supported the cause including the PACU, OB, and Perioperative Nursing Staff. Even though the Lifebox Challenge has concluded the effort to support safer surgery worldwide continues on, as O’Gara says they will continue to host events to raise money for Lifebox. For more information about this charity, visit www.lifebox.org.”