mothersofafrica's blog

The Students....

By Dr Sara Hunt

The three of us are going to be teaching thirteen students.  The group is a mixture of 2 absolute novice nurse anaesthetists, 8 students who are now in the second and final year of the course (all of whom are familiar to Dave and myself because of our trip last year) and three new students from the teaching hospital in Monrovia. It’s lovely to see old friends again especially Mother’s Of Africa sponsored student Martha Yollain. On the first day we split the group into two teams for some quick fire questions. The results are impressive. It is very clear to me that the students I taught last year have now gained a good knowledge base. Which we hope means that, along with all the local teaching they receive, we are doing something right!

  The students are a very mixed bunch – although mostly just out of nursing school, some are in their 30’s or 40’s with families they have left behind in remote villages while they live on compound to learn and progress. Many of them are even running other jobs at the same time !!

 

The set up...

(by Dr Sara Hunt and Dr Sue Catling)

 

 

 

Phebe Hospital houses the original Anaesthetic Nursing teaching programme for Liberia, however there is now only one medically qualified anaesthetist in the whole country. A teaching programme has just started but currently all the anaesthesia is delivered by the nurse practitioners who are unsupervised by medical anaesthetists. The aim of training is that they will perform at the standard of trained medical anaesthetists….so our teaching was to be of the standard delivered to UK anaesthetic trainee doctors.

 

 

We taught daily in the recovery area of the operating theatres,  (pic 1 : teaching in the recovery area of Theatres – power but no windows!!) which had power from the generator most of the time,  and in the school of nursing  (pic 2 : “teaching in the nursing school – windows but no power!”) – which didn’t, but which had large classrooms with a big veranda outside. We usually worked  from 8.30 till 5 with a break for lunch, and we used every method we could think of – PowerPoint when there was electricity, chalk and board, quizzes  in teams, real-life “simulation “ with mannequins, acting out patient problems, - we even had 2 of us pretending to be molecules in order to demonstrate a basic point in physics!!!! (yes, that was worth seeing – Oscars for Sara and Dave’s performance of Boyles law!!)

 

Pic 1    Pic 2

 

The plan was to stay on site on the hospital compound. When we arrived on day 1 (after 20 hours of travelling) we discovered the house we’d been assigned had only two beds (there are three of us)  no fridge, no water and ..worst of all … no mosquito nets. Not great in a malaria ridden area! And even more worrying to hear an experienced nurse say he didn’t “believe” in mosquito nets .....what???

As team leader my sense of humour began to fail at this point but we managed to negotiate a move into the house I stayed in on the 2009 trip.-Massive relief.

 

There was a hospital canteen  -The Flagpole Cafe - that produced food for the students ; mainly rice with river fish – which to our western palates were very bony- and “river greens” which tasted a bit like spinach. The overall effect was like a fish and spinach curry but without the curry. (We later discovered that they were in fact being kind by not adding the local chillies to the food for us ..........!!) It also was our source of bottled water, for which we were very grateful.  The food was perfectly adequate and nutritious, and came in giant portions - but after just a few days we were dreaming of pizza  chips and ice cream !!!!  (pic 3 : ” the girls at the flagpole canteen”)

 

 

pic 3

 

The house we eventually moved into had a resident cook – John, organised by the doctor who was already there, and for a few dollars a day, he cooked lunch for us every day. It was the same basic food as on offer at The Flagpole, (with chillies on the side as an option ) -  but he also found us bananas, papaya and pineapple. John  was a godsend, and was very happy to increase his output to feed all of us – he made a big difference to our well-being and comfort in Phebe. Thank you John. (pic 4 : John the cook ).

 

 

 

A quick introduction to the team...

 

Introductions (by Dr Sara Hunt)

 

I think we had better introduce ourselves before we go any further.

My name is Dr Sara Hunt and I have the grand title of “trip lead” for the 10 day teaching trip to Phebe Hospital. It has to be said that at some points during the organisation of this trip I had wished I wasn’t trip leader, but I suppose everyone feels that way when you’re organising such a complicated trip!

I’m a consultant Anaesthetist in the University Hospital of Wales, Cardiff.

This will be my second visit to Liberia with Mothers of Africa so theoretically “I know the score”, but I’m not sure you can ever be fully prepared for something like this.

Accompanying me is Dr David Place who is also a consultant anaesthetist at UHW and who specialises in Cardiac Anaesthesia. He has undertaken several trips to Africa before and has also previously visited Phebe. Best of all he has a diploma in tropical medicine so we are relying on him for his expert opinions if anything crops up we haven’t seen before in the wilds of Cardiff.

Last but by no means least is Dr Sue Catling, a consultant anaesthetist who works in Singleton Hospital in Swansea and specialises in Obstetric anaesthesia. She has NEVER been to Africa before and, having attempted to “brief” her on what to expect, I’m surprised she still wanted to come at all!

 

So why did I come? (Dr Sue Catling)

 

 I suppose the answer is that despite my apprehension about personal safety and health risks I felt that I could really contribute to this idea. What have I acquired all my teaching skills for over these past years if I can’t put them to use in a totally different environment? Partly I wanted to help this poor, war-torn country restart their anaesthetic service, and partly I wanted to test myself, and see whether I can be sufficiently flexible to teach in such an extreme setting. Partly selfless and partly self-centred I suppose. 

And what did I find?

A hospital with critically limited resources – e.g. they’d recently had no oxygen because the oxygen concentrator had broken down,, but with students so keen to learn that they absorbed knowledge like sponges and were scoring up to 88% in formal exams (written and OSCEs)  by the end of the visit. A hospital with no equipment for barrier nursing, but where nurses willingly admit and care for Lassa fever victims to the best of their ability. A hospital where the students are dependent on outside aid for their books and teaching materials, but who use what they have with such enthusiasm and dedication that they would put many UK anaesthetic trainees to shame. One would almost think their lives depended on it.

Would I go back? Absolutely!  Pass me my chalk, who needs powerpoint!!

Liberia February 2010

 

The first Mothers of Africa teaching trip of 2010 was from 8-17^th February to Phebe, Liberia - a country on the West coast of the continent that is still recovering from a civil war that left hundreds of thousands dead and devastated the economy.

 

Three consultant anaesthetists from the Welsh NHS (Dr Sara Hunt, Dr Dave Place and Dr Sue Catling) left their usual work for two weeks to live with and teach Liberian anaesthetic nursing students in the hope of improving their medical education, and ultimately kick-starting Liberia’s anaesthetic service.

The following posts are aimed at giving you an insight into their experiences and the lives of the Liberian students – what are the challenges facing Drs there? How do students learn when every teaching resource must be sourced from outside the country? What’s it like working in a hospital where the electricity generator can stop because the  diesel supply  runs out, where the water is pumped from the local river, and where having malaria is ‘like having a cold’?

All posts have been written by the Drs from the trip but have had to be uploaded retrospectively due to the complete lack of internet connection in the region while they were there.

Mothers of Africa - who are we?

Mothers of Africa is a Medical Educational Charity that trains medical staff in Sub-Sahara Africa to care for mothers during pregnancy and childbirth.

Did you know....

A Boeing 747 of mothers die in childbirth every single day in Africa.

In Africa a woman’s risk of dying from treatable or preventable complications of pregnancy and childbirth over the course of her lifetime is 1 in 22, compared to 1 in 7,300 in developed regions.

In a country like Benin, there are 11 anaesthetists in a country of 11 million. There are 140 anaesthetists in Cardiff alone!

Goal 5 of the UN’s Millennium goals is to decrease maternal mortality by 75% by 2015. It is a big goal, with big international talk and support. There is some progress, but in the meantime Mothers of Africa is making a real and practical difference.

Since the charity started in 2005, 15 trained anaesthetists have travelled to Benin, Togo, Ethiopia and Liberia to support the training of health care workers in these countries. We hope that this training empowers the people of these countries to improve their own provision of healthcare in a sustainable way.