Tag Archives: Healthcare

Potholes, pulseoximeters and pyramids

The Ambatondrazaka Anaesthesia Team get hands on with the new pulse-oximeters

The Ambatondrazaka Team get hands on with the new pulse-oximeters

The journey to our second of 20 hospitals in Madagascar turned out to be quite an adventure! The long and winding road that leads to Ambatondrazaka is an 827km round trip from the Africa Mercy in Taomasina, and gets some pretty heavy use from large trucks carrying timber, rice, and other goods. So many thanks to our team co-ordinator Ali who negotiated 12 hours of road like the one below to get us to our destination! When the rain stopped however the view was truly beautiful.

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On our arrival we were joined by a local translator named Leah, who often works with the local Peace Corps. The team at Ambatondrazaka are very busy, serving as a regional referral centre and trauma unit for a very large region, so it was fantastic to have 24 people from their team join us over the 3 days to develop their own local version of the WHO Checklist for use in their operating theatres.

Simulation sessions in the operating room allowed all the members of the team to get used to using this safety checklist tool, and many commented in the course feedback how they enjoyed seeing the effect of using this system on team spirit, encouraging open and effective communication, helping to keep the patient safe by dealing with potential problems before they arise.

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It was my privilege to deliver a teaching session on monitoring and managing oxygen levels during surgery in my slowly improving French, with help from Leah to translate into Malagasy! As Bear Grylls loves to remind us in his survival programs, you can only survive around 3 minutes without oxygen, so the new Lifebox pulse-oximeters we brought with us enable the team to detect and manage falling oxygen levels much earlier during the dangerous time during and immediately after surgery when problems with oxygen delivery are frequent and potentially fatal. These units really are little ‘boxes of life!’

The anaesthetic team including a doctor and 3 anaesthetic nurse practitioners immediately put the teaching to use in the afternoon with managing a simulated hypoxic episode in the middle of surgery using the treatment algorithm for falling oxygen levels.

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As with all the hospitals we are delivering training in, we plan to follow up in a few months and see how this team is doing, so it is very exciting to see the passion and commitment of these Malagasy colleagues to develop their teams and give the best possible care to their patients.

After a short break on the ship, the Checklist team will head out to our next hospital for our biggest course yet, I won’t be back to the Ship before December so will get used to living out of a suitcase for the next 2 months!

I almost forgot the pyramids… Rice is a several-times-a-day feature of the gastronomic experience here, but this presentation in Ambatondrazaka was a spectacular first!2015-09-23 19.54.59

Welcome to my Madagascar blog!

Hi! My name is Linden. From August 2015, I am taking a year off from my training as an anaesthetic doctor in London to work in Madagascar with a team from Mercy Ships and Lifebox. I will be posting updates and reflection on this blog as I go.

For the first time in history, you’re more likely to be killed by a surgically-treatable condition than an infectious disease. However millions of people around the world don’t have access to safe surgery and anaesthesia that can save and transform lives. Mercy Ships and Lifebox are two organisations working hard to see that picture change.

The charity Mercy Ships run the world’s largest non-governmental hospital ship, the Africa Mercy. She is staffed almost entirely by volunteers and brings medical care to some of the world’s poorest people.  I will be joining her during her second field service in Madagascar.

After 2 weeks in the operating theatres on board the ship, I will spend the next several months travelling in a small team of local and international volunteers from Mercy Ships partnering with the NGO Lifebox. We will be bringing vital medical equipment (including pulse oximeters which monitor blood oxygen levels- see below) and team training to hospitals all across Madagascar, supporting them in providing safer surgery and anaesthesia. If you would like to get updates please feel free to subscribe using the button on the right hand side of this blog! You should also be able to access updates via my twitter and Facebook accounts. Thank you for your support and I hope you enjoy the blog!