Stephen Acosta, MD
Stephen Acosta, MD
Anesthesiology · Chapel Hill, NC

UNC dreaming Malawi Africa

October 19th
Lilongwe, Malawi

Project Description

I traveled to Malawi earlier this year as a CA3 Anesthesiology resident. I spent a month as one of the first residents to participate in this new UNC Department of Anesthesiology Global Health Elective Rotation at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi.

Graduating at the end of June I plan to return later this year as UNC Anesthesiology faculty. My mission this time around will be two fold.

1. I will be acting in a new role supervising two Anesthesiology residents from UNC that will be on their global health elective at KCH. I will also be providing clinical and didactic education to Training Anesthesia Clinical Officer Students (TACOs) along with simulation training for the students and clinical officers.

With only 2-3 Anesthesiologists (MD) in the entire country of Malawi it is important that we help with the education of Anesthesia Clinical Officers in order to promote a safe surgical environment.

2. I plan to start a Quality Improvement Project focused on antibiotic administration before surgery. The goal of this project is to help reduce surgery related infections at KCH.

Population Served

Malawi medical officers and surgical patients in Lilongwe Malawi. Malawi is one of the poorest countries in Africa with limited access to healthcare.

Expected Impact

The World Health Organization's "Safe Surgery Saves Lives" initiative has set out to improve the safety of surgical care around the world. Anesthesia care is crucial to this initiative and I believe education is one of the building blocks to help achieve this goal.

The TACOs we will be working with are the future of safe Anesthesia care in Malawi. Education is long lasting.

Trip Photos & Recap

I was an Anesthesiology resident when I first visited Kamazu Central Hospital (KCH) in Lilongwe, Malawi in January 2018. Having graduated since then I was fortunate to return to KCH as an Attending Anesthesiologist this past month. It was exciting to be back. Their six new operating theaters had opened up and the Training Anesthesia Clinical Officers (TACOs) I had helped teach and train back in January were getting close to graduating from their program; a few of them would staying on as staff at KCH. My primary role this time was to supervise the two UNC Anesthesiology residents that would be spending four weeks in country on their Global Health Elective rotation. The two weeks I spent in Malawi flew by, but it turned out to be a productive trip. The highlights of my time included:

Worked on a project entitled “Quality Improvement Study to enhance efficacy of Spinal Anesthesia in a LMIC through education and standardization”. During this visit we provided a lecture on Spinal Anesthesia to the Anesthesia Clinical Officers and rolled out a spinal anesthesia protocol for Obstetric and Gyn surgeries.
Started work on another Quality Improvement Project focused on perioperative antibiotic administration.
We purchased 38 chairs for their Anesthesia classroom with funds raised by my colleague Aravind Reddy. While in Malawi with me in January he had scrub caps made with local fabrics by a local tailor. Sales of those caps where donated for purchasing the new chairs.
Clinical training in ultrasound guided brachial plexus nerve blocks utilizing the Ultrasound machine that was donated by UNC during this trip. We still need to work on getting a reliable supply of nerve block needles.

Thanks to the Dox Foundation for helping support this trip allowing us to contribute to the education and quality of anesthesia care at Kamazu Hospital.