I will be working at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi through the University of North Carolina Hospital’s (UNCH) Project-Malawi program; a collaboration between UNCH and the Malawi Ministry of Health. This is one of two teaching hospitals in the country, which is especially important for educating anesthesia providers. Access to anesthesia care is extremely limited in Malawi. There are 2-3 anesthesiologists in Malawi, so providers who primarily care for patients in the operating room are known as clinical officers. The majority of my time will be split between education and simulation for the clinical officers, working on a quality improvement project to improve the safety of delivery anesthesia care in a resource limited setting, and directly caring for the patients in the operating room.
I will work with local Malawians as patients, students, and healthcare team members. More than half of the population in Malawi lives under the poverty level; many people have few resources, including limited access to healthcare. In addition to providing safe care in the operating room as clinicians, the training we provide for the clinical officer students will be benefit the country as the anesthesia providers are disbursed around the country after completing their education.
This project continues to foster continued collaboration between anesthesia residents from UNC and physicians and trainees in Malawi, and I am honored to be a part of this group of healthcare providers. In the operating room, the collaboration allows for surgical teams and anesthesia providers practicing in different circumstances to work together and learn from each other to help both sides improve their understanding of medicine. The clinical officers will hopefully be better prepared to provide anesthesia care after participating in the interactive didactics and simulations. I also hope to better prepare these learners for improved crisis management. I also plan to complete a small QI project to improve the safety of anesthesia care at KCH.
This medical rotation was very beneficial in my education - learning how to problem solve and trouble shoot in a low resource environment helped improve my critical thinking skills and crisis management. I spent most mornings providing lectures to the anesthesia clinical officers, reviewing ACLS, cardiac arrhythmias/EKG interpretation, and the difficult airway algorithm both with PowerPoint lectures and interactive simulation. I also helped with on a QI project for improving the efficacy of spinal analgesia for Caesarian section. The rest of my day was directly caring for patients in the operating room and ICU, where bad outcomes are common and I worked with the anesthesia team to provide the best possible patient care.