As a regional anesthesia and acute pain medicine fellow, I will be utilizing my training to provide nerve blocks for surgical anesthesia and improve postoperative analgesia for patients in Kigali, Rwanda. With outdated anesthesia machines, lack of standard American Society of Anesthesiologists monitors available and medication shortages, the ability of anesthesiologists in Rwanda to be able to perform surgeries under regional anesthesia is paramount. In addition, analgesia after surgery in Rwanda is fairly limited, so the increased use of regional anesthesia will greatly benefit Rwandan patients. An important part of my trip will be to help teach the anesthesiology residents and attendings how to perform nerve blocks so that they can continue to help patients and hopefully teach others as well. I will be providing education both in the clinical perioperative setting as well as outside the operating room via didactics for the residents.
This two-week project will take place at University Central Hospital of Kigali in Kigali, Rwanda. I hope that my time in Rwanda will benefit the residents, attendings, patients and hospital staff in Rwanda and surrounding countries. Teaching ultrasound guided regional anesthesia will help broaden the skill set of Rwandan anesthesiologists and allow them to perform nerve blocks when applicable instead of placing patients under unnecessary general anesthesia.
The expected impact of this mission is to provide anesthesiology residents and attendings of Kigali, Rwanda the tools they need to provide safe and effective regional anesthesia. The impact of educating future anesthesiology residents in Rwanda will carry forward for many years as they go out into rural communities and provide anesthesia in areas that may not be able to provide safe general anesthesia and/or teach the future generations of anesthesiologists in Rwanda and surrounding countries.
I had the privilege to travel to Kigali, Rwanda in February 2020 to help provide regional anesthesia for Rwandan patients and teach the University of Rwanda anesthesiology residents regional anesthesia so that they can continue to utilize this invaluable technique in the future. The anesthesiology residents were eager and grateful for the opportunity to learn how to perform nerve blocks to better care for their patients despite their limited resources. While it was initially jarring to see the limited resources of the University Central Hospital of Kigali (CHUK), the residents were motivated to learn at every opportunity.
As a regional anesthesia and acute pain medicine fellow, I was able to provide education to the residents both in and out of the clinical setting. During the resident’s didactic day, I lectured the residents on regional anesthesiology as well as provided hands-on experience with scanning live models and practicing in-plane technique with phantom gel models. In the perioperative setting, most of the blocks were done for orthopedic trauma patients, as well as elective orthopedic procedures, mainly focusing on teaching and performing brachial plexus, femoral and sciatic nerve blocks. There were also a number of pediatric orthopedic cases we were able to provide regional anesthesia for.
It was an honor and privilege to work with the anesthesiology residents at the University of Rwanda and gave me a deeper appreciation for the resources and education that I receive and the importance of sharing these to those who eagerly and genuinely want to provide better care for their patients in a low resource setting.