Sara (Hebbeler-Pittenger) Pittenger, MD
Sara (Hebbeler-Pittenger) Pittenger, MD
Anesthesiology · Chapel Hill, NC

UNC Project Malawi

September 6th
Lilongwe, Malawi

Project Description

The University of North Carolina, Chapel Hill has a long-standing relationship with Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. Specifically, the department of anesthesiology has a dedicated mission to send an anesthesia care team (2 faculty and 1-2 residents or fellows) twice a year to participate in both direct anesthesia medical care as well education for local anesthesia officers and other medical providers. This work is further support by institutional relationships that promote ongoing education for the local medical teams and the support of medical supplies throughout the year.

My direct clinical role while in Lilongwe will be focused on pediatric anesthesia care and education in pediatric anesthesiology. We will participate in daily didactic sessions, real time clinical support, and will carry out a regional anesthesia workshop while at KCH.

This will be the first mission trip to KCH following the COVID pandemic and our team will focus on reestablishing relationships with the Lilongwe medical team, reassessing ongoing needs, and reinvigorating the educational mission. It is an honor to be able to return to this important service!

Population Served

Located in Southern Africa, Malawi is one of the poorest countries in the world with the population economy dependent largely on agriculture. Access to health care in this impoverished nation and incredibly limited, as is the prevalence of physician-based medical and surgical care. Approximately 95% of clinical anesthesia care in national hospitals in Malawi is provided by clinical officers in inconsistent and poorly supplied conditions - including lack of electricity, limited/no access to anesthesia machines, and medication shortages.

This project focuses on the education of existing clinical officers at KCH in order to improve their ability to provide care for this high need population.

Expected Impact

The impact of this project is both immediate and sustainable. While direct hands on care impacts only a limited population, educational efforts for the KCH anesthesia house officers and other medical providers will have lasting impact. Prior trips for this organization have introduced care practices such as regional anesthesia which is both cost effective and has a higher safety profile. We will present a daily didactic series addressing a wide variety of clinical topics and accompanying tangible resources (cognitive aids) to stay with the anesthesia house officers for future reference. All shared material will remain with the team at KCH for their use.

Trip Photos & Recap

This trip to Kamuzu Central Hospital (KCH) in Lilongwe, Malawi was an incredible opportunity for our team and for the Anesthesia Officers in training there. Over the course of my 2 week stay in Lilongwe, we were able to carry out daily classroom didactic teaching, low fidelity simulation and hands-on procedural and conceptual teaching in the operating theaters. We were also able to provide direct medical care for a variety of complex pediatric and adult patients and in doing so work side by side with the local Malawi medical team. The anesthesia officers were incredibly receptive to the teaching provided and many still keep in contact with our team to share interesting cases or to ask questions. It was a very rewarding and eye-opening opportunity that I am grateful to have experienced and I look forward to returning to Malawi in the near future to continue this important educational endeavor.