I will be planning to both practice anesthesiology and teach the fundamentals of anesthesiology to training nurse anesthetists and anesthesiologists. I will be providing education both in the operating room and outside of the operating room via didactics and organized simulation sessions. The simulation sessions will include but are not limited to the practice of regional anesthesia, neuraxial anesthesia, and ACLS/intraoperative adverse events. Didactics will be held most evenings throughout the week and will be both powerpoint and discussion-based learning activities.
Malawi is considered a low income country according to the World Bank. It is also documented throughout the literature that there is a severe shortage of both surgical and anesthesia practitioners and resources within the country, which is heavily burdened by both acute and chronic medical illness and diseases, including HIV and malaria. It is thus my hope that the entire population of Malawi will benefit from this project. Although my scope of practice will be limited to only a few hospitals in Lilongwe, Malawi, because I will spend a majority of my time teaching nurse anesthetists and anesthesiologists, these individuals will then be able to take this knowledge and provide anesthesia throughout the country.
The expected impact of this mission is to provide anesthesia practitioners within Malawi the tools that they need in order to provide safe anesthesia moving forward, which is the exciting prospect of this mission. Not only will I be able to provide direct patient care and impact patients in that way, but I will also be able to have a lasting impact through the anesthesia practitioners that I help to educate during my mission. Further, the hope is that this is the beginning of a long-term education plan that UNC will establish in Malawi such that UNC is able to provide a nearly continuous education program to anesthesia practitioners.
Our mission for our trip to Kamuzu Central Hospital was to both contribute to patient care and the education of the anesthesia providers within the facility. We spent the majority of our time in either the operating rooms or the intensive care unit and most of our teaching was done in an informal setting while caring for patients. We also provided organized lectures and discussion-based sessions several afternoons each week as well as an ultrasound/regional anesthesia workshop one weekend. It was clear throughout our time in Malawi that all of the medical providers were very excited for us to be there and to be available to help them in any way possible. Our hope is that we continued to strengthen relationships with the providers at Kamuzu Central Hospital and provided them with an improved level of knowledge so that they are able to better provide safe care for patients in the operating rooms and the intensive care unit. We also are working on several research projects with members of the anesthesia department at Kamuzu Central Hospital, including one to decrease their failure rate of spinal anesthetics and another to improve their pre-operative antibiotic and timeout compliance.