January 16-17, Butare Rwanda.
More info and signup at zeropain-rwanda.com.
January 16-17, Butare Rwanda.
More info and signup at zeropain-rwanda.com.
The University of Alberta Division of Otolaryngology and Office of Global Surgery are seeking the assistance of an Anesthesiologist to join in a surgical partnership with Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya. This would involve administering a one-day advanced Airway course, as well as involvement in some of the rest of a 10 day series of workshops.
The full letter describing the opportunity is available here: AnesthesiologistForMTRH_Oct2019.
Is so, consider applying to be a resident member on the Canadian Anesthesiologist’s Society International Education Foundation Board of Trustees! We are now seeking one resident member to join our Board of collaborative and inspiring experts from across the country. Your role will be to help represent the trainee voice, help to grow our network of like-minded residents and fellows, and find new ways to spread the word about the important work we do.
Find out more here (PDF).
If you have any questions, don’t hesitate to drop us a line at email@example.com.
Location: Calgary Telus Convention Center
Date: Sunday, June 23, 2019
Location: Calgary Telus Convention Center
To register: Go to casconference.ca, or click here.
Description: This workshop is intended for people who may not have any global health/overseas practice, or may already be doing some but are interested in other options. It will be an interactive workshop session, with an expert panel and lots of opportunities to ask questions.
More information, including panelists, in the promo poster (PDF).
In the past 50 years, MSF has become a major player in the world of medical humanitarianism. When people think of MSF, many images and questions come to mind. Is it for me? Can I leave on short missions while continuing to practice in Quebec? Should I go once I have retired? After my residency? What is security like on the ground?
Inspire Through Clinical Leadership and Inspire Through Quality Improvement and Patient Safety will be hosted on the same domain, and news and contact information for all three courses will be available there as well.
Following on from our exciting developments in India and Bangladesh last month, this month we take you to Bujumbura, Burundi, where Lifebox and local partner ATSARPS (Agora des Techniciens Supérieurs Anesthésistes Réanimateurs pour la Promotion de la Santé) organized a pulse oximetry workshop and distributed pulse oximeters to each of the country’s 54 public hospitals. With 46 anesthesia providers in attendance, the workshops were covered by national media. Read more here.
Sept. 5-9, Prague, Czech Republic
The 17th WFSA World Congress of Anaesthesiologists is proud to announce four competitions!
Three of them are for country entries and one is for individuals. Winners will be announced at the Closing Ceremony besides the winner of the individual competition, there will be a chance to win two Congress Dinner tickets which will be given at the first day of the Congress. You have a unique opportunity to support your country or win two tickets to the best social evening of the Congress.
It is easy to take part! Click on the competition below if you would like to know more (this will take you through to the WCA website).
No matter how much international experience under your belt the initial days in a low-income country are a medical seismic shock with potential register on the Richter scale. Call it medical jet lag. A recalibration is required that necessitates a reconsideration of what you take for granted at home. My approach is to listen and simply absorb. The surgical cases are very much the same but disease processes also very different. Medical presentations are more advanced as access to definitive treatment are more limited.
A well-trodden medical maxim states that when you hear hoof beats think horses rather than zebras. It is used to illustrate the point that uncommon presentations of common diseases occur with greater frequency than rare conditions. In Abyssinia the zebras are the horses.
Anesthesiologists were in the bathroom or asleep at the wheel when job titles were being handed out. Most people can’t pronounce it, no one can agree on how to spell it and even other physicians don’t really understand what we do. We are the witches and warlocks of the medical world. “Life guard” would be more appropriate but instead that moniker was coopted by teenage babysitters in speedos. All the credit to them and the marketing firm that locked down the term. It stands to reason. The anesthesiologist’s role is to suspend consciousness, maintaining normal physiology and guard life while the barbaric acts are performed, which under any other circumstance would constitute torture. Needless to say that the invention of anesthesia is one of the greatest human achievements of all time, right up there with the domestication of fire and the printing press. I say we go toe to toe with the pool kids and let the chips fall where they may.
There is a ying and yang between surgeons and anesthesia colleagues; an interdependence that takes place through the mutual care of our patients. One requires the other and alone they serve no functional purpose. We are partners in an elaborate dance where the patient sets the tune, surgeon decides the steps, and the gas passer sets the dance floor. In high-income countries the symbiotic surgeon-anesthesia relationship has an equal power dynamic and modern medicine has finally recognized that the patient is the one ultimately in charge. In Canada, surgeons and anesthesiologists require five-year training programs alike for a sum total of 13 years of post-secondary education. We stand on equal footing in the operating theatre and frequently collaborate on choosing the best approach for a surgical journey for the patient.
The shortage of anesthesiologists and surgical load in low-income countries has resulted in a shift to use non-physician anesthesia providers with less training to fill the gap. Today the mainstay anesthesia providers in Ethiopia are anesthetists. They provide very good care and are technically quite skilled within their scope of practice. Some surgeons may prefer the anesthetists as they may be more willing to take direction without protest. Pesky anesthesiologists have a tendency to voice concerns and suggest elective surgical procedures be coordinated with the overall health of the patient to ensure optimal conditions and a reduction in postoperative complications. We often insist pain management strategies such as an epidural, which can be perceived to consume precious operating time and threaten case cancellations, all in the best interest of the patient.
Part of our role is to encourage collaborative decision making in concert with our surgical colleagues while demonstrating techniques and providing advice on anesthetic plans to ensure a safe surgical course. The first few days require acclimatization to the patients, their conditions, the surgeries and the flow of the hospital. Once you know where to find the bathroom with running water and remember to bring your toilet paper you can focus on clinical care.
Jason McVicar, February 25 2019
How’s that for the next summer blockbuster? Who am I kidding, in film anesthesiologists are akin to wardens: a plot device reserved for wallflowers or villains.
I’m back in Addis on the garden terrace of the Ghion Hotel. From this little government sponsored oasis, combined with jet lag, and a St. George premium lager I could convince myself I’m almost anywhere. Except Ottawa. The polar vortex and snow squalls clearly don’t reach the northern ridge of the Great Rift Valley.
It is exciting to be back at the Black Lion Hospital and Addis Ababa University in the Ethiopian capital. I’m working again with the Canadian Anesthesiologists’ Society International Foundation or CASIEF for short. It’s not a sexy name like Save the Children or World Vision but this charity does great work. CASIEF is a scrappy little organization built on the vision of benevolent anesthesiologists 50 years ago. The charity’s first date was in Nepal and evolved with a successful courtship in Rwanda built on the dedication of a few very dedicated souls such as Drs. Jeanne, Angela Enright, Franco Carli and Patty Livingston. Today relationships also exist with the anesthesia programs in Guyana, Burkina Faso and here in Ethiopia.
The CASIEF model is one built on relationships: Education Development would best characterize the mission. The model primarily consists of a visiting professor program from Canadian institutions where teachers travel to assist with clinical teaching in the operating theatre and deliver lectures with a partnership to assist with curriculum and professional development. Teach a friend to fish type thing but the learning is truly bidirectional. As trust is built the scope spreads across a variety of domains such as leadership, professionalism and research. The mandate is to collaborate with partners to build capacity for safe, sustainable anesthesia and perioperative care through education, knowledge translation, and advocacy. Like any engagement there are fits and starts but the long term evolution of growing yesterday’s students into today’s professional leaders is remarkable.
I didn’t forget my laptop this time. On the last visit in 2017, I managed this same trek only to leave the lifeline to all my educational materials in the seat pocket of the commuter flight in Toronto- a teacher without tools. The residents on the trip, Sophia and Karim, came through with resources and expertise. Having that pesky final Royal College exam at the end of 13 years of training on the immediate horizon has wide-ranging benefits both at home and abroad. We provided operating room table-side instruction by day and crammed lessons together by night at the hotel. Often the teaching topics were requested the day before. Our routine most evenings would consist of huddling in the hotel lobby scouring resources and cobbling to together lessons while making small beer sacrifices to Etherna, the undisputed God of Wi-Fi as she teased us with broken links to pearls of pharmacology and physiology. It was the best of times, it was the worst of times.
Humanitarian parlance has an old adage, “This isn’t our first rodeo.” This is my third visit to Addis Ababa. There is something special about returning to a place you have visited before. You never really go back to the same place. Change is inevitable. Development and progress relentlessly march forward. Roads are paved, buildings fall and get put up, mostly by the Chinese in these parts. There is a growing familiarity but I am not exactly the same person on each subsequent visit. Traveling as a wide-eyed medical student or first time faculty carry an innocence that fades with each return. Small quotidian familiarities appear in subtle ways. The warm blast of the first breath of sub-Saharan air on the tarmac, the texture of enjera and kitfo cuisine and the thousand yard stare of a grizzled wanderer to ward off touts comes more naturally with each arrival.
There is a personal cost to being away from family. I’ll be honest, dread creeps into the last day before any overseas work travel now. It hasn’t always been this way but every trip since we started our little family has an element of regret. Kids change things.
Humanitarian work, if that is what I am going to call this, is rather incongruent to family life. The demographics of the volunteers or aid workers are very bi-modal: pre and post children. The challenges of leaving a family with household kids at any age are a significant barrier. You often have to call in supports from friends and extended family. I am certainly grateful to those in our lives who have helped us get through these strained times. I just video called home and my 4-year-old son refused to acknowledge me. The two year old was genuinely happy to see me and had the inquisitive instinct to ask again where Ethiopia was. The debts incurred will have to be repaid.
Back into the theatre tomorrow. All the world’s a stage…
Jason McVicar, February 15 2019