CASIEF RWANDA

Download the CASIEF-Rwanda volunteer guide. Rwanda suffered a devastating genocide in 1994, after which there was only one anaesthesiologist in the country for years. Despite a remarkable countrywide regeneration, Rwanda had only a few consultant anaesthetists by 2005. CASIEF was invited to assist with anesthesia resident training at the National University of Rwanda (now University of Rwanda). The educational partnership began in 2006.

The program model has been that Canadian and American volunteer anesthesiologists and senior residents visit Rwanda, one month at a time, for resident teaching and capacity building. Since 2010, donations to CASIEF have enabled over 100 volunteers to teach anesthesia in Rwanda and nine Rwandan anesthesia residents to complete electives in Canada. The program has graduated 14 residents since 2006, increasing the number of staff anesthesiologists threefold.

As the number of anesthesiologists in the country continues to improve, the focus has now shifted to strengthening local teaching skills, offering training in sub-specialized areas of anesthesia and collaborative research. CASIEF is mentoring graduates of the program to be educators and leaders in creating Rwandan solutions for improving perioperative care in Rwanda. The ultimate goal of the CASIEF-Rwanda program is to ensure anesthesia excellence in a self-sustaining program.

CASIEF has supported anesthesia in Rwanda through:

• Post-graduate teaching and the development of a full anesthesia curriculum focused on anesthesia in the Rwandan context
• The establishment of a Simulation and Skills Centre for multidisciplinary team-based training
• Collaborative delivery of five SAFE Obstetric Anesthesia Courses for anesthesia providers (mostly anesthesia technicians working in isolated, under-resourced conditions throughout the country)
• The establishment of the Rwandan Pain Society including ongoing capacity building of Rwandan pain management teams

The CASIEF Rwanda Volunteer Guide describes the partnership, local context, and volunteer teaching role in detail. The Ikinya Documentary also describes the partnership and impact.

Volunteer

The CASIEF Rwanda program is not recruiting new volunteers at this time. If you are a previous CASIEF Rwanda volunteer who would like to discuss returning to Rwanda, please contact Dr. Ana Crawford (rwanda@casief.ca).

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ANESTHESIA RESIDENCY TRAINING IN GUYANA

For several years, McMaster University has had a partnership with the Surgery Department at Georgetown Hospital (GHPC) and the IHSE (Institute for Health Sciences Education) in Georgetown, Guyana and they helped develop an independent surgical residency program. However, there was no formal anesthesia training program in the entire country; every physician anesthesiologist received training outside of Guyana. Dr. Alex Harvey, anesthesia program director at IHSE, had a vision of developing an anesthesia residency program and, in 2012, turned to McMaster University Department of Anesthesia for assistance.

McMaster faculty collaborated with Dr. Harvey to develop an anesthesia residency curriculum; the first two residents began the program in 2013. With funding from McMaster University Department of Anesthesia and the International Outreach program of the St. Joseph’s Health System, both residents will complete anesthesia electives at McMaster University in 2016. The program will continue to include elective opportunities for senior residents from Guyana. McMaster faculty facilitate weekly academic sessions for residents in Guyana through videoconferencing.

The goal of this partnership is to help build a strong anesthesia residency program in Guyana. Residents graduating from this program will be able to provide skilled anesthesia care across a range of surgical subspecialties, and be committed to academic anesthesia and building anesthesia capacity within the country. The next step in the development of the residency program in Guyana is to arrange regular visiting faculty to provide clinical and classroom teaching. CASIEF and ASA-GHO have partnered to recruit and coordinate these volunteers.

Volunteer

We are currently recruiting volunteers for 2016-17 who can commit to two-four weeks in Guyana. Please contact guyana@casief.ca for more information or complete the online application.

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CASIEF/TAAAC-ANESTHESIA ETHIOPIA

Ethiopia is a vast, land-locked country located in the north west Horn of Africa region and has a population of approximately 94 million people. There is a critical shortage of anesthesiologists in Ethiopia. In 2015, CASIEF was asked to help recruit volunteers and generally support the ongoing Toronto Addis Ababa Academic Collaboration (TAAAC)-Anesthesia project. TAAAC-Anesthesia is a partnership between the Departments of Anesthesia of the University of Toronto and Addis Ababa University that was begun in 2011. The goal of the TAAAC-Anesthesia project is to increase the number of anesthesiologists practicing within Ethiopia and ensure high-quality anesthesia residency training can be obtained without needing to leave the country.

The AAU Department of Anesthesia had four consultant anesthesiologists in 2011. TAAAC, together with other international partners including the University of Bergen, Norway and Seattle Alliance Outreach, has helped train seven additional residents who have since joined the AAU Department of Anesthesia as faculty. AAU has now committed to training multiple anesthesia residents per year on an ongoing basis and is establishing a local cardiac anesthesia program.

TAAAC organizes three annual month-long teaching missions to Tikkur Anbessa Hospital (Black Lion) – the major teaching hospital for AAU and the site of one of only two anesthesia residency training programs in the country. Trips are composed of two staff anesthesiologists and one-two senior anesthesia residents or fellows. The major focus of each trip is clinical instruction/supervision of AAU anesthesia residents. Team members are responsible for delivering teaching in both the classroom and clinical setting. Clinical care and the provision of anesthesia services remains the responsibility of the designated AAU staff anesthesiologists and there are no on-call duties or responsibilities. Canadian residents and/or fellows are expected to deliver (or assist with) lectures, journal clubs, and trouble rounds to AAU anesthesia trainees and act as peer mentors. There are also opportunities to collaborate or mentor research projects with AAU faculty and trainees.

Team members receive modest accommodation and in country transportation by AAU; airfare to Addis Ababa is provided only for staff members committing to a four-week trip. Canadian residents continue to receive their regular salary while pursing this overseas experience but may also qualify for a travel stipend or honorarium from their own academic institution.

Volunteer

We are currently recruiting volunteers for 2016-17 who can commit to four weeks in Ethiopia. Trips take place in February, April, and October. Please contact Program Director, Dr. Greg Silverman (ethiopia@casief.ca) for more information or complete the online application.

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CASIEF BURKINA FASO

Burkina Faso has a maternal mortality ratio of 371:100,000 live births. Access to safe anesthesia is often not available to pregnant women. Through ongoing partnership, CASIEF hopes to help contribute to improvement in maternal outcomes in Burkina Faso.

CASIEF has been developing a relationship with the Society of Anesthesia and Reanimation of Burkina Faso (SARMU-B) and the anesthesiologists of Burkina Faso for the past few years. Initially, SARMU-B reached out to CASIEF about the critical shortage of pulse oximeters in the country. Through the generous donations of CASIEF members and friends, 117 pulse oximeters and 28 neonatal probes were distributed in October 2013 at a Lifebox Training Course co-facilitated by CASIEF Past-Chair, Dr. Angela Enright.

In June 2015, Professor Naziningouba Ouédraogo, President of SARMU-B, presented at the CAS Annual Meeting in Ottawa. He spoke about the challenges of establishing an anesthesia residency training program in Burkina Faso. At that time, an agreement was reached to deliver the SAFE Obstetric Anesthesia Course in Ouagadougou.

With the financial support of CASIEF and WFSA, the SAFE Obstetric Anesthesia Course was offered in March 2016 to 32 anesthesia providers. A further 15 anesthesiologists participated in the instructor trainer course. It was clear that local instructors and participants really enjoyed the course and learned a great deal. Their confidence grew and it is hoped that they will be able to apply the lessons learned in their home hospitals.

The new Burkinabé instructors will run SAFE OB courses throughout their country. All of the materials and mannikins necessary to do so were donated to the SARMU-B by CASIEF and the WFSA. Two Canadians, Dr Sylvie Cousineau (Montreal) and Dr Angela Enright (Victoria) taught the course alongside one of our Rwandan graduates, Dr Benjamin Semakuba Amani, and American CAS member, Dr Faye Evans. It was a very eclectic group, supported by Mr Remy Turc of Lifebox. The Burkinabé Minister of Health and the Canadian Chargé d’Affaires attended the presentation ceremony.

CASIEF is continuing its support of anesthesia in Burkina Faso by sponsoring a young Burkinabé anesthesiologist to attend the 16th World Congress of Anaesthesiologists in Hong Kong in August 2016. Dr Cheik Bougouma will present a poster on his work on pulse oximetry and the Surgical Safety Checklist in Burkina Faso. We are also supporting a pediatric anesthesiologist from Burkina Faso to participate in the formation of a Global Initiative for Children’s Surgery. This is a group of surgeons and anesthesiologists who want to make sure that children are not forgotten in the global push for safe surgery. Dr Bertille Ki will represent the views of pediatric anesthesiologists from French West Africa.

Volunteer

CASIEF’s role in Burkina Faso differs from that in Rwanda, Guyana and Ethiopia in that we are not providing on the ground teachers for their program. Rather we are trying to support their teaching efforts and hope to return in the near future to train their teachers in the SAFE Pediatric Course and the Essential Pain Management Course. Since Burkina Faso is French speaking, any anesthesiologists who speak French and who might be interested in teaching these courses, please contact burkinafaso@casief.ca or complete the online application.

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