An interesting, exciting and varied role.
Ben Silverman and Jude Cheong-Leen
Anaesthetic trainees from the Imperial and Central London Schools of Anaesthesia
We are two British anaesthetists setting up an MSc for Ethiopian non-physician anaesthetists in Gondar. This will start in September 2010 and in order to succeed, the MSc course will need tutors from the UK, for periods of 3 months to a year. Senior trainees, consultants or retired anaesthetists in the UK would be ideal. This is an opportunity to provide relevant clinical teaching without having specific clinical commitments. The set-up will enable an interested anaesthetist to settle in rapidly, such that their time here is productive and rewarding. For anyone considering working in a developing country, this is somewhere you could have a very beneficial role.
As two London anaesthetic trainees, we have taken a one-year “OOPE” to come to work in the country’s third largest city. Gondar is located in the mountainous highlands of Northern Ethiopia at an altitude of 2100m, with the stunning Simien Mountains to the north and Lake Tana – the source of the Blue Nile - to the south. Amharic is the local language, but fortunately for us, the language of clinical teaching is English.
The hospital is a university teaching hospital with a catchment population of over 3 million. It has a medical school and provides BSc courses for other health professionals including anaesthetists. There are ten BSc anaesthetists, but no physician anaesthetists in the hospital – hardly surprising in a country with fewer than 15 in total. The five operating theatres cover surgical specialties including general surgery, gynaecology and obstetrics, orthopaedics, urology, paediatrics and ophthalmology.
Many patients present late in the course of their disease and particularly common general surgical cases include gastrojejenostomies (for gastric outflow obstruction secondary to peptic ulcer disease) and thyroidectomies. The latter group often present with massive goitres and distorted airway anatomy. General anaesthesia is usually with ketamine or thiopentone followed by halothane. Whilst resources are limited, currently there are pulse oximeters in all theatres and capnography and DINAMAP in several.
During our time here we have been involved in a number of different projects (teaching, designing and introducing drug administration charts, conducting a number of audits, advising on a medical HDU and constructing anaesthetic machines), but one of our major roles is to develop further training for the BSc graduates. The key goals are to improve clinical practice, as well as to promote evidence-based anaesthesia, increase involvement in continued professional development and improve staff retention. In order to achieve these goals in the Ethiopian context, an MSc course is the most appropriate solution. We are currently finalising the curriculum. One critical feature of the proposed curriculum is that it will be very clinically relevant and theatre-based, in contrast to the BSc which contains a large theoretical component.
The curriculum will contain clinical blocks in the following specialties: general surgery/gynaecology/urology, regional anaesthesia, pain, obstetrics, paediatrics and trauma. There will be some seminar/workshop teaching but most of the course will involve theatre-based clinical teaching, rather than theoretical or academic topics.
There is an active and supportive link between Gondar University Hospital and the Leicester NHS Trusts and Leicester University. No previous connection with Leicester is necessary for those interested in working in Gondar. The Link will provide general advice, additional support and will co-ordinate teaching on the MSc course. There are frequent visits by health professionals from Leicester to Gondar and vice versa and there is a friendly and social ex-pat community of all ages.
If you have any interest in this project, could consider working in Gondar or would just like to know more, please contact us at or . The Leicester Link website is http://www.le.ac.uk/gondar.