30th June, 2008
Most children undergoing surgery in Kenya are anaesthetised by clinical officers or anaesthetists with minimal training in paediatric anaesthesia.
Dr Zipporah Gathuya of the Department of Anaesthesia at the Kenyatta National Hospital, the country’s largest referral hospital, said Kenya has only three paediatric anaesthetists, and none are being trained locally in this field.
To make matters worse, she said, children are usually presented for surgery at a late stage of their illness due to limited access to quality health care in the country.
Dr Gathuya was speaking at the first Pan African Anaesthesia Symposium held in Nairobi early this week, attended by 370 surgeons, anaesthesiologists, nurses and clinical officers from 20 countries. The delegates, many of whom work in rural hospitals with little equipment or professional support, shared their experiences and discussed challenges to provision of safe and effective anaesthesia in Africa.
“Doctors and clinical officers are often unwilling to train in anesthesia, while some of those with the training quit because they find the work too stressful,” Dr Gathuya explained.
The Director of Medical Services Dr Francis Kimani, officiated at the opening of the conference, organised by the African Medical and Research Foundation (AMREF) and sponsored by Smile Train USA with the theme ‘Partnerships for Safe Delivery of Anaesthesia in Children in Africa’.
Kenya has only 120 specialist doctor anaesthetists, a paltry 13 of whom work in public hospitals. Most of the rest are in private practice, mainly Nairobi, with the rural areas bearing the brunt of the problem. For all of the hundreds of doctors who can operate at the Kenyatta National Hospital and the University of Nairobi, there are only nine anaethetists. The ratio at the rural Moi Teaching and Referral Hospital is one to 13.
“There are 300 clinical officer anaesthetists in Kenya, 200 in public hospitals and 100 in private hospitals. But we need more than 1,000 specialists in anaesthesia in order to deliver adequate services,” said Dr Kimani. To bridge the gap, he said hospital managers are encouraging more doctors to train in anaesthesia and efforts are being made to make the career more innovative and attractive. Other measures include training in regional anaesthesia for doctors and clinical officers, as well as opening up anaestheology to other cadres such as nurses.
As a result of the shortage, the country relies heavily on outreach missions organised by non-governmental organisations to facilitate anaesthesia for children with cleft lip and palates, congenital heart lesions, or those in need of orthopaedic and plastic surgery.
AMREF has been running surgical outreach programmes in East Africa for 50 years, ensuring that thousands of children, and adults, receive safe and effective surgery.
The aim of the programme is to treat patients who would not otherwise have access to the care they need, and to train local doctors, nurses and other health workers in rural areas to carry out this work themselves.
AMREF’s planes take specialist surgeons to areas where there are no communications, limited medical services and little or no surgical services. We travel to inaccessible areas that can only be reached by plane, where health clinics and hospitals try to support hundreds of people staying in outlaying villages where the only health facility may be a man selling paracetamol in a roadside kiosk.
Read more about our Clinical Outreach Service
The Smile Train is an international charity founded in 1997, dedicated to helping millions of children in the world who suffer from cleft lip and palate. Over the last eight years, Smile Train has performed more than 280,000 cleft surgeries in 74 of the world’s poorest countries. For more details visit www.smiletrain.org |