I often think about Josephine and Chara. They were both been patients of mine who needed complex surgery. Complex surgery often requires complex anaesthesia.
Sierra Leone, May 2011: 2 year old Josephine chokes on a stone and it becomes stuck in her lung. There is one surgeon in Sierra Leone who thinks he can help, but there isn’t an anaesthetist capable of anaesthetising her. Mercy Ships and I agree to help. Unfortunately the surgeon can’t remove the stone, so Josephine is left fighting for her life in the intensive care unit on the ship. She needs a specialist lung surgeon but Sierra Leone has none. There is a surgeon in Ghana but, no paediatric anaesthetist for lung surgery. The nearest place would be South Africa, and it would cost over £250,000 ($400,000). So, we flew a surgeon from Kenya to the ship and Josephine made a miraculous recovery.
I thank God that when Josephine needed help, Mercy Ships and I could provide the specialist help .
Togo, May 2012: 1 year old Chara has Crouzon’s syndrome and needs specialist surgery to adjust the bones of her face and skull. Her bones have developed abnormally and without surgery Chara could become brain damaged and blind. A German craniofacial surgeon came to the ship to perform the major surgery Chara needed. Initially she recovered well but then developed complications of infection and leakage of fluid that surrounds the brain (CSF). These were difficult to treat and delayed her discharge which was critical because the ship was leaving Togo in June. Chara had to be discharged to a local hospital and she subsequently needed further surgery. But no anaesthetist was prepared to anaesthetise her, and even the neurosurgeon was reluctant to operate on such a small child. So, Chara will be transferred to Germany to complete her treatment.
I used to work in a large university hospital with specialist paediatric services. Children received whatever they needed. Sadly that is not true for most children in Africa, for whom health services are often woefully inadequate. In particular, there is a shortage of surgeons.
Imagine…. England with only 200 surgeons. We would have the same access to surgery as the average African.
Imagine…. England with only 25 surgeons. We would be better off than the average rural African. And the average rural African would have to travel hundreds of miles to see the surgeon and PAY for the initial consultation and surgery. Earning less than $200 per year, they would never afford the cost.
10% of all adult deaths in Africa are due to lack of access to surgery, and 20% of all child deaths.
Furthermore, most anaesthetists in Africa are not doctors. They have done a 3 year technician course and actually do a tremendous job in very difficult circumstances and for very little reward. However, most have inadequate training in paediatrics, so cannot anaesthetise children for complex or life-saving surgery. In Togo, I estimate there were only 2 medically qualified anaesthetists.
Josephine was lucky, but Chara was not so lucky. Chara needs to travel to Germany to complete her treatment because we had to leave. I’d like to see ‘luck’ become unnecessary. I’d like to see at least one specially trained children’s anaesthetist in each African country.
Too big a vision? May be.
Is it possible? I hope so.
Will I see it happen in my lifetime? Probably not.
But does that deter me? No.
I believe we all need a vision, and we all need hope. Hope that will outlast our lifetime. Without vision and hope I don’t think we ever achieve very much. Many great achievements in history took a lifetime to complete, and many were finished after their champion died. William Wilberforce and the abolition of slavery is a great example. And I highly commend the film Amazing Grace to anyone who has not seen it. It is one of my favourite films.
I have a vision – to train anaesthetists to help children like Josephine and Chara.
I have a hope - healthcare in Africa can be transformed.
What is your vision, what is your hope?
Mercy Ships is involved in training surgeons, anaesthetists and nursing staff. We work with the Ministry of Health and the Ministry of Foreign Affairs in the countries we visit, to identify the needs and how we can help. Thank you for reading this and supporting the work we do.
