Anaesthesia

There are roughly 80 anaesthesia providers in Sierra Leone serving an estimated population of 8 million people. These are mostly Anaesthesia Nurses, who use predominantly spinal anaesthetic or ketamine as a safe and inexpensive means of anaesthetising patients requiring surgery. However, the increasing complexity of surgery offered across the country has meant that the anaesthetic capabilities have also had to improve. This is especially true in Masanga Hospital, which has become a referral centre for complex abdominal surgery and trauma for the country.

Masanga Anaesthesia Team

The Project

The Masanga Anaesthesia Team has worked incredibly hard to match this increased surgical complexity and deliver safe anaesthetics for their patients. This has been achieved in several ways.

The introduction of a new ‘draw over’ anaesthesia machines allows the team to use a gas anaesthetic which improves operating conditions for surgeons and reduces recovery times for patients.  They have also received additional training in airway management which has enabled safe intubation when indicated, reducing the risk of aspiration during surgery. With the help of ex-pat nurse Jenna, the team have introduced a Recovery Room which offers a higher level of care to post operative patients and allows faster identification of post operative complications.

A Draw-Over anaesthetic delivery system, specially designed for settings such as Masanga

Next Steps - Sustainable development

We are excited to see the ongoing development of the Masanga Anaesthesia Team. This will be led by an experienced Anaesthesia Nurse who has recently been employed as head of the department. We will continue to work closely with the team in Masanga, raising money for new equipment and providing additional training in areas such as regional anaesthesia.

We're pleased to have developed a partnership with Bangor Hospital in Wales where the anaesthetic department is helping support training in Masanga, develop guidelines and fund raise for equipment. 

Developing a new recovery room for post-operative patinents

Latest Developments - Regional anaesthesia training in Masanga

Despite improvements in anaesthesia services across Sierra Leone in recent years, complications from general anaesthesia are still common. One approach to reducing the number of complications from general anaesthesia is to instead use regional anaesthetic techniques. This method involves injecting a local anaesthetic around the nerves to numb part of the body, allowing patients to stay awake during their surgery. However, regional anaesthesia is not widely practiced in Sierra Leone and it is not currently part of the training for nurse anaesthetists in the country.

Earlier this year a team of anaesthetists and plastic surgeons, working with Masanga UK, travelled to Masanga to run the country’s first regional anaesthesia training course. The course taught nurse anaesthetists from all over Sierra Leone how to perform a specific regional anaesthetic technique called an axillary nerve block. This procedure numbs the arm and hand, allowing patients to undergo surgery without needing a general anaesthetic.

The course was held over two weeks and covered both the theory and practical skills needed to successfully perform the axillary nerve block. The nurses also gained hands on experience, performing the nerve block on patients who were undergoing surgery for burn-related injuries.

The success of this course shows that it is possible to teach nurse anaesthetists in low and middle-income countries such as Sierra Leone how to perform regional anaesthesia techniques and reduce reliance on general anaesthesia. Since the course ended, the nurse anaesthetists who took part have continued to successfully use the skills they learned to improve patient safety and care.

One challenge is that ultrasound machines, which are essential for the procedure, are not widely available in Sierra Leone. Our goal is to raise funds to provide these machines, so we can return to the country to offer further training and support.

Have a look at the Jungle Diaries page to learn more about the course and view the course video.