Mwanza, Tanzania from Anesthesia's Matt McEvoy


Again, I am excited by the educational opportunities at Bugando. Rob’s efforts are reflective of what can happen as our department makes a concerted effort over the next 5-10 years at Bugando. (For a vision of where we can be headed, read Peters JL, et al. Anesthesia Teaching in Ghana: A 10-Year Experience. Intl Anesthes Clin, 2010; 48:23–37) There are only 2 nurse anesthetist schools in Tanzania, a country of 40 million people! Thus, the graduates there will treat a vast population of people in need. The stories that we could tell, the memories that we collected, and the friends that we made are precious. From the 4 year-old in tamponade with a septic pericardial effusion to the 45 year-old lady with a 17 kg uterine mass(!!!) to the patient with tetanus and a massive PE in the ICU, the medical care is challenging in a very resource-limited environment. The memories of learning to use the E.M.O. machine (and getting anesthetized at the same time!), learning a better position for spinals, and experiencing multiple, likely preventable perioperative deaths makes a multi-colored collage for reflection. Finally, the faces and smiles of the lovely Tanzanians who give their best each day and are eager to learn caps off the experience. At the end of the day, and in this season of thanksgiving, it is good to be reminded that human beings are created with intrinsic worth and that it is a blessing to be in medicine, a profession of service with challenges and blessings that are rarely experienced elsewhere in life. As we look to the future at Bugando, I am excited about our partnership. As mentioned, the educational needs are great from pre-op to the OR to the PACU. However, I believe that an improved educational program can lead to low-cost, sustainable changes in the healthcare system that will have lasting effects for years to come. And now, a parting thought…I think that in this time of economic stress and need for cost-consciousness, we could learn a lesson from Bugando Medical Centre about how to brand healthcare at MUSC?