Zambia Anaesthesia Development Program (ZADP)
Working in partnership to support the sustainable development of safe anaesthetic and critical care practice in Zambia since 2012
What is the Zambia Anaesthesia Development Program (ZADP)
The Zambia Anaesthesia Development Program (ZADP) is our longest running collaborative program. It is a partnership of physician anaesthetists from the Global Anaesthesia Development Partnerships (GADP) and the Society of Anaesthetists of Zambia (SAZ). The partners work hand-in-hand to develop safe anaesthetic and critical care by identifying priority areas that need addressing followed by strategies that aim to make an effective, sustainable impact. This is done via training, quality improvement projects, patient safety initiatives and research. The partnership is now into its second decade of operation. Many individuals and organisations have worked with ZADP to get it to where it is today.
This is what the ZADP has achieved
68
Anaesthetic trainee volunteers have supported ZADP in-country
31
Zambian doctors have completed clinical training to become a physician anaesthetist
35
Anaesthetic consultant volunteers have supported ZADP through short-term in-country placements
48
Zambian doctors have been supported in their anaesthesia training
How Does the Zambia Anaesthesia Development Program (ZAPD) Work?
The ZADP works on its objectives via different methods. The main areas of work are delivered by in-country teaching at University Teaching Hospital, Lusaka and Ndola Teaching Hospital.
Lusaka, University Teaching Hospital
There is a well-established fellowship program based in Lusaka at University Teaching Hospital. Junior (UK post-Primary FRCA equivalent) and Senior fellows (UK post-Final FRCA equivalent) live in country for a period of typically 3-12 months. Fellows are clinically and educationally supported by local and remote Consultants. Their main role is to support local Consultants deliver the anaesthesia training program.
They do this by:
Providing well-being support
Clinical simulation sessions to allow local trainees to rehearse the management of rare or life-threatening clinical scenarios in a safe space
Providing support for exams with OSCE and viva practice.
Supporting local quality improvement and patient safety initiatives.
Teaching in theatre, supporting trainees to run their lists and deliver safe anaesthesia in addition to teaching specific clinical skills such as regional anaesthesia.
Visiting Consultant Anaesthetists join the program for a period of weeks to months to provide senior support to in-country fellows and local healthcare providers. They may also deliver training relating to a specific area of expertise such as regional anaesthesia or critical care. It is strongly acknowledged by those who have volunteered with the program that individuals learn as much from the experience as they do teach.
Ndola Teaching Hospital
Ndola Teaching Hospital is the second hospital in Zambia to deliver Specialty Anaesthesia Training. Ndola is the third largest city in Zambia and is situated in the Copperbelt region. Almost 3 million people live in this region with tertiary services being provided by two main hospitals, Ndola Teaching Hospital and Arthur Davison Children’s Hospital. With only 5 physician anaesthetists working across all sectors in the province, physician anaesthetist density is 0.18, far lower than the national average of 0.45 per 100,000 (2018).
Ndola 0.18 PAPs per 100,000 population
The ZADP has an initiative to support the Consultant and trainee anaesthetists in Ndola with scheduled visits by in-country fellows approximately every 6-8 weeks. The focus of these visits is similar to the training priorities at University Teaching Hospital; in-theatre teaching, simulation, regional anaesthesia and well-being support. Trainees in Ndola are also supported remotely via the remote teaching program.
Regional Anaesthesia
Regional anaesthesia is when a local anaesthetic is injected near a nerve or groups of nerves to
make part of the body numb. This is an important anaesthetic technique as it helps with pain relief after surgery and sometimes can allow surgery to happen without a general anaesthetic.
The Zambia Regional Anaesthesia Project began in 2020 with the aim to build safe regional anaesthesia services across Zambia. Despite numerous challenges, there has been good progress. Regional anaesthesia was virtually non-existent in public facilities prior to this project, it is now becoming a real option for patients, especially for those who would otherwise be deemed unfit for general anaesthesia. The aim of the project is to create a sustainable, self-sufficient regional anaesthesia service that will provide cost-effective and safe patient care. See the 2022 Impact Report and Dr Polela’s blog for more information on how this project is being delivered and what has been achieved.
Quality Improvement (QI) and Patient Safety Initiatives
ZADP provides support to local Consultants and trainees undertaking QI projects or patient safety initiatives. This support may relate to the design and execution of such projects or to the dissemination of the findings into the global anaesthesia community.
Goodhand S Kalenga M. Introducing the ‘GAS Card’ in Zambia – portable airway checklists for low and middle-income countries. 2023. The International Anaesthetist, RCoA.
Betteridge N, Mumba, K & Williams, H. Zambia: the benefits of in-country volunteering post-pandemic. 2023. The International Anaesthetist, RCoA.
Research
ZADP provides support to local Consultants and trainees undertaking research. This may be related to the design and execution of research projects or, as with the QI projects, helping individuals showcase their work at Conferences or through publications in Journals.
Remote Teaching
During the COVID pandemic travel restrictions prevented Fellows and visiting Consultants from delivering in-country teaching. With the continued need to deliver teaching to anaesthesia residents a remote teaching program was set up in 2020.
The anaesthesia and critical care syllabuses are delivered throughout the year with bi-weekly teaching sessions for Juniors and Seniors (4 sessions per week). The remote teaching program allows residents to attend sessions with more flexibility and enables the Ndola trainees to have access to weekly teaching. The program also allows trainees to be mentored or undertake viva practice remotely. The program is run by members of the ZADP Committee and Remote Teaching Fellows.
The success of this program means that it continues today, in spite of the return of in-country teaching.
If you’d like to support the remote teaching program either on an ad hoc basis or more regularly as a Remote Teaching Fellow then please get in touch.
Collaborations
Inspire Through Clinical Teaching
Inspire Through Clinical Teaching and ZADP have been working together to support medical
education training among healthcare workers in Zambia since 2016. It is a four-day multidisciplinary course for clinical teachers in low and middle-income countries. It was developed by anaesthetists with backgrounds in medical education to address a perceived gap in formal training in teaching skills.
21 Inspire Through Clinical Teaching courses have been run to date across 8 countries training more than 350 healthcare workers. 7 of these courses have been held in Zambia in partnership with ZADP
21
Courses
8
Countries
350
Health Workers Trained
7
In Zambia with ZADP
In 2022, we ran the first face-to-face Inspire Through Clinical Teaching course since the pandemic began. This course, held at Ndola Teaching Hospital, trained 20 multidisciplinary healthcare workers, all local teaching faculty, including doctors, nurses, physiotherapists and clinical scientists. The course faculty were also from multiple disciplines including anaesthesia, surgery and nursing. All participants reported they enjoyed and benefited from the course, they learnt new skills and they felt the course was relevant for their clinical teaching role. The most frequently received feedback from participants was that the course was interactive, engaging, simplified and to the point.
Educational Supervisor Training
Anaesthetic educational supervisors are experienced anaesthetists who support trainee anaesthetists in accessing learning opportunities and dealing with difficulties impacting their training.
In 2022, the first course to train educational supervisors in Zambia was run. This was a collaboration between the Royal College of Anaesthetists (UK), the Society of Anaesthetists of Zambia and ZADP. The course was requested by Zambian anaesthetists to address an identified need in training- the need for greater support for trainees in meeting their individual educational needs as well as developing the skill set to provide this support in newly-established consultants. One of the key drivers was Dr. Anthony Chisakuta, a Zambian anaesthetist with a heart for education and the Head of Anaesthesia training programs in Zambia.
11 anaesthetists from 4 countries were trained in educational supervision
7
Anaesthetists
4
Countries
Read our latest Impact Report to find out more about the educational supervisor training that ZADP delivers.
“I would say every instructor needs to have this kind of training!”
“A great opportunity to share experiences of supervising training in anaesthesia”
“Really informative on the needs of the learner and how to harmonize them with the objectives of the teaching program specifically regarding the work environment and assessments”
Interested in Joining a Fellowship?
If you are interested in joining the ZADP fellowship, please get in touch, we have 3, 6 and 12 month placements in-country.
Read Our 2022 Impact Report
We are delighted to share with you our latest ZADP Impact Report celebrating the achievements and learning of 2022. The report showcases how we continue to navigate challenges to build safer anaesthetic care in Zambia.