My Southern African Anaesthesia Adventure
At What Point Did You Decide That Anaesthesia Was For You?
Tell Us About The Anaesthesia Department Where You Work In Sierra Leone
Although Connaught Hospital is big, our department is very small. Physician anaesthetist training only started in Sierra Leone quite recently, perhaps 2018 or 2019. That is when the anaesthesia residency program started. Prior to this we have always had, and still have a heavy presence of nurse anaesthetists who have done their diploma or BSc in Anaesthesia. Currently, in Sierra Leone we don’t have physician anaesthetists in any other facility outside of Freetown, everywhere else is manned by nurse anaesthetists. Our department has three consultants and we have about seven trainee physician anaesthetists. So, we are increasing and are hopeful that it will get better.
What Made You Apply To The ZADP?
I was actually in one of the provinces on a project with Kings College London and partners in health. It was my second time working on this project and I knew the coordinator from Kings College as she had come to our anaesthesia department a few times. She asked me whether I had ever considered doing anything with anaesthesia outside of West Africa because she knows that for us trainees in Sierra Leone we predominantly stay here.
This conversation happened after many tea breaks together where we would just have conversations about work. I had actually already thought about looking for opportunities elsewhere, but I had no idea about how to go about it. She told me that she would keep an eye out for me. The very next morning after we had had that conversation, we were having breakfast and getting ready to leave for the project when she showed me a Twitter post advertising a fellowship with ZADP. It was the last day of the project and we were meant to be returning that day. The deadline was at midnight that night! With some guidance from the team, I managed to get my application in just in time!
What Were You Hoping To Achieve By Joining The ZADP Fellowship In Zambia?
I went for both personal and professional reasons. The greatest percentage, was for me to learn how anaesthesia is done in a place that is not West Africa. Also, I knew that there would be a heavy presence of UK-based trainees and I thought that this would be a perfect opportunity to learn a lot from fellows coming from the UK. I also knew that I was going to be the most junior trainee of the fellows so I would learn a lot from others. The lesser percentage, was that it was time for me to see Southern Africa, to have a personal adventure.
What Did You Learn During The Fellowship?
I’ve learnt so much, I’ve grown personally and professionally.
I didn’t appreciate it at the time but my professional learning started before my ZADP fellowship by learning from my work colleagues at Connaught Hospital. My two main bosses truly lead by example. They don’t just tell you how to do something, they also enact it. Sadly, our department lost an anaesthesia trainee, a brilliant man who had been like a mentor to me. He had guided me and I’d often stood in his shadow, learning from him. When he passed on I saw myself taking on new roles and taking up more responsibility. I started doing the weekly rota without being told. I started doing cases that I previously had stepped back from. My role with ZADP gave me the platform to enact what I had learned in Sierra Leone, as I was now a teacher and a leader of more junior trainees. I didn’t realise it but I already had the foundation from my home department. It’s been so important to me to represent ZADP professionally and to be my best self. You have to act like you are representing something and not just turn up for yourself, but for other people.
Specifically, ZADP allowed me to develop my time management and my communication skills. Time management was something I was lacking prior to the ZADP experience. Now I find myself getting up and going to work early. This fellowship was an opportunity, and I believe that to whom much is given, much is expected. I knew that I was going to be in charge of people and I had to show up and lead by example. I hope this leading by example will be with me for the rest of my life.
I learned so much about communication and active listening. My ability in both improved tremendously because I was meeting people from different backgrounds and I knew that my approach had to be different to the way that I deal with people I am familiar with in Sierra Leone. I’ve learnt how to listen to other people’s perspectives and that all you have to do is listen and you will gain so much from others. I gained a new perspective about how sometimes things that are said can be misinterpreted. It’s so important to take your time when communicating in different languages or to find a different way to communicate with others.
What Have You Learned Clinically?
I’ve learned so much, where do I start? The first thing is, I have been exposed to neuroanaesthesia. For me to do a neuro case at home I have to go to a private institution to do a rotation there for a week or two or I have to wait to go to Accra in Ghana. In Zambia, I found the opportunity to do neuroanaesthesia. I no longer just had to read about it in a book, I actually got to do it! I also got to do a lot of paediatrics and obstetrics. The obstetric department in Sierra Leone is not based in the facility that I work in so I don’t get frequent exposure to it. Working in Zambia was a brilliant opportunity to do obstetrics as it is in the same complex as the other theatres. My obstetrics has improved significantly and my phobia for obstetrics has also reduced!
Do You Think Working In Zambia Is Similar Or Different To Sierra Leone?
Similar to an extent, but it’s different to a larger extent. The similarity is the fact that you see the common trend of diseases such as the advanced disease processes. In both countries people present very late with advanced diseases, everything that I have seen in Zambia are things that I have seen in Sierra Leone. The main differences relate to the man power and supply chain. In Zambia the man power is significantly more than in Sierra Leone so it was interesting for me to see how such a big department manages and allocates its staff. Additionally, whilst both countries are LMICs there were more times in Zambia that we ran out of consumables in theatre. We don’t have advanced medications or equipment in Sierra Leone, but we do have a constant supply. The need to adapt to inconsistent supplies in theatre was a big difference for me. So, in summary, the similarities were the disease processes, but the actual running of the department was very different.
Tell Us About Your Experiences Teaching In The Classroom And Facilitating Simulations.
We already do presentations at home so doing online teaching was not new for me, but I appreciate as with anything the more you do the better you get. I used to get nightmares about doing presentations, but now it feels easier as I have now done so many. With regards to simulations, I have previously done the SAFE paediatric course as a candidate and so I had experienced simulation as the learner. I hadn’t been the person facilitating simulation before so I found that doing the simulation sessions with ZADP have been so useful. I can appreciate how useful it is to rehearse these critical events, it has helped me significantly. You can never compare the adrenaline pump of a real-life event to a simulation session. My boss actually got to know that I had been doing simulations in Zambia and he asked me to be simulation lead for our department in Sierra Leone.
What’s Next For You?
I want to increase my exposure to research, how to write abstracts and manuscripts. I want to complete more training such the 18-month long virtual Critical Care Research Academy Course supported by the WFICC. I will also continue to prepare for my exams next year. I also want to continue my yoga journey, one that I continued whilst I was in Zambia. My dream is to be a yoga instructor, and this dream I shall make a reality.
I would recommend anyone do the ZADP fellowship at some point in their life, a lot can happen in six months. My entire life has changed not just my professional but also my personal. I have a different perspective on so many things, I’ve also really enjoyed living in Southern Africa. I had thought that I would be homesick by the end of the first month, but I wasn’t even by the end of the fourth month. I actually only got homesick when there was a particular dish that I needed to eat and this dish can only be prepared by my Mum!