The month of February began on the 10th with a new ICU mission made up of nurses Mrs. Aranzazu Velez Arregui, Mr. Luis Manuel Perez Balmaseda and Mrs. Pilar Garcia Esteban accompanied by Dr Hamish Thomson (Anesthesiologist), whose stay lasted until day 24th.
Upon arrival, they were introduced by Dr. Aurora Lázaro Asensio (Intensivist) who was finishing her stay at the Mnazi Mmoja Hospital.
During the first week, they dedicated themselves to working hand-in-hand with the nurses, at bedside, carrying out all the nursing tasks with continuous teaching of good practices. They analyzed the unit, its shortcomings and possible improvements. They emphasized the importance of “Nursing Allocation“, essential in the care of critically ill patients. Evaluation, observation and identification of worsening of the critical patient from the ABCDE approach. They created a work routine based on nursing needs: Breathing, circulation, neurological, pain, hygiene … etc.
In the second week, they continued to insist on Nursing Allocation and everything described above. Unanimously by the staff and after seeing the deficit in knowledge of mechanical ventilation, a didactic poster was made on the ventilated patient and his care. A ventilation workshop was held, very well received by the staff. Within the care of the critical patient, they highlighted the importance of the hydroelectric balance, after seeing the lack of a nursing record and after analyzing the charts, it was decided with the staff and the supervisor to improve these charts in order to keep better quality nursing records. .
His assessment of the mission has been summarized in these words: “We have all returned happy for having had the opportunity to participate in a project like this. On a personal and professional level, the experience has been, let’s say incredible. But the sadness that accompanies us on the way back, after joining our lives and jobs, it is difficult to take it away, in our world with so many resources. If we were aware of all this before, now we are face to face with it. We would love to return and continue working with the team from ICU of Mnazi Moja Hospital “
On the 17th, a new German mission made up of Dr Joachim Oertl (Neurosurgeon), Dr Phillip Hendrix (Neurosurgeon), Dr Simon Müller (Neurosurgeon), Dr Chritoph Sippl (Neurosurgeon), Dr Akos Csokonay (Neurosurgeon), Dr Julia Szoro (Anesthesiologist), and Dr Franziska Maisser (Anesthesiologist).
His work focused on: the organization and material review, medication, equipment, instruments. Cases selection for surgical intervention. Surgery of previously selected cases.
This has been the second stay of the team, their impressions have been transmitted to us: “It was as pleasant as in the first meeting at the Zanzibar Institute. Especially, the cooperation with the head of anesthesiology was again magnificent. Also, the help (non-bureaucratic) of the radiology department with the X-ray images was splendid. As always, the help of local colleagues from the neurosurgery department was also excellent “
Dr Carola Gutierrez Melon (Intensivist) began her mission of the UCI Project on February 22nd and extended it until March 10th; she continued with the theoretical and practical training program for local doctors from the UCI team. Patients were cared for in the Unit and carried out evaluations in the ER and in conventional hospitalization plants. Neurosurgery postsurgical patients were also attended. The three warehouses of the UCI were organized, inventorying the material and removing everything that was not useful. Once again, efforts were made to make their stay there profitable for the local team, with a special focus on teaching.
On February 25th, a large group of volunteers from our Gynecology project arrived at Pemba island, coordinated by Dr Rosa Barrachina Tortajada (Gynecologist) and made up of: Dr Encarna Miñana Aragon (Anestesiologist), Dr Fernando Carbonell Castello (Surgeon), Dr Sonsoles Aragon Alvarez (Anesthesiologist), Dr Marta Pedrosa Soler (Surgeon), Dr Joana Vilaplana Faus (Gynecologist), Dr Marta Gallego Chinillac (Gynecologist), Dr Ana Adell Sales (Pediatrician), Mrs. Begoña Ibañez Alonso (Midwife) with the nurses Mr. Cristian Olivert Riera and Mrs. Mavi Mingacho Cervera.
They was carried out programming of patients assessed by the local surgeon (Dr. Makame). Assessment and assistance of urgent cases that arose during their stay. Complex wound cures (pressure ulcers, complicated diabetic foot, soft tissue infections and burns) were included. An inpatient visit pass was made to assess progress and treatment of possible complications. Consultations on patients in charge of other specialties such as Internal Medicine and Pediatrics were attended. The emphasis was on improving the aseptic conditions of the operating room and the prevention of infections associated with surgery, instructing local personnel to adopt these measures in a protocolized manner.
They continued with the Hernia Project, started in 2017, obtaining mosquito netting, cutting it and sterilizing it to take it to Pemba: Hernia pathology of the abdominal wall (hernias and eventrations) constitutes a very important volume of patients in need of surgical solution given the high incidence. It was calculated that the incidence of inguino-femoral hernia may be as high as 40% of the population in developed countries, and that the incidence of incisional hernia may be greater than 20% of all laparotomies. Twelve interventions on abdominal wall hernias were performed, without immediate complications.
Finally, our UCI Project coordinator, Dr Pablo Extremera Navas (Intensivist) traveled to Zanzibar with Dr Maria Aroca Ajenjo (Intensivist), who extended their stay until March 22nd and April 5th respectively.
Durante su estancia realizaron formación docente del staff médico. Colaboración en técnicas invasivas. Ayuda anestésica en NED Institute. Manejo postquirúrgico de pacientes críticos. Manejo pacientes críticos. Elaboración de base de datos.
During their stay they carried out educational training of the medical staff. Collaboration in invasive techniques. Anesthetic aid at NED Institute. Post-surgical management of critically ill patients. Preparation of database.