UCI MNAZI MMOJA HOSPITAL PROJECT (ZANZIBAR) II
The basis of the Project is the solidarity of all the volunteers who altruistically decide to go to Zanzibar and contribute with their experience, decision making and work.
From its start in August 2016 to March 2020, the NED UCI Project has organized more than 40 missions and a total of 88 volunteers (intensivists, anesthetists and nurses), some even repeatedly, have collaborated with the project maintaining a consistency to what throughout the entire period. This sustained presence of volunteers has allowed the same line of work to be followed and, above all, to create a work routine for local staff on what day-to-day life should be like in an ICU. We plan to maintain this dynamic in the coming years.
| NED Intensive Care Project: Missions & Volunteers |
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On the other hand, and thanks to donations from all the volunteers and the NED Foundation, during this period we have managed to build and equip a Pharmacy for the UCI as well as two warehouses that at the beginning of the project were non-existent.
The Pharmacy is supplied by various means; from the donations of the volunteers, as we have already mentioned, from the patients and their families who, depending on their economic level, collaborate with the purchase of material and medication and finally through the Mnazi Mmoja Hospital itself, which since the end of 2018 has begun to provide medication and own UCI material.
There is still a long way to go to be a ICU pharmacy in a developed country, but the construction of the ICU pharmacy itself has allowed us to work in an environment capable of responding to urgent daily needs.
| Material before and after the construction of the pharmacy. |
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As an essential part for the operation of an ICU, admission criteria and action protocols have been established adapted to the context of the Mnazi Mmoja Hospital in Zanzibar.
The ICU admission criteria was one of the first measures implemented to correctly select the patients who were admitted taking into account the limitations of a unit with limited resources. Initially not well accepted by the rest of the departments of the Hospital due to its restrictive nature, however, they have been the basis with which to start working seeing results in the short term. With the passage of time and the improvement of the unit and the hospital, these criteria are progressively changing to adapt to the new needs and reality of the hospital. In addition, ICU protocols have been created to standardize treatments and actions.
A database has been established in order to analyze the work carried out.
Finally, a class program has been established to be taught by volunteers to the UCI staff with the aim of completing it every two years and repeating it cyclically in a more updated way.
Perhaps most important of all, beyond the statistics, is the change in perception that has been achieved in the Hospital around the ICU. Currently, the ICU is considered an example to be followed by the majority of the Hospital staff (from nursing to Medical Management staff).
| Change of perception of the ICU in the Hospital. |
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The local staff is being trained for free in Intensive Care thanks to the professionals who come altruistically on a regular basis.
La unidad está creciendo gracias a, inicialmente el empuje de la Fundación NED, pero recientemente también debido a la inversión del propio Hospital respondiendo a las necesidades creadas por el Proyecto UCI. La Unidad ofrece apoyo y confianza al resto de departamentos del Hospital en situaciones críticas, incitando a la realización de cirugías y técnicas más complicadas y a ingresar pacientes más complejos.
The unit is growing thanks, initially, to the push of the NED Foundation, but recently also due to the investment of the Hospital itself, responding to the needs created by the UCI Project. The Unit offers support and trust to the rest of the Hospital’s departments in critical situations, encouraging the performance of more complicated surgeries and techniques and the admission of more complex patients.
Thinking about the future, given the good feelings that the project maintains in terms of significant improvements in the UCI, satisfaction of the local staff and good impressions from the volunteers, we think that we should continue with the UCI project for two more years and then return to evaluate it once again.
Therefore, we continue to look for volunteers who want to collaborate with the project in the coming years. Our top priority remains ICU-experienced nurses and medical intensivists / anesthetists. We must not forget that the basis of the Project is to train local staff in an ICU in a developing country. One of our great hopes for the future is to be able to send local personnel abroad so that they can stay for a time in a first-class ICU and learn another way of working with all available means.
Thanks to the compilation of cases in the database by the volunteers, results are being generated that we plan to publish soon in congresses and scientific journals.
We plan to maintain this dynamic as there have been many new and old volunteers who have confirmed their desire to collaborate again .
We really want to thank all of you for using your time, experience and money in solidarity in a project like this. There are two keys to making this project work; having found young local staff eager to learn and the generosity of good people with high specialized health training who are aware of the luck of being born in the right place and want to give something in exchange for it.
Coordinator Report
The coordinator of this great project is:
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Dr Pablo Extremera Navas
Neurointensive Coordinator |
