SAFE Obstetric Anaesthesia, Bujumbura, Burundi. Brief report

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1 SAFE Obstetric Anaesthesia, Bujumbura, Burundi August 29 th - 1 st September 2017 Brief report Background: Safer Anaesthesia From Education is a global training initiative launched by the Association of Anaesthetists of Great Britain and Ireland (AAGBI) working in collaboration with the World Federation of Societies of Anesthesiologists. The aim is to provide training to anaesthetic providers worldwide, to enable them to deliver vigilant and competent anaesthesia. Two courses have been developed, a 3-day paediatric course and a 3-day obstetric course. The courses involve an additional day to provide Training of Trainers. SAFE Burundi: This was the first SAFE Obstetrics course in Burundi. It was held in Bujumbura, capital of Burundi as a collaboration with Mr. Gilles Eloi Rwibuka from the Burundi association of nurse anaesthetists ATSARPS (Agora des Techniciens Superieurs Anesthesistes Reanimateurs pour la Promotion de la Sante) and his team. Anaesthesia in Burundi: Burundi has a population of approximately 11 million and is described as currently having a GDP third lowest in the world. There are currently 4 physician anaesthetists and 89 nurse anaesthetists in the country, 39 nurse anaesthetists work in the public sector. Facilities and equipment vary greatly between the hospitals. Anaesthetic nurse training takes three years and there are 3 training facilities in Bujumbura. 100 nurse anaesthetists will qualify this year, but sadly a number of the nurse anaesthetists who attended the course are currently unemployed due to lack of funding. Dates: The course was run from 29 th -31 st August with a Training of trainers course run on 1 st September Faculty: Country Organiser: Mr Gilles Eloi RwiBuka Translators: Dr Herbert Mubamba (physician) Mr. Innocent Mugisha (medical student) Course Director: Dr Gill Van Hasselt, Consultant Anaesthetist, Poole General Hospital International Faculty: Dr Elizabeth Shewry, Consultant Anaesthetist, University Hospital Southampton Ms. Louise Emmett, Clinical Midwifery Manager, Chertsey Dr Serge Mudipanu, Anaesthetist, Uganda

2 Dr Olivier Mulisya, Obstetrician, Democratic Republic of Congo Dr Gary Dickinson, Consultant Anaesthetist, North Hampshire Hospitals Dr Allie Green, ST7 Anaesthetist, St Thomas Hospital Dr Francesca Saddlington, Fellow Anaesthetics, Broomfield Hospital Dr Alexander Leigh, ST6 Anaesthetics, UCLH Education Fellow Dr Lauren Wilson, ST5 Anaesthetics, UCH Course Venue: Both the SAFE course and TOT course was hosted at Kings Conference Centre, a good venue with av facilities, they also provided catering for the course. Delegates: 40 delegates from 22 different hospitals attended all 3 days of the course. They consisted of 32 anaesthetic nurses, 8 anaesthetists nurses in training. The SAFE Course: The local press were in attendance and both radio and TV interviews were given, supporting the specialty of anaesthesia in Burundi. The Burundi Ministry of Education visited the course on the second day. SAFE Training kit: No problems with training kit occurred. Monitoring and Evaluation: Monitoring and Evaluation was performed as follows: Change in knowledge assessed by pre and post course MCQ tests Change in skill ability assessed by before and after course skills tests Delegates completed both the pre and post course MCQ tests and both the pre and post course skills test The average pre-course MCQ score was 75.48% (range 56-96% ) and the average post-course score was 82.9% (range 62-94% ) with an average increase of 7.42% The average pre-course skill score was 1.6/10 (range 0-4.5) and the average post-course score was 8.2 /10 (range 5,5-10) with an average increase of 6.6/10.

3 Reaction and Enjoyment measured by numerical analogue scores Learner Satisfaction with Academic Sessions: Lecture on airway and general anaesthesia: 5.5% 94.4% Airway breakout sessions: 5.5% 5.5% 88.9% General anaesthesia breakout sessions: 5,4% 2.7% 91.9% Spinal anaesthesia breakout sessions: Lecture on critical care and resuscitation: 5.4% 5.4% 89.2% Critical care breakout sessions: 2.7% 2.7% 5.4% 89.2% Lecture on maternal trauma: 10.8% 89.2% Maternal resuscitation and sepsis breakout sessions:

4 8.1% 2.7% 91.9% Lecture on pre-eclampsia and eclampsia: 2.7% Pre-eclampsia and eclampsia breakout sessions: 2.7% 97.3% Lecture on haemorrhage: 11.1% 88.9% Haemorrhage breakout sessions: Learner Satisfaction with General Aspects Was the course enjoyable? 10.8% 89.1% Did it improve your knowledge? 10.8% 89.1% Do you think it will improve your clinical ability?

5 8.3% 91.7% Was it relevant to your day to day work? 5.7% 2.86% 91.43% Do you think what you have learned will improve the care you give to patients? 5.4% 16.2% 78.4% Would it be a useful course to run in your hospital? Training of Trainers: On the final day a Training of trainers course was run for 8 of the delegates. This course was well received and lead by the international faculty on this occasion. The feedback was very positive and the course was rated as excellent (10/10) by 6 delegates and 9/10 by 2 delegates. The President of the Burundian Anaesthetic Society expressed the hope that we could return to run a further SAFE course in Central Burundi and this was endorsed by the Minister of Education representative who expressed the same view. Future: The local faculty were pleased with how the course performed. They have requested for the course to run again with their support and we hope to increase the role of the local faculty as time progresses. There was strong local support for ongoing educational work- a second SAFE course in central Burundi. This view was echoed by the President of the Burundian society of Anaesthetic providers, and the Minister of Education representative who attended the course. There was very positive media coverage of the SAFE course and Training of Trainers Course with radio and television interviews and newspaper coverage. Gratitude is expressed to Dr Keith Thompson who did a lot of liaising and groundwork to set up the course. Dr Keith Thompson also funded the two African Faculty members (Dr Serge and Dr Olivier) and contributed in support of the UK faculty. It is hoped that the AAGBI will support our follow up SAFE course in Burundi, consequent on the success of this first course which we predominantly self funded.