Ever wonder what goes into planning a three-day surgical camp at Kabudula Community Hospital? As Global Health Fellow Angela can tell you, it’s a lot of coordination, time, creativity, and logistics. Here’s an overview of what Angela does to plan a camp, and we’ll dive into some of the challenges she often comes up against in our next post.
As we prepare for the next surgical camp at Kabudula later this month, the first step is to make sure that funding is available to cover all resources needed. Surgery is expensive, especially in more rural settings, and so many factors must come together to ensure success.
Set Patient Goals: in February, we plan to host a three-day camp and serve 40 patients.
Personnel: successful camps require highly skilled medical professionals with specialized training in surgery, and there are too few of these individuals compared to Malawi’s population. This month, we’re inviting two surgeons from Kamuzu Central Hospital (KCH) in Lilongwe to join us at Kab. Visiting surgeons sign up to work on their off-duty days, and we pay them for their time. This will allow us to serve more patients while training Kab’s staff.
Set Capacity Building & Training Goals: four members of Kab’s surgical staff, two clinicians ad two nurses, will receive training from two visiting surgeons on major procedures. Three more of Kab’s staff, two clinicians and one nurse, will complete minor procedures on their own, with supervision from the visiting surgeons.
Scheduling: in planning the dates for a surgical camp, we start with the availability of KCH’s surgeons. We then check that there are no scheduling conflicts for Kab staff or facilities. We usually schedule the camps around the 3rd week of the month, which gives us ample time for preparations and to analyze outcomes in a single month. This month, we’re starting our three-day camp on Monday, February 21.
Prepare Operating Theater & Supplies: the wear and tear on Kab’s theaters and equipment usually calls for some type of service or maintenance between camps. In preparation for our February camp, we are fixing all operating tables including applying new oil and hiring a welder to complete repairs.
Pill Packing: AHA purchases painkillers and antibiotics in bulk and must repackage the pills from jars of 1000 to baggies of 30 per patient.
AHA Volunteer Jonathan prepares pills for an upcoming surgical camp.
Kab staff move the full oxygen tank into the facility for use.
Check Oxygen Levels: depending on the oxygen levels at Kab, the oxygen cylinder must be refilled either before or after the camp. This is vital for all patients, especially for those cases requiring general anesthesia. Refilling the oxygen cylinder is an all-day event that requires hiring a truck to carry the empty cylinder from Kabudula to an industrial area called Kanengo, exchanging the empty cylinder for a full one, and returning to Kab. In all, it takes about five hours to get the job done.
Patient Screening: Kab is responsible for advertising upcoming patient screening days. Now that the program is more well known, screening days are very well attended and there is rarely a shortage of potential patients. Patients undergo routine health tests such as blood pressure and temperature, answer questions about their ailment, and are determined whether or not they are a good candidate for a surgical camp at Kab.
Patient Scheduling: when scheduling patients for camp, we must consider the number of surgeons, length of procedure, whether its an in-patient or out-patient procedure, available facilities and supplies, and patient demographics.
Nurse Christina calls patients to schedule their appointments.
Procuring Pharmaceuticals: Malawi’s government currently provides minimal materials for C-sections and emergencies, but little else. AHA must fill gaps and provide the basic materials needed for all procedures. We are currently talking with the District Health Office about the possibility of increasing allocation of surgical materials for Kab now that we have increased the capacity for surgery and demonstrated impact, but this may not happen until later this year when their new budget takes effect.
Logistics: we arrange transportation for the visiting team along with any materials they are bringing, transportation for patients, lunch for all, and incidentals like fuel for the generator during power outages and snacks for patients who miss meals due to NPO (time a patient may consume nothing by mouth prior to an exam or procedure). Right now, it is rainy season in Malawi and daily power outages are inevitable, so additional funds are needed for generator fuel to keep power on during the camps. Malawi’s healthcare system still operates using all paper, so we print the paperwork needed for patient records and we prepare interview questions for patients.
Your Support: your donations make this possible, helping us help people who would otherwise not have access to surgical care, while building the capacity of the health system to increase access to this type of care in the future. Our camps have grown from serving a handful of patients during our first international camp in 2018 to now serving hundreds of patients annually, and procedures being done by local surgeons as well as visiting international teams. With increased support from the government and AHA’s commitment partnership, we can make surgical treatment part of routine care at community hospitals like Kabudula, which will greatly improve life in rural communities because of the huge positive impact that resolving a surgical condition has on a patient for the rest of their life.