And now from Kyle...

Blogging! I mostly document my trips on Snapchat, as it takes essentially no time or mental energy, and these are qualities I favour when it comes to documenting things. However, even I can’t resist Patty’s drum-beating for her good old-fashioned blog, so here I go...

Kitt and I arrived on Sunday after 36 hours of travel from Halifax. As you read about in her post, we had our first day-long teaching session with the Rwandan residents yesterday. I don’t know who was more satisfying to watch: the excited, engaged trainees or Patty, their smiling, exuberant mentor. It’s going to be a fun month. 

This morning we woke up a bit tired, but quickly shifted gears and made our way to our first day in the ORs. The hospitals in Kigali serve as referral centres for many of Rwanda’s 12 million inhabitants, so a greater proportion of surgeries done here are of high acuity. Of course, the available resources differ from what we are accustomed to in Halifax. As Kitt and I are following in the footsteps of many previous Dalhousie residents, we had been thoroughly prepared for the environment that we encountered today. 

That said, I was still a bit surprised. We had two critically ill infants. Their situations might come to a resident’s attention once or twice during our four-months of pediatric anesthesia at the I.W.K. Unfortunately, here they are commonplace.

At the beginning of the day, Patty provided us with some perspective by pointing out various advancements that had been made at this large public hospital since her first visit in 2008. However, our Rwandan colleagues are still pushing for modern resources in many key areas. An optimal anesthetic could not be performed for one of our pediatric patients because important drugs were not in stock. The ‘scavenging system’, which removes noxious anesthetic gases from the operating room, was not hooked up because the available tubing didn’t fit the outlet on the machine. In the pediatric room, there wasn’t even tubing. For hours, gas was pumped into the operating room. The staff anesthesiologist, who today was covering four residents in four case rooms, found time to joke: ‘every night I go home and have a deep halothane sleep.’ As you can see from Patty’s pictures, this evening Kitt did as well! 

With the large cohort of residents in the program, the future is bright. Many are already working to make improvements to patient care and safety where feasible within their system. We are hoping to find ways to empower them, as their clout within Rwanda’s healthcare system will only increase after they complete their training and bolster the country’s ever-growing contingent of anesthesiologists. 

I’ll be spending the rest of the week orienting myself at two of Kigali’s other teaching hospitals, preparing for next week’s academic sessions, and mentally bracing myself for hours of biking after Kitt and Patty in the hilly Rwandan countryside this weekend.

Faithfully from the deck of the Serena,

Kyle 

(jkj86 if you enjoy 10 second clips of fun things I see in Rwanda, like Patty’s lively gesticulating or Kitt frequent napping)

Kitt in the Serena PACU with MAC 0.5 of halothane