First time at CHUK and the Sim Center

From Mary:

Rwanda has taken possession of me. Until last Saturday night I had never set foot on African soil. I knew in my heart that I would come here one day, this was made a certainty when, several years ago, Gaston, with his guileless look, said “Mary, when are you coming to Rwanda?” My response, at the time was “When you and Patty can use me best, I will come”.

 As it turns out the first International Rwandan Pain Conference was the occasion chosen. I will tell you about that wildly successful event in the next “from Mary”  blog. First I want to share some stories  from CHUK and the Sim Centre. I  was delighted to join the team (on this occasion Patty, Jon, Stephen and Chris) for Monday teaching at the Sim Center. It was a privilege to meet the residents and to discuss difficult cases under the avocado tree outside of the Sim center. The cases were complex but the tools are here to manage them. There are not as many drug options in Rwanda but there is a basic pharmaceutical suite (acetaminophen, morphine, tramadol, amitriptyline, gabapentin, ketamine and lidocaine) which used creatively can assist with most problems. It was interesting to me to learn that serious burn injuries in babies and cesarian section pain are big issues here. It was especially fun to co-lead with Patty, an opportunity we do not get when in Canada.

 I was very impressed when Magnus, the psychologist, arrived under the avocado tree. Here I have to digress for a minute to tell you that in the morning I was very fortunate to meet Dr. Lisine Tuyisenge, consultant pediatrician and Director of all Medical services at CHUK (pronounced “say-ash-u-ka”) (University Teaching Hospital Kigali). On this particular day Dr. Lisine was also serving in an acting capacity for her boss so there were people bringing in important looking documents for her review and sign as we met. Lisine is the local lead for the Microresearch project that our very own Dr.Noni MacDonald and collaborators are facilitating in Eastern Africa. Lisine connected me with Magnus as he is on the pain committee at CHUK and we are aiming to get pain teams involved with the micro research initiative (www.microresearch.ca) which is all about helping develop research projects to find sustainable solutions for local health care problems.  Lisine sent Magnus over to the Sim Center and as he strode up the hill to join us under the avocado tree all the residents reached out to shake his hand and greet him warmly and he greeted them all by name in return. After Magnus left I asked the residents how they all knew Magnus so well. I was curious because, in Canada, the Anesthesia residents do not necessarily know the psychologists. They said that Magnus did  a lot of work with them in the ICU. I thought Psychologists in the ICU! ... how wonderful, I said Canada has a lot to learn from Rwanda! Spoiler alert: this is not the only thing we can learn from Rwanda.

Meanwhile, inside the Sim centre it was fun to see Jon lying on the stretcher with one of the trainees using the ultrasound (there were 4 working ultrasound machines!) to identify what I assume were vascular and neural structures in Jon’s axilla. Jon with head turned toward the monitor was instructing and acting as patient all at the same time, well done Jon! Stephen did a great job summing things up for the group and commending them for their hard work. Chris, who is also here for the first time, from Toronto, was an integral member of the team and it all came together as if this crew had worked together a hundred times. The residents were engaged, enthusiastic and the place was full of positive energy. I was impressed to see this Sim Center that I had heard so much about and so proud of Patty and the team. We also had the chance to meet Claudine one of the residents who will be coming to Halifax soon.

Team chat before lunch

Patty with residents in sim centre

Jon, Stephen and Chris