Following the Rwandan genocide, there was only one anesthesiologist left in the country to serve a population of eight million.
Since 1994, Rwanda has been working to re-establish its health-care system, and Dr. Patty Livingston of Dalhousie Medical School has been instrumental in opening the first simulation and skills centre in the central African country this summer. The new facility, located at the National University of Rwanda, will help train local doctors and other health professionals.
Prior to the opening of the Faculty of Medicine Simulation and Skills Centre, most medical training in Rwanda was by lectures and observations. There were few opportunities for hands-on practice.
"In medical school, I'd never heard of simulation training,” said Dr. Gaston Nyirigira, a Rwandan anesthesiology resident. “We usually used books, lectures and drawings. You would crowd in and watch once with the surgeon. The second time you do it yourself right on the person, and call if you need help."
Nurses, medical students, residents, and physicians can now practice discrete skills, such as suturing, at the skills centre. They can also participate in team training around the management of complex emergencies, such as obstetrical hemorrhage. All of these skills can now be learned without risking harm to patients.
Building capacity
"It has been thrilling to experience the enthusiasm of the students who are able to practise techniques they may have only watched in the past,” said Dr. Livingston, a staff anesthesiologist at Capital Health and the medical director of global health at Dalhousie Department of Anesthesia, Pain Management and Perioperative Medicine. She was in Rwanda for the centre’s grand opening in late July.
“They are excited to be taught in a good learning environment, with proper training tools and supportive teachers. Keen learners are a delight to teach."
Teaching programs have been designed to use durable, low-cost materials, along with sound educational principles, for a sustainable program in this low-resource setting.
"The importance of this centre is tremendous,” said Professor Patrick Kyamanywa, dean of medicine at National University of Rwanda. “We hope it will advance the quality of medical education and the healthcare service in Rwanda.”
Dr. Livingston’s work has been supported by a $100,000 Rising Stars in Global Health grant from Grand Challenges Canada. The agency funds big-impact ideas in health care.