Omar Issa Omar has recently returned to Tanzania after having been part of a fellowship in Obstretic Anaesthesia at Karolinska sjukhuset in Solna, Sweden.

Why did you become an anaesthetist?

It was in 2002 and I was working in the department of Obstetrics as assistant medical officer. During one ward I met a mother who needed a caesarean – the day’s first case. She was taken to theatre and reviewed by the anaesthetist in the operating theatre. He did a spinal block with lidocaine as it was the only drug available. Suddenly the patient said “I need water I am dying, doctor”. Unfortunately the anaesthetist was out the room. I shouted to him and he came back. The patient had become unconscious.
I got mentally stuck. What should we do next?  Then I realized she really is dying and I am going to lose both the mother and baby. I make quick decision to operate and I deliver a live, healthy baby boy! But the anaesthetist was having problems and the mother died. The theatre was run by only one anaesthetist and two part-time anaesthetists who worked at night on alternating days. Their hours were too long and they were tired. We investigated what happened on the day of the case and we concluded that the death was due to a complication of the spinal anaesthesia that was not identified and treated correctly.
It was very sad and hurt me a lot. So I starting thinking what was wrong and what should I do about it. In 2003 I make a decision to train in anaesthesia for 2 years so I could become an anaesthesia doctor.
After finishing my training I went back to the hospital. I have implemented improved standards, and although there was some resistance to change, slowly the staff understood and supported me.

 What is the state of anaesthesia in Tanzania?

There are 47 million people in Tanzania but less than 20 specialist doctors in anaesthesia. About 95 percent are working in Dar es Salaam. Most anaesthesia is done by nurse anaesthetists – there are about 200, or by untrained staff.  There are shortages of drugs, equipments and the ministry of health does not prioritise anaesthesia.

What is needed in Tanzania to improve anaesthesia to save mothers lives?

I think we need to do a survey of all the obstetric operating theatres in the country and we should create national obstetric anaesthesia standards that must be followed by all hospitals in the country. Training programmes should be increased and improved, records kept, anaesthesia services evaluated, supervised and followed-up.

What will you do after your fellowship in Obstetric Anaesthesia at Karolinska?

I will make several presentations to all staffs and administration team at my hospital to tell them what I have learned and what my plans are for improvements short term and long term. I will do in-service training to all the staff in the labour ward about managing obstetric emergencies.
I will work to create an Emergency Obstetric Team, prepare emergency checklists, set up meetings and micro seminars weekly with different groups of staff and conduct emergency simulations at least once a month.

 What would you like Life Support Foundation to do?

Life Support Foundation could assist in a survey of anaesthesia in Tanzania with financial support and manpower. Life Support Foundation could choose some of the regions after the survey which have really bad obstetric anaesthesia and try to improve the situation.

Tim Baker

Dr Omar Issa Omar training at Karolinska Hospital

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A team of Swedish anesthesiologists, obstetricianss, midwives and nurses are right now preparing for the fifth course in obstretic anaestehsia at the Muhimbili University Hospital in Dar es Salaam in November 2013. The course will be attended by  50 Tanzanian doctors, midwives and nurses working in different hospitals in Dar es Salaam.

The aim of the course is to reduce maternal deaths in Tanzania.
The course lasts for three days and will be held from the 5^th to 7^th November.

This is why we want to teach in Dar es Salaam

Klara Hasselrot, Resident in Gynecology:

“The world might sometimes seem very large, but the need to bear and give birth to a new life, staying safe and healthy is, I imagine, the same  for women all over the world. But we have different possibilities to succeed with that aim. To take part in this project has of course an altruistic side, but that’s not the only reason. It gives me great satisfaction to meet the world through my professional role rather than from a distance or under a sunshade during a holiday. “

Tim Baker Specialist Anesthesiologist:

“There is so much preventable suffering in the world. Children, mothers and young adults are dying due to a lack of simple, life-saving medical interventions. The world is so unfair – there are so few doctors in the countries with the greatest burden of disease. In particular the unequal distribution of specialist Anaesthetists is so striking – there are 200 in one Swedish hospital, Karolinska, but only 13 in the whole of Tanzania with its population of 44 million! I want to use my training, my knowledge and my experience where it is most needed – in low-income countries. “

Henrik Jörnvall, Consultant Anesthesiologist:

”I participate in the MKAIC-project and Life Support Foundation for a lot of different reasons. First of all the needs are endless and the beneficiaries are largely unable to support or vocalize their cause on their own. My work within the projects also puts a perspective on my work and life here at home – one doesn’t bother so much anymore about our “problems”. Finally, the projects give me a challenge that, to be honest, is quite big – I’m developing my professional skills and at the same time hopefully will make an actual difference in the long run for those with the greatest needs”.