Duke Anesthesiology Global Health Program

Duke Health Sends Supplies to India to Assist with Covid-19 Crisis

Hundreds of boxes of protective gear and equipment are now available to health care workers in New Delhi thanks to the quick, coordinated response of Duke Health faculty and staff. India experienced a sharp spike in COVID-19 cases in the spring of 2021, overwhelming the country’s health system.

Global Health PPE ShipmentsWhen he first learned of the crisis, Madhav Swaminathan, M.D., professor in the Department of Anesthesiology at Duke, swiftly coordinated colleagues across Duke Health — in the departments of anesthesiology, perioperative services, pharmacy, surplus, supplies and more — to gather more than 150 boxes of equipment into two large shipments.

Donated supplies included personal protective equipment such as masks, gloves, and isolation gowns as well as respiratory care equipment such as filters, oxygen masks, resuscitators, and oxygen delivery devices. The first two shipments both arrived in May during the height of India’s COVID crisis.

“We wanted to do something helpful and tangible for the people on the ground who are suffering. Through our contacts and networks, we know a lot of hospitals and charities that are working to help sick patients who are ill with COVID,” said Swaminathan. “We wanted to help them, so we gathered a whole group of people here at Duke and friends and colleagues throughout the Triangle and we started raising funds and donations for this effort.”

Duke Health donated a large amount of the equipment. In choosing what to donate, staff took into account surplus items and also the types of items that would be most useful for providing continuous respiratory care.

“It’s not just the ventilators that run out, it’s some of the basic, disposable items, and that’s where we can step in and help,” said Charlotte Reikofski, health systems director for Respiratory Care Services at Duke University Hospital.

After supplies were collected, the next hurdle was to organize and label them in a manner so they would reach the specific end donation where each item was needed — a massive coordination that the team accomplished in just a few days.

Kuldip Patel, Pharm.D., associate chief pharmacy officer at Duke University Hospital, coordinated his team to assist with this effort. Colleagues in the American Society of Echocardiography (ASE) — a professional organization in which Swaminathan is a member — provided funds for the shipment. Colleagues in the Duke Global Health Institute’s Global Health PLUS program helped organize the in-country delivery.

“As an Indian, I think this is an amazing chance and opportunity for the team here at Duke with support from Duke leadership to contribute to this tremendous effort,” said Patel. “COVID is not over. Though we may have started to see signs of improvement in this country and other countries, we’re far from solving the crisis. This is a global pandemic and it’s not over yet so we want to continue to do as much as we possibly can to prevent further loss of life.”

Swaminathan is equally amazed and grateful for how many people in the community came together so quickly to make it happen.

“I think that everyone in the Triangle who has roots or connections in India knows someone who is ill, has been hospitalized, or has passed away,” he said. “I think it’s very meaningful for all of us who work in healthcare — no matter what our role is — that we’re able to help people who are struggling in other parts of the world. India happens to be the hot spot at this point, but anyone who is struggling around the world really deserves our help — our expertise, knowledge, and materials.”

Key, Lindsay. Duke Health Sends Supplies to India to Assist with Covid-19 Crisis. Duke Health News, May 2021.

Blogs from Abroad

Dr. Adeyemi OlufolabiThe world changed in 2020 with the arrival of the coronavirus pandemic. Despite significant challenges that curbed many programs and goals, the one constant was our department’s global engagement and defining achievements, 7,300 miles away in Rwanda, known as the “Land of a Thousand Hills.”

Having spent close to two years there in 2018 and 2019, I had introduced labor pain analgesia in the highest tertiary hospital of the country, the University Teaching Hospital of Kigali (CHUK). Both IV and neuraxial labor analgesia were established. Dr Edouard Uwamahoro, my protégé who had trained in Nigeria and is the only Rwandan obstetric anesthesiologist in the country, partnered to ensure sustainability.

Unfortunately, mission duties sent him to neighboring countries and the program was in danger of a setback. Within the last few months of 2020, and through advocacy, I successfully received approval from the government and the CHUK administration to deploy a newly-appointed consultant dedicated to maternity care at CHUK, who is driving forward the anesthesia service within the maternity unit. The hospital is now working towards ensuring this process is sustained to the benefit of its patients.

I trained and introduced the use of intrathecal morphine for cesarean section and other gynecological operative procedures using specific guidelines and protocols, significantly improving pain management. I am pleased to say this has continued with anecdotal feedback from the midwives caring for postoperative patients.

I returned to Rwanda in September 2020 on the invitation of the largest private hospital in the country to initiate a similar comprehensive obstetric and gynecological analgesia program. Didactic training occurred over a three-day period followed by a three-week on-site setup, initiating a structured rollout, showcased in the Rwandan media.

The King Faisal Hospital team was determined to ensure this service is sustainable and that it has provided staffing, equipment and drugs. The staff was extremely grateful for the institution of this new service and we celebrated on my final visitation day. We have now established improved pain management in the maternity units in the biggest public and private hospitals in Rwanda. A laudable achievement.
Blog by Dr. Adeyemi Olufolabi

Dr. Andrew WongMy trip to Rwanda with Dr. Olufolabi was focused on getting a “taste of global health.” I spent time with the residents at Rwanda’s main academic medical center, the University Teaching Hospital of Kigali, observing how they practice anesthesia in a resource-limited setting. Much of my time was spent working with their residents in the maternity and general ORs and teaching at Monday all-day resident education conferences. I had the fortune of visiting at the same time as a small team from the University of Virginia, and together we gave short lectures, held problem-based learning sessions, and ran low-fidelity simulations with a marker and easel pad to “display” vital sign changes on the “anesthesia machine” in response to interventions. Teaching in an austere environment was challenging, but we were met with an enthusiasm from the residents that was incredible. Dr. Olufolabi and I also traveled to different hospitals of varying care acuity levels throughout the country to see differences in anesthetic care. There are so many things we take for granted here in the US that you realize are not available everywhere else (like various medications, ultrasound, IV infusion pumps, body warmers, technician and biomedical engineering support), and it helped me to better appreciate all the vast infrastructure that keeps Duke running day to day. There were many moments where we had to engineer innovative solutions to problems – like using a hair dryer as a heat source for a body warmer. At the end of the month, I helped gather data on maternal mortality to assess the efficacy various QI measures implemented in the maternity ORs over the past year. All in all, it was a fantastic opportunity that I highly recommend for anyone who is even remotely interested in global health.
Blog by Dr. Andrew Wong


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