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Improving Uganda’s Surgical Outcomes through Regional Anesthesiology Education

Mulago Hospital

This is the fourth of an ongoing series of blog posts from the Global Health Initiative, an international educational program from the Department of Anesthesiology aimed at advancing the practice of regional anesthesiology abroad. To read previous installments by Dr. Lee Rasamny and Dr. Jennifer Charles, click here.

This trip to Uganda marked my second journey to the opposite side of the world — Kampala, Uganda — to teach ultrasound-guided regional anesthesia techniques to anesthesia residents at Mulago Hospital. With the support of our Ugandan colleagues at the hospital, I was able to return as part of the Department of Anesthesiology’s Global Health Initiative.

Mulago Hospital
Mulago Hospital in Kampala, Uganda partners with anesthesiologists from the Global Health Initiative at Hospital for Special Surgery (HSS) to bring regional anesthesiology to its patients.


The first seminar of the four-day workshop was attended by almost all of the anesthesia residents and even a few orthopedic surgery residents; each attendee was very eager to learn about the benefits, indications, and utility of regional anesthesia and its potential impact within Mulago Hospital. Even after discovering that the operating theaters did not have running water, a common problem in limited-resource health care settings, the providers’ enthusiasm was not tampered.

Each day started with lectures on the basics of regional anesthesia, the physics of ultrasounds, and specific peripheral nerve blocks that the residents would perform later in the day under my supervision. After only a few days of training, even the most junior residents successfully performed ultrasound-guided peripheral nerve blocks on surgical patients.

Mulago Hospital’s anesthesia machines monitor patient’s vital signs during surgery. A major component of the Global Health Initiative is to help anesthesiologists work with the equipment they already have to improve the level of anesthetic care available to patients.

To better understand the residents’ opinions on the utility and potential benefits of expanding the role of ultrasound-guided regional anesthesia, we conducted a survey before and after the workshop. We learned that the residents believed that increasing the use of ultrasound-guided nerve blocks would lead to improved safety, efficacy, and patient satisfaction. They also believed that the orthopedic surgeons will support expanding ultrasound-guided regional anesthesia. The vast majority of the residents reported that their skills in capturing the appropriate images using ultrasound and their ability to perform the specific ultrasound-guided blocks improved across the board after the workshop.

The timing of the trip came at a very interesting political environment in Uganda. Presidential elections were only weeks away, and because civil unrest during this time was not uncommon, we were certain to visit before the elections started. One of the most intriguing things I noticed was that the state of Ugandan healthcare was at the forefront of the Ugandan presidential debates. This focus showed just how important the issue of improving the state of healthcare is throughout the entire country.

The Global Health Initiative plans to return to Mulago Hospital to run more workshops and to continue to supervise the expanding role of ultrasound-guided regional anesthesia. Our goal is to improve the skill and knowledge of the local workforce through sequential teaching trips. Ultimately, we hope that local anesthesiologists will become the champions of these advanced skills, and can disseminate their knowledge and education throughout their local communities. The future of global health outreach relies on sustainable development through education and teaching.


Dr. Lee Rasamny is a 2015-2016 Regional Anesthesiology and Acute Pain Medicine Fellow focusing on global outreach.

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