For one week in October, the Division of Pediatric Anesthesiology at Monroe Carell Jr. Children’s Hospital at Vanderbilt welcomed this year’s Global Pediatric Anesthesia Scholar. This academic exchange has been very successful, with this being the fourth year of its existence.
Dr. Tsitsi Chimhundu-Sithole completed her anesthesia residency at University of Zimbabwe (Harare) and in 2016, entered the East Africa Pediatric Anesthesia Fellowship through the World Federation of Societies of Anaesthesiologists (WFSA). Faculty members of the Department of Anesthesiology at VUMC have been actively involved in the development and implementation of this fellowship for many years. Part of the fellowship provides the opportunity to come to VUMC to observe both clinical and academic systems and then apply her new understanding in Zimbabwe, a low resource setting, where she is involved in education and clinical practice.
Jenna Sobey, MD, explained that the global scholar is brought to MCJCH and Boston Children’s Hospital to observe before he or she goes to the American Society of Anesthesiologists Annual Meeting to present a poster. Dr. Sobey and other leading global pediatric anesthesia facilitators in Boston partner to provide this unique educational opportunity for these scholars.
Mark Newton, MD, said there is a massive global imbalance in healthcare, and efforts should be focused on seeking solutions that impact children. “The VUMC Department of Anesthesiology is an international leader in anesthesia education and research in low- and middle-income countries, and having Dr. Chimhundu-Sithole here with us from Zimbabwe is just one building block that will further extend VUMC’s role in providing safe pediatric anesthesia in Africa. The Department of Anesthesiology is committed to deep-rooted, measurable, sustainable academic interventions which focus on the needs of the partnering country, and this case is a great example, with Dr. Chimhundu-Sithole coming to spend time with Dr. Sobey and her team at Vanderbilt,” he commented.
Dr. Chimhundu-Sithole said she learned a great deal during her time at MCJCH, but she isn’t the only one learning. “I think one thing we realize when working with our colleagues from across the globe is that sometimes you can accomplish safe anesthesia care with much fewer resources than we are all accustomed to working with on a daily basis,” Sobey said. “The bidirectional learning for our faculty and trainees is an aspect of the exchange which at times gets overlooked.”
One of the biggest things Dr. Chimhundu-Sithole will take back home is how to run an efficient OR. “The system is less efficient at home, and in the end we end up doing fewer cases. When I go back, I want to increase efficiency, prepare ahead of time and reduce time between cases,” she said. She said she also wants to focus on training nurses in the recovery room. The nurses in Zimbabwe are not equipped to do more complex cases. She also wants to expand the ability to do cases outside her hospital and train and employ more highly skilled non-physician anesthesia providers (NPAP) to work in the more rural regions of the country.
Dr. Sobey pointed out that Dr. Chimhundu-Sithole has amazing resiliency. “She is pursuing super specialized training to go back to her country. She is the only pediatric trained anesthesiologist in her country at this time.”
“She is taking on a lot to try to further facilitate education in pediatric anesthesia and accomplishing great things with the resources that she has,” Sobey said. “We know that continuing to provide safe anesthesia in her area is challenging, but it’s amazing how much she has been able to accomplish thus far already.”
Dr. Chimhundu-Sithole said she is really grateful for this opportunity to come to MCJCH and learn. “At home it tends to be really busy and I’m worried more about pushing cases, but here there’s a lot of care and people taking time to talk to the parents and I think, in terms of my personal practice, I will change that. Just giving parents an extra minute to talk to them, answer their questions and allay whatever fears they have,” she said.
This partnership extends the VUMC impact nationally, with partnership between leading children’s hospitals in the USA, but also internationally, with a new colleague and pediatric anesthesia leader in Zimbabwe who will help guide that country’s policies and standards as the care for pediatric surgical patients improves.