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Crawling steadily towards safe surgery in Ethiopia

Crawling steadily towards safe surgery in Ethiopia

Senait Bitew is a public health professional with a nursing background. She has worked in the health sector for more than 15 years and has managed programmes for the safer surgery non-profit - Lifebox - for the past three years. This month, she was appointed Lifebox’s Head of Programmes for East Africa, where she expects to deliver programmes and strategic plans for Lifebox across the region.  The Reporter’s Samuel Getachew discussed with her the activities and impacts of Lifebox. 

R. Share with me the highlights of LifeBox.

S. Lifebox is an international non-profit organization working to make surgery and anesthesia safer on a global scale by investing in tools, training, and partnerships. Founded in 2011 by four of the world’s leading medical organizations and chaired by surgeon and writer - Dr. Atul Gawande, Lifebox works across three core pillars of Safer Surgery – improving anesthesia safety, reducing surgical infection rates, and strengthening surgical teamwork. The core of our work in 2020 has been to support partner healthcare providers respond to the COVID-19 pandemic with pulse oximeters, training materials, and technical guidance.

R. What have been some of its major activities in Ethiopia?

S. Lifebox began working in Ethiopia in 2016, partnering with the Federal Ministry of Health and its partners on Safe Surgery. Work started with the distribution of pulse oximeters - the medical device that clips to your finger to measure oxygen saturation in the blood - alongside safer anesthesia training. Not only are pulse oximeters an essential monitoring tool when patients are undergoing anesthesia during surgery, it is also one of the critical tools in the triage of COVID-19 patients. In total, Lifebox has distributed more than 1,700 pulse oximeters to hospitals across Ethiopia - more than a third of that has been to support our health system in the fight against the COVID-19 pandemic.

We’ve also been partnering with other Ethiopian initiatives to combat the virus, such as collaborating with N95decon and the Optical Society of American Foundation, Addis Ababa institute of Technology (AAiT) and St.Peter specialized hospital to build and pilot a project testing decontamination using UV-C cabinets. This pilot project is to help the COVID-19 response in Ethiopia and other African countries to help in disinfecting N-95 masks by killing or inactivating the microorganisms. 

Another collaboration we invested on is the partnership with the Ethiopian COVID-19 Response Team (ECRT) - a group of 1,800 volunteers and Tegbare’id Polytechnic College. Lifebox is supporting ECRT’s and Tegbare’id Medical Device Maintenance Project to repair existing medical devices at a critical time for healthcare facilities in Ethiopia.

Before the pandemic hit, Lifebox’s main area of work in Ethiopia was Clean Cut - a program that works to reduce the rates of infection occurring after a patient undergoes surgery by partnering with facilities to improve their infection prevention practices. Clean Cut works closely to engage members of a hospital’s surgical team - surgeons, anesthesia providers, nurses, sterile processing technicians, as well as hospital management.

The most exciting part is that the pilot project in Jimma University Specialized Hospital, Tikur Anbessa Tertiary Hospital, Menelik II Referral Hospital, St Peter’s Specialized Hospital, and Fitche General Hospitals saw the rates of surgical site infections reduce by 35%. These impressive results were published in the British Journal of Surgery last month. With the support of the Federal Ministry of Health, we’re building on this success by rolling this work out to hospitals across the country and beyond.

R. How many people has it helped so far and what has been its impact on the ground?

S. Over the last nine years, Lifebox has distributed more than 25,000 pulse oximeters with training in 116 countries and trained 10,000 healthcare providers. This work has made surgery safer for over 20 million patients. Our work now, in the reality of COVID, is pivoting our work to be implemented by local teams with online support from Lifebox clinical teams. Lifebox has just appointed Dr. Tihitena Negussie Mammo, an Ethiopian Associate Professor of Pediatric Surgery and a Consultant General and Pediatric Surgeon as its Global Clinical Director to help Lifebox scale its impact across East Africa and worldwide.

R.What is its long term vision?

Lifebox’s vision is a world where safe surgery is no longer a luxury. Five billion people in the world lack access to safe surgery.  In some parts of the world, the risk of death following surgery can be 22 times higher than in a high-income country. Lifebox will continue its work in strengthening surgical systems through tools, training and partnerships to make surgery safer - for every patient, every time.

R.How are recipients selected?

Lifebox’s work is founded in partnerships, led by local clinicians that are experts in their field. We know that in some settings, resources may be scarce or a health system inhibits safe surgical care. Our aim is to support healthcare providers to provide the safest surgical care possible. We see this as an equal partnership rather than a recipient model. We work where the surgical need is greatest and Lifebox - through its relationships with health Ministries and networks - can make the biggest impact. This impact is definitely being felt here in Ethiopia through work such as Clean Cut.