Intended for healthcare professionals

Education And Debate

Only if she has a fishing rod!

BMJ 1998; 317 doi: (Published 19 December 1998) Cite this as: BMJ 1998;317:1711
  1. Raymond Towey (, consultant anaesthetist,
  2. Ernestina Kimaro, assistant medical officer anaesthetist
  1. Department of Anaesthesia, Burgando Medical Centre, PO Box 1370, Mwanza, Tanzania

    It is difficult carrying out a research project in sub-Saharan Africa if you are local doctors. The clinical workload is heavy and there are few trained staff, and because of the lack of supporting infrastructure every task requires more energy than you anticipate. We tried to answer one question: “What are the obstacles to safe anaesthesia in the rural districts of our catchment area?”

    We are based in an urban centre on the southern shores of Lake Victoria in Tanzania, east Africa, in the tertiary referral hospital for a population of eight million. We knew from informal feedback from the anaesthetists in the outlying districts that there were many problems, but we wanted hard data, not anecdotes. Where were the obstacles? Was it lack of drugs, equipment, or personnel? With the help of funds from the Irish Government aid agency, HEDCO, we did a survey of an area of 67 500 square kilometres with a population of four million.

    This survey was no easy task. It meant that one of us (EK) had to visit the 27 hospitals in the region, some in very remote …

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