Lifebox in Ethiopia

A systems-approach to provision and training on pulse oximetry: towards a culture of safe surgery in Ethiopia


Between 2011 and 2012, Lifebox® distributed 256 units throughout Ethiopia with the help of partners – including Chain of Hope, Operation Smile, CHAI, and Smile Train – that made possible small, regional distributions.

In 2015 we received generous funding from the Flatley Foundation to increase the breadth of our engagement in Ethiopia to new regions. The first of these initiatives was conducted in the Southern region of SNNPR by Dr Biku Ghosh and then Lifebox Fellow, Dr Nick Owen. A total of 100 oximeters were distributed, with 27 anaesthesia providers trained in their use.

With guidance from Dr Abebe – Former Dean of the School of Medicine at Addis Ababa University and CEO of the Black Lion Specialized Hospital – we followed up by targeting a new population.

“I believe in academics, and that programs are much more successful if they’re integrated into the teaching of the nurses, the anesthetists, the surgeons,” said Dr Abebe. “If you insert change into the academics, the BSC nurse in anesthesia, the MDs, the surgeons, it might be slow work, but once you have a population of many health professionals who believe they can’t work without this change, there’s no turning back.”

In June of 2016, in collaboration with the Addis Ababa University, Tikur Anbessa Hospital, and the Ethiopian Association of Anaesthetists, a team of Lifebox faculty led the training of 128 anesthesia students and the distribution of 140 pulse oximeters. Upon completion of their degree, BSc students are deployed by the Ministry of Health to serve a term in hospitals outside of the capital, facilities that are under-resourced relative to the hospital that trained them and often do not have access to essential monitoring. By targeting students before their departure, Lifebox not only reinforced their exposure to safe monitoring practices, but also brought essential monitoring to Ethiopia’s most remote hospitals. It might be slow work, but we’re on our way to encouraging young professionals to increase the standard of anaesthesia provision through their practice.

“Now I have my own pulse oximeter and I don’t have to worry if the store is locked and that I’m alone at night with a broken pulse oximeter. I really feel confident how I can manage hypoxia.”

Ethiopian anaesthesia provider

“It [the Lifebox workshop] helps me think about how to solve the hypoxia problems systematically.”

Ethiopian anaesthesia provider

“It taught us to be competent enough to diagnose and manage hypoxia that occurs during anaesthesia.”

Ethiopian anaesthesia provider

Clean Cut® from Lifebox Foundation on Vimeo.