A Long Term Relationship

It started with this photo:

October 2011: Dr Jerry Cohen, ASA president elect and University of Florida associate professor, presents Lifebox chairman Atul Gawande with a GIANT CHEQUE.

Actually that’s not true.  It started with this article, backed up by this article, which prompted Dr Sephalie Patel, a resident anesthesiologist at the University of Florida, to propose a challenge: 100 percent departmental support for Lifebox.

Clearly the U of F anesthesiology department, like its football team,  plays for the field!  The challenge quickly gathered speed.  From residents to faculty, support staff to ASA president elect Dr Jerry Cohen, the 135 oximeter target – one for every member of the department – grew closer.

Now you don’t just throw around a giant cheque – people will get hurt – and head of department Dr Kayser Enneking had a notion to develop this fundraising success into a long-term relationship with the healthcare community of another country.

Gainsville, Florida to San Pedro Sula, Honduras (the long way round)

At the same time, about a thousand miles due south in Honduras, Dr Carolina Haylock Loor – president of the Sociedad Hondurea de Anestesiologia, Reanimacion y Dolor (SHARD) – was looking for ways to help her colleagues deliver safer anaesthetic and surgical care.  In many of the hospitals, equipment was a major barrier.

Sometimes there wasn’t enough:

And sometimes there was too much – a tangle of machines and cables, different models and manuals in every hospital, making it very difficult to maintain equipment or train providers:

At Lifebox we quickly realized: these colleagues on a mission have got to meet!

And so in March we sat down together at the World Congress of Anaesthesia.  Half in English, half in Spanish, we made warm introductions and grand plans: to enhance country-wide patient safety across Honduras with Lifebox pulse oximeters and the WHO Surgical Safety Checklist – and take the first steps in establishing a long term, mutually-beneficial, capacity-building relationship between Lifebox, the U of F and SHARD.

Hola! Hello!

Things haven’t really slowed down since.

Dr Haylock Loor worked directly with the University of Honduras and the Honduran Ministry of Health  to plan for the smooth import of 135 Spanish language pulse oximeters (Lifebox oximeters are available with an interface in English, French or Spanish); the WISE-Foundation, run by Bella and Yogesh Patel (Sephalie’s parents), stepped in to help with fundraising; Rafael Nin, father of anesthesiology resident Dr Olga Nin, leant his business nous to nurture the group from a ragtag bunch of highly efficient medical professionals to the UF Lifebox Honduras powerhouse you see today!

A scoping visit in gave the team some insight into appropriate engagement – where they could be most helpful and how the oximeter distribution and education programme could have the most impact.

Along the way they even had time to meet with the First Lady of Honduras…

Finally the big day arrived!  Reflecting the multidisciplinary nature of the WHO Surgical Safety Checklist, a multidisciplinary team with expertise ranging from anesthesia to radiology to surgery to engineering delivered a packed workshop to anaesthesia providers from all across Honduras.

And of course they distributed oximeters:

Lots of oximeters!

What’s so exciting about this collaboration, is that after all the work – the work is only just beginning.  There is no limit to what a relationship like this can achieve, and what mutual benefit it brings to both sides.

We were delighted to invite the U of F team to join the Lifebox panel session at the ASA’s Anesthesiology 2012 last month, on How to Deliver Lifebox Training in the Field (interested?) and we can’t wait to see what happens next, with eight further educational trips planned in the next two years.

This is an incredible example of what can be achieved with intelligent engagement, communication, teamwork and a spirit to challenge the unsafe status quo.

We’re inspired, and hope other groups will be likewise inspired to set their own challenges and work with us to Make It… (Zero).