A week in the Life of Niger

This week we’re joining the Liya Kebede Foundation on Instagram, sharing our work in Niger and the impact that safer surgery has for mothers and babies worldwide.

It’s been five months since our countrywide project put training and a pulse oximeter into every government hospital and recovery setting.  To celebrate this milestone, and thank the LKF for their kind invitation, we spoke to Dr Faye Evans: paediatric anaesthesiologist, and co-lead faculty for #SaferSurgeryNiger.

Let’s start at the heart of the matter: would you give an anaesthesia without a pulse oximeter?

Well I trained with oximetry – it has always been around for me as a monitor, and going without would make me incredibly anxious.  If I don’t hear the beep of that oximeter – something is wrong. But would I do it?  Interesting question.  In the U.S. using a pulse oximeter is considered a standard piece of equipment.  Very few individuals would agree to performing an anaesthetic without one. However, working in a low-resource setting is a very different situation.  A pulse oximeter might be difficult to find.  I would do everything I could to locate one, but in a life-saving situation… As our colleagues in Niger know, when it’s an emergency, you don’t really have a choice.

Why is safe surgery essential for maternal health?

Childbirth can be a dangerous process wherever you are in the world.  And if you can’t get the right care during complications of labour you’re not only risking the life of the mother, you’re risking the unborn baby. These aren’t people who have chronic illnesses – who, if they die, it’s sad but perhaps not unexpected.  This is a completely preventable death.  These are people in their prime, and at the start of their lives.  To see them die – it shouldn’t happen.

Did you see any surgery in Niger? 

At the teaching hospital in Niamey we watched a team induce a small baby – put her under anaesthesia.  There was minimal equipment, but they used the monitors they had, and it was quite controlled – a really nice job.

Inducing a small baby makes people very nervous, even in a big hospital in the U.S. Say you have a problem – the oxygen levels go down – they have no reserves.  Under three months old they’re so tiny and fragile that things happen really fast.

What impressed me so much in Niamey was the hospital team’s calm demeanour – a systematic approach to the procedure, monitoring to the best of their ability.  They’re incredibly well-educated, and they did their best with what they had, to be as safe as they possibly could.

What difference do you think the donation of oximeters will make?

It was so exciting when we were handing them out!  If you look at the map of recipient facilities, you can see how far people had come.  Some of the hospitals in Niger had no oximeters at all – so to get this piece of equipment is truly valuable.  A silent OR is a very uncomfortable thing.

What will you remember about your time in Niger? 

The people were amazing. Incredibly appreciative of the work we are doing and committed to improving the care of their people.  Our host Dr. Sani Chaibou and his team were inspiring!

The other thing that struck me that while Niger was the hottest place I had ever visited.  It’s very brown and dry, and the women dressed in the most beautiful colorful outfits. The contrast was very striking.

But mostly what struck me during the trip was the dedication.  Many of the  physicians we met who had gone abroad to train, but they all felt like they wanted to come back and make a difference. After our trip we realized we must come back as well.