2023 Footprints of Progress

Lifebox footprints of progress for safer surgery and anesthesia in 2023

A Smile Train-Lifebox Capnograph in an operating room for anesthesia monitoring

The Smile Train-Lifebox Capnograph at Yekatit 12 Hospital Medical College, Ethiopia. ©Yosef Amare Tsehayu/Lifebox, 2023.

1. Tackling the Global Capnography Gap with the Smile Train-Lifebox Capograph

This year Lifebox and partner Smile Train addressed a major gap in anesthesia safety by making available an affordable, high quality capnograph suited for use in low-resource settings. A capnograph is a life saving monitor that immediately detects when a patient is not getting adequate oxygen during anesthesia – avoiding devastating harm. It has been a staple in operating rooms in the United States for more than three decades, yet is nearly entirely absent from low-and middle-income country operating rooms. 

This year 150 anesthesia providers have been trained in Ethiopia and Uganda and we are working with Smile Train to equip 350 operating rooms with Smile Train-Lifebox Capnographs. 

“Capnography devices are found in ICU and operating theaters of only a very few hospitals ranging from primary to tertiary levels, in our country.  So, we are not able to monitor our patients under anesthesia and identify problems such as wrong placement of the air tube. We have now received two capnography devices from Smile Train-Lifebox and our health professionals have been provided training. This is a great contribution that will help us save so many lives."
Dr. Elias Tewabe, CEO, Yekatit 12 Hospital Medical College, Ethiopia

Clean Cut for Long Bone Fracture training at Queen Elizabeth Hospital in Blantyre, Malawi. ©Lifebox/Alick Chimzere 2023.

2. Fighting Wound Infection in Malawi

Lifebox has worked with 35 partner hospitals across seven countries to impact over 208,000 patients with our surgical infection reduction program – Clean Cut.

We launched work in Malawi with the Johnson & Johnson Foundation to reduce wound infection in patients with long bone fractures. Wound infection is the leading complication associated with long bone fractures, which are cracks or breaks in the long bones of the body. Clean Cut for Long Bone Fracture is being implemented in partnership with the Queen Elizabeth Central Hospital in Blantyre with initial results showing reductions in the rate of wound infection of over 30 percent.

“I am proud to be part of Lifebox’s unwavering commitment to expand its services to several countries including Malawi. Carried out with the support of the Johnson & Johnson Global Surgery Initiative, our Clean Cut for Long Bone Fracture project is a significant milestone in improving patient outcomes by reducing surgical site infection rates and streamlining compliance to safe practices and enhancing surgical teamwork.”
Dr. Damiano Chaula, Clean Cut for Long Bone Fracture Fellow, Malawi

3. Lighting Up Operating Rooms with the Lifebox Light

Every year, an estimated 24 million patients are put at risk of serious harm simply because their surgeon lacks the light needed to operate safely. This year, Lifebox and COAST launched the Lifebox Light: A durable, affordable headlight suited for use in low-resource operating rooms.

Surgeons using the Lifebox Light report improved surgical safety – including better visualization, increased accuracy, confidence, and focus, shorter surgery duration, and a reduction in patient harm. Lifebox and COAST plan to equip over 1,200 surgical providers with Lifebox Lights for safer surgery.

“So there was a time we had power failure here in this very room. We had a patient on the table when the current went off and we used [a] phone to complete the surgery. And with God being on our side, we were lucky, we didn't leave anything in the patient and the patient survived the surgery and walked out of the hospital. But these are terrible instances.”
Dr. Arthur Jones Wuoh, surgeon and Medical Director, C.B. Dunbar Hospital, Liberia.

Genet Girma, first time mother, was treated for an infection post birth at ALERT Hospital in Addis Ababa, Ethiopia. ©Lifebox,2023.

4. Transforming Maternal Health 

More than 10,600 women participated in the Lifebox CLEAN-CS program. CLEAN-CS is a randomized trial to improve the safety of cesarean delivery by reducing rates of postoperative infection. Nine hospitals in Ethiopia took part in the trial with preliminary results showing significant reductions in maternal postoperative mortality and neonatal mortality. CLEAN-CS is a Bill & Melinda Gates Foundation Grand Challenges Initiative.

"I have undertaken Lifebox’s training, and I understand how critical it is to adhere to the checklist. While many infection cases are identified while the patient is still at the hospital, women also face the risk of getting infected after they leave the hospital, and this calls for us to continuously try to improve the situation. ” 
Dr. Nardos Aynalem, Gynecologist and Obstetrician, Alert Hospital, Ethiopia 

Adeola Ogunrinde, nurse, monitors a patient with a pulse oximeter at JFK Hospital, Monrovia, Liberia. ©AhmedJallanzo/Lifebox,2023.

5. Distributing 35,000 Pulse Oximeters For Safer Anesthesia

This year, Lifebox added another beat to the rhythm of hope by supplying its 35,000th pulse oximeter.  A pulse oximeter is the only piece of equipment included on the WHO Surgical Safety Checklist  and is a minimum standard for safe anesthesia. Yet operating rooms across the world still lack this essential device – putting millions of lives at risk. 

This year we supplied 779 pulse oximeters across 34 countries, including Nigeria, El Salvador, and Bangladesh.

“Initially we did not have pulse oximeters in our post anesthesia care unit to monitor our patients. But now that we have a Lifebox pulse oximeter we're able to recognize some post anesthesia complications using this important device. At one time, we had a postoperative patient who was hypoxic due to opioid overdose. We were able to respond and intervene immediately and saved the life of the patient because we had the pulse oximeter on our hands! The Lifebox pulse oximeter monitor is really helping us in the management of post-operative care of our patients.”
Galgallo Huka, Marsabit County Referral Hospital, Kenya

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