“There is no surgery without anaesthesia. You can train 100 surgeons – but there will be no operation.”

In August 2014, Lifebox trustee Dr Isabeau Walker travelled with long-time Lifebox friend and president of the College of Anaesthetists of Ireland (COI) Dr Ellen O’Sullivan to Queen Elizabeth Central Hospital in Blantyre, in the south of the country.

Last year, survey undertaken by Cyril Goddia (head of the Anaesthesia Clinical Officer training programme), with Gradian Health Systems, revealed a significant pulse oximetry gap.

So we set about a project to close it.

Some anaesthesia colleagues travelled 10 hours to get to Blantyre, from small rural hospitals across the region. They were working without pulse oximeters, or having to share one between two to four theatres. Basic monitoring was a finger on the pulse and an eye on the colour of the patient’s lips.

Thanks to the Cycling Surgeons, who took on hill and dale and puncture in the name of safer surgery, to the COI who led the faculty alongside our Malawian colleagues, we were able to donate 100 pulse oximeters and deliver training to 80 anaesthesia providers and 20 clinical officer surgeons.

“Thousands of lives will be safer as a result of all your efforts,” Dr Walker reported back. Of the photo from the course – “The smiles say it all!”

Two weeks later we were back in the north, at Kamuzu Central Hospital with ACTS – the African Conference Team led by Dr Keith Thomson. This three-day conference (in the ‘Warm Heart of the Warm Heart’, according to Fanny Mtambo, who supports the UNC Project-Malawi) was an opportunity to improve practice in an area of anaesthetic care that makes up almost 80% of emergency cases: obstetrics