Currently I work as a nurse practitioner caring for critically unwell patients in Aberdeen Royal Infirmary. In conjunction with the Soapbox and NHS Grampian, I have recently been lucky enough to spend some time with the healthcare team who work in an Intensive Care Unit (ICU) in Felege Hiwot Hospital, Ethiopia. Normally I think of intensive care as expensive care setting, with increased staffing ratios and lots of high-tech equipment. I was curious to learn more about how to provide critical care in a more resource-limited setting.
From the moment I landed in Bahir Dar, I was made to feel very welcome. The healthcare team shared their friendship, their coffee and their experiences with me, even though it felt that all that I did in return was supply a seemingly never-ending torrent of questions- “What is that for?” “Why is that happening?” etc. etc.
Ethiopians use a different calendar and way of ‘telling-the-time’ and so it took a while to orientate myself. However, as soon as I was in the ICU with patients with familiar clinical conditions I started to feel at home. The team’s clinical examination and procedural skills were impressive and I learned a lot from their informative ward rounds. I was soon questioning my own practice, wondering if, in the UK, we sometimes overdid the number of tests and paperwork – did such things really benefit patient care? Aspects such as this definitely gave me a lot to think about. I was also impressed by their ingenuity – I had never seen so many different uses for a simple intravenous fluid infusion set. This equipment was skilfully turned into everything from suction catheters, to curtain ties to chest drain tubing, however, but I’m not sure this would go down well if I started to do this in Aberdeen!
It did not take long to start to understand some of the challenges the staff faced. The issue of limits to healthcare funding was familiar, but here it was on a very magnified scale. The nurses and doctors were resilient. I could see that they knew what was ‘best practice’ but had learnt to compromise so that they could continue to provide care even when the most basic of resources such as water and electricity were not available. They shared their frustrations with me and were almost in disbelief when they asked me to describe our ‘free-to-all’ national health service.
Since being back, I definitely look at things differently. I understand that the Scottish healthcare system is not perfect but I appreciate what we do have and the importance of its sustainability. I understand better the importance of practising efficiently and encouraging others to do the same.
My mosquito bites may finally be starting to fade but my memories of the staff and patients of Felege Hiwot Hospital remain strong- I am currently writing a more detailed report of my experience, suggesting ways in which services could be developed. I am sure there are many ways both patients and staff can benefit, both here and in Ethiopia and I am looking forward to seeing how this friendship grows in the future.
Read more about our work in Ethiopia: