International

BSG Sponsored Endoscopy Training at Kamazu Central Hospital - Malawi

Endoscopy Training at Kamazu Central Hospital (KCH) Endoscopy Unit - Lilongwe-Blackpool Endoscopy Link 25th February – March 1st 2013.

Visit by Dr Mark Hendrickse(MH) Consultant Gastroenterologist, Blackpool Teaching Hospitals NHS Foundation Trust

Background

Lilongwe is the largest city and capital of Malawi. Kamuzu Central Hospital(KCH) is the main government funded tertiary referral hospital, with an estimated number of beds varying from 600 – 1000 beds. Upper GI bleeding from portal hypertension complicating schistosomiasis and oesophageal cancer are major causes of morbidity and mortality hence the need to have a comprehensive endoscopy service. Through links with the Mersey school of Endoscopy and the Liverpool Malawi Welcome trust previous visits to KCH endoscopy unit in 2011 and 2012 by MH, Dr Paul O'Toole (POT) and colleagues initially involved a basic skills in gastroscopy course for surgical registrars, assessment of endoscopy nurse practice / training and decontamination, and subsequent follow up of trainee endoscopist / endoscopy nurse training evaluation. Recommendations on endoscopy unit expansion, decontamination requirements and support in nurse training were also made. After visits to the Blantyre endoscopy unit and participation in endoscopy nurse training programme in 2011, Rachel Jiya (RJ) and colleagues produced a comprehensive report detailing suggested developments / improvements required in the KCH unit. This has been forwarded to The Matron and the Hospital director at KCH.

Aims of current visit:

  1. To assess endoscopy training requirements of current trainees
  2. To provide small group teaching with all surgical trainees on:
    1. management of upper GI bleeding with particular emphasis on Variceal bleeding (including use of sengstaken tube)
    2. endoscopic therapy particularly variceal banding, oesophageal dilatation and stenting
  3. Review endoscopy training for surgical trainees committed to GI surgery
  4. Provide a refresher / enhanced skills course for those with endoscopy experience
  5. Basic skills course for those with no or very limited endoscopy experience
  6. Evaluate more experienced endoscopist (GM), and run a training the gastroscopy trainer course
  7. Set up meetings with Hospital director, Matron and Head of Department to take forward recommendations from previous visits / report by RJ and colleagues
  8. Assess current endoscopy unit equipment / facilities and future requirement

A full report of the visit may be downloaded below: