by Dr. Abner Taye Kebede

25 February 2009

Lebowakgomo, South Africa: It was in 2005 that I came across the UNV Limpopo Doctors programme, designed to assist the province’s various health facilities through the provision of specialist doctors where there were critical shortages. The news brought about fond memories of my first encounter with a Belgian volunteer with whom I worked for a short period in one rural hospital in Ethiopia at an early stage of my career.

I was just out of medical school at the time and was hoping to land a job in one of the big towns and enjoy the respect and financial rewards for all those tough times at medical school. The medical school armed me with knowledge about thousands of diseases and how to diagnose and treat them. But my first month at work was really the time I learned what it all meant to be a doctor.

I found out that my daily routine ranged from administrating the hospital to getting my queue of patients in the morning. My work also required me to constantly liaise with town elders, for whom I was the trusted advisor and confidant in all matters related to health and social development issues.

I still vividly recall young children brought to me by parents seeking my advice on the advantages of education. The support and guidance of my Belgian volunteer colleague was of paramount importance in those early days of my career.

Given the above background and subsequent experiences, I was pretty confident and felt appropriately qualified for the South Africa project. In addition, being an assistant professor and a consultant anaesthesiologist in a university hospital and my understanding of volunteerism prepared me well for the task awaiting me ahead.

On my arrival in South Africa for the first time in 2005, I was lucky enough to attend the UNV annual meeting which provided me with the opportunity to learn more and get the overall picture of the project I was to join.  

The then UNV Programme Officer Mr. Alex Rusita informed us, during an orientation meeting, that the UNV volunteers had a crucial role in supporting new Government policy initiatives and priorities to improve service delivery in all sectors of the economy. This struck a chord in my mind and reminded me of my first rural practice; gave me a hunch that my stethoscope and magic gas may not be the only things I needed for the mission ahead.

I still have a fresh recollection of my arrival day in my new home, almost four years ago, Lebowakgomo Hospital in the rural township of Limpopo Province about 250 km from the South African administrative capital, Pretoria.  

It was a new hospital constructed in 1999 and run mostly by new graduate doctors. I was given a wonderful welcome reception fit for a king. The head of the hospital took me around various sections of the hospital and guided me to important locations I must know in the township, which actually were the marketplace, petrol station and the road to the next big town.

On my first introductory meeting with the doctors I was shocked to learn the unacceptable high rate of anaesthetic complications the hospital was facing, especially involving maternal anaesthetic complications. I could see the relief and appreciation my arrival had stirred among the young doctors.

I was given a chance to introduce myself to the hospital staff and proudly said that I am an anaesthetist by profession and a UNV volunteer. The first question I received was: "Did a UNV volunteer assignment mean that I was stationed for a short time only?" It was with this encounter that I started my primary role of advocating for volunteerism.

The task of establishing and building up the anaesthesia unit kept me busy for the first months. The eagerness and dedication of the operation staff and doctors to provide better care and equip the hospital to handle the challenges faced day by day made it possible to quickly pass the first hurdle.

I was able to markedly reduce the rate of anaesthetic referral cases to tertiary hospitals: the establishment of paediatric anaesthesia played a big role. In addition a regular pre- and post-anaesthetics care service and strengthening of critical care follow-up rooms in each ward had a sound impact in improving patient care.

My early days in the hospital used to be hectic and full of dramas in the theatre. Being on call for emergency anaesthesia throughout the month is not an easy task. The calls to my house in the middle of the night to attend to failed intubation, resuscitation, and numerous other complications used to be a daily occurrence.

My accommodation, which was advantageously located 120 steps from the operation theatre, was my running field during those nights attending to emergencies. The telephone calls and sometimes the banging on my door in the middle of the night followed by the urgent voices of nurses informing me of a critical situation in the theatre and urging me to come and rescue the situation used to be so common that sometimes I just slept wearing my operation theatre's green attire. I am happy to say these things are history now; most doctors are well enough equipped in basic anaesthesia skills to address emergencies.

In a town where recreational facilities are non-existent, my evenings and weekends are mostly spent in one of the hospital corridors with an Internet connection. My routine evening schedule is well known among the doctors; a welcome regular interruption is when interns and doctors come for informal consultations and to discuss challenging patients.

My corridor office gave me a vantage point to see my colleagues coming to hospital in their free time to help out with emergency cases or just revisit their critical patients. I trust volunteerism always starts at home and I strongly believe that this is just a first step to future volunteerism.

The opening of an Intensive Care Unit, in 2006-7, was a milestone in the history of our hospital. In addition the hospital managed to successfully organize and run a two-month interns' training and a one-month community doctors' training in anaesthesia which I am very proud off. This accomplishment has earned the hospital a well deserved recognition as an internship training centre.

Furthermore, expansion of service delivery programmes and accreditation of the hospital to a district level one hospital was the priority in this period. I was given the task of developing policies, management guidelines, treatment protocols and teaching manuals for anaesthesia, the intensive care unit and the emergency unit (out-patient unit) and upgrading of this unit to attain the scope set for the level one district hospital.

As a result of the sustained hard work by the management and staff, the hospital was accredited as the first health facility in September 2008 and recognized by the Council for Health Service Accreditation of South Africa (COHSASA) among more than 42 health facilities in the province.  

On 29 October 2008 I was awarded the best anaesthetist achievement award for outstanding performance and lasting contribution on innovation in the public service. I believe this honour bestowed on me was not only in recognition of my personal contribution but also was an endorsement to all the UNV volunteers working in the province.   
 
In my heart I will always be indebted to UNV for giving me this opportunity to apply my knowledge and experience for the benefit of society, live and work among the South African people and learn their beautiful cultures. As it is beautifully expressed in local languages I would like to end by saying 'Re a Leboga!' (thank you!) to UNV.