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Framework Program in Global Health:
Spring 2008 Grant Recipient

Adam IddrissAdam Iddriss
Evaluation of Surgical and Anesthesia Access and Appropriate Technology in the Gambia

Country: The Gambia

Advisor: Fizan Abdullah

Program: MD candidate at the School of Medicine

Project Abstract:
The leading causes of death in the Gambia include road traffic accidents, anemia, and pregnancy-related complications such as sepsis, obstructed labor, and hemorrhage. All of these conditions require immediate life-saving, basic surgical and anesthesia care. Unfortunately, most first referral level health facilities in the Gambia have no specialist surgical teams. In addition, the lack of health technologies to perform essential interventions such as respiratory support, suction, and provision of oxygen often inhibits quality surgical procedures in the Gambia. New evidence suggests that surgery can have an integral role in primary health care and is a viable strategy for prevention, and a cost­ effective way of dealing with many of the health challenges of the resource-constrained settings. Thus, interventions which seek to quantify the availability of surgical services would be of tremendous benefit to the Gambia. In such a resource-constrained area, it becomes increasingly important to quantify the quality of surgical and anesthesia care being provided, develop resource-appropriate technical interventions, and establish policies for the optimal use of medical technology to improve patient health. The primary objectives of this project will be to 1) gather information on the situation of access to basic surgical and anesthesia care in the Gambia; 2) develop surgical and anesthesia equipment specification guidelines; and 3) develop a tool for assessing the progress of the World Health Organization's Global Initiative for Emergency and Essential Surgical Care Project.

Personal Summary:
operating theaterThrough my time in the Gambia, I was able to explore my interest in global health and immerse myself in a different culture.  I was fortunate to have a wonderful host family to help me embrace the new environment, which made my experience more fulfilling.  I felt like a part of the family and the food was amazing: benachin (Jolof Rice) and supakanja (okra stew) are super delicious!

A large part of my work involved traveling around the country to different health facilities to investigate surgical capacity.  The facilities we visited ran the gamut from well-equipped to ones that were only minimally capable of delivering care.  The one thing that was consistent was the dedicated staff of each health facility we went to.  As I met and shadowed doctors and nurses in their workplaces, I was able to gain deeper insight on the challenges to providing healthcare in a developing country.  Learning more about the obstacles to healthcare and identifying ways to make change has propelled my interest in public health and global studies.

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