Bi-directional Partnership with University of Rwanda Continues

A tea field outside Nyungwe National Forest

The country of Rwanda stands as a proud example of reinvention. From a country divided by civil war and horrific genocide aimed at exterminating an ethnic group — whose swift killing totaled nearly one million individuals in just under three months’ time — to now serving as a beacon of hope of public health and policy. The country of Rwanda sits in central sub-Saharan Africa bordered by Tanzania to the east, The Democratic Republic of Congo to the west, Burundi to the south, and Uganda to the north. While compromising a land area about the size of Vermont, its population totals 12 million. This country, which had one physician anesthesiologist after the genocide in 1994, now graduates ten new anesthesiologists annually.

Dr. James McAvoy, chief resident in the Department of Anesthesia, Perioperative and Pain Medicine traveled to Rwanda with the Department’s Division of Global Health, co-sponsored by the American Society of Anesthesiologists Global Humanitarian Outreach (ASA-GHO) and the Canadian Anesthesiologists’ Society International Education Foundation (CASIEF) on a teaching mission aimed at developing Rwandan anesthesiology residents’ skills in simulated and clinical settings. This effort, led by Dr. Ana Crawford, targeted improving intraoperative and critical care management strategies for adult, pediatric, and maternity patients. The primary sites for rotation were the military hospital, Kanombe; Kigali’s private hospital, King Faisal; and the University Teaching Hospital of Kigali (CHUK).

Global health demands its participants to constantly question the motivation for undertaking projects and to reinvent methodology before, during, and after an experience in an effort to provide high-impact interventions which are aligned with the community they serve. In this context, the concept of community is entirely fluid. We feel that cultivating a global anesthesia presence is important not only for doing good in the greater sense, but to engender a sense of worldly connectedness for trainees; after all, it’s a pretty small place! Now James has friends halfway across the world with whom he trades notes in topics ranging from ventilator management to neuraxial anesthesia to being an effective leader as Chief Resident!


A potter throwing a mug at the Gatagara Pottery Collective.

Drs. James McAvoy (back row, left), Ana Crawford (back row, far right), Rebecca McGoldrick (first row, left), and Sara Strowd (center) with the residents of The University of Rwanda in the simulation center after working through a postpartum hemorrhage scenario.

Drs. Ana Crawford and Kaitlin Flannery familiarize themselves with the anesthetizing equipment. Dr. Flannery completed a joint project with Rwandan residents studying intraoperative thermoregulation in both adult and pediatric patients; the results of this study led to a significant decrease in rates of hypothermia, which increases surgical site infections, cardiac complications, and the need for blood transfusions.