Uganda’s Ambitious Critical Care Vision and Plan: An Interview with Dr. Arthur Kwizera
The Government of Uganda is undertaking an ambitious effort to increase critical care capacity by fully equipping ICUs at all regional referral hospitals across the nation.
Photo Cation/Credit: ICU at Lira Regional Referral Hospital/Government of Uganda
We’re proud the Gradian Comprehensive Care Ventilator (Gradian CCV) and our model of robust training and service can support this critical moment and the partners on the frontlines, such as the Association of Anesthesiologists of Uganda (AAU) and Joint Medical Store (JMS)—a leading medical device and pharmaceutical distributor—making this change a reality for the nation’s COVID-19 response and future health system strength.
The AAU and JMS recently produced a series of short video interviews with anesthesiologists and intensive care specialists about the current state and future vision of critical care in Uganda and what it’ll take to get there, from policy to equipment to education and tackling the biggest challenges to progress.
Dr. Arthur Kwizera is an anesthesiologist and intensive care specialist at Mulago National Referral Hospital, a lecturer at the Department of Anesthesia and Intensive Care at Makerere University College of Anesthesia, an AAU member, and the president of the Intensive Care Society of Uganda. Kwizera discusses how the government, the AAU, and partners like Gradian Health Systems are growing the country’s intensive care capacity in the face of the COVID19 pandemic.
“Hello, everybody. My name is Arthur Kwizera. I’m an anesthesiologist in Kampala, Uganda. The other things I do is I am a senior lecturer at the Department of Anesthesia and Intensive Care at Makerere University College of Anesthesia.”
“So with regards to anesthesia and intensive care in Uganda, there is a lot that is going on. The Association of Anesthesiologists of Uganda and the Intensive Care [Society] of Uganda, both of which I’m part of, are actually engaged in trying to resolve issues with regards to perioperative care of our fellow countrymen, postoperative care and also our intensive care or acute care.”
“We at the Department of Anesthesia at Makerere University have spawned the development of an emergency medicine program, as well as bred some really great and young anesthesiologists who are called on to do very good things for this country’s perioperative and acute medicine aspirations or strategies.”
“What we are doing right now is that we are currently engaged with growing Uganda’s intensive care and capacity. With this program, we’ve chosen a path where we’ve reviewed the current anesthesia specialist training to heavily embed the component of intensive care. Because not everyone can go [to] a fellowship in intensive care medicine, and yet we need anesthesiologists or the anesthesia provider to be able to handle the acute need in a dedicated environment.”
“What we are doing right now is that we are currently engaged with growing Uganda’s intensive care and capacity. With this program, we’ve chosen a path where we’ve reviewed the current anesthesia specialist training to heavily embed the component of intensive care.”
“This will help us build the capacity that we need to provide intensive care services in regional environments, district hospitals as well as health center folks. We’ve also been involved in the creation of a critical care nurse program. But the idea is to train at least a thousand nurses through the country who will be able to provide acute and intensive care at our region area of hospitals.”
“Members of the association have been involved in the creation of NSOAP. NSOAP is the National Strategic Plan for Surgery Obstetrics and Anesthesia for the country. And in this regard, every patient would be – we believe at least 95 percent of patients – would fall under this category, within the ministry of healthcare – such as – in other respects, some of our members are part of the national COVID task force, advising the government and helping the Minister of Health prepare guidelines for treatment with patients with COVID-19. And to date, the government has committed to building at least 18 new intensive care units at the region of our hospitals and every intensive care will be at least ten beds.”
“Members of the anesthesia fraternity have been involved in helping quantify the oxygen delivery and oxygen needs of the country as well. In addition to that, members of the fraternity have been involved in, at the global level, being part of expert panels for the World Health Organization advising and contributing, creating treatment guidelines for sepsis, for influenza, as well as COVID-19. One of the other things that the association is involved in is in helping build capacity and working with the Minister of Health for more anesthesiologists such as myself and others to be trained and skilled in the art of lifesaving medicine.”
“We believe that every general referral hospital of having at least six or seven anesthesiologists, and health centers having at least six or seven bachelor’s degree holders of anesthesia, we can reduce maternal and infant mortality by at least 50 percent. The Association of Anesthesiologists is involved in research. Many members of the association are publishing work and doing research in ways that can help everything from not just the government of Uganda, but the World Health Organization and other governments improving perioperative, postoperative, and intensive care of the patient wherever they might be.”
“Everything that the association, the members of the association have been trying to do and have been trying to do have not been without the great help and support of partners. The principle partner in this organization is the Minister of Health in Uganda. The Minister of Health has been able to provide scholarships.”
“One of the other things that the association is involved in is in helping build capacity and working with the Minister of Health for more anesthesiologists such as myself and others to be trained and skilled in the art of lifesaving medicine.”
“The other significant partner we’ve had that is actually working with us right now to improve intensive care and perioperative is Gradian [Health Systems]. They assist in innovation and creation of an anesthesia machine that even the lowest cadre perioperative medicine can use. That’s called – the machine is called a UAM [Universal Anaesthesia Machine].”
“And not only did they do that, but they also went ahead and help the development of the acute care ventilator. This ventilator [Gradian CCV] is affordable, … reliable and [can] also deal with the vageries of the environment.”
“We have other partners, like of the Association of Anesthetists of Great Britain and Ireland, that have played a huge role, especially in the sponsorship of tools. … So I want to say thank you to these partners.”
“We encourage other people or organizations who would like to work with us to build anesthesia and intensive care capacity in Uganda to reach out and have a conversation with us about how best we can do this. My name is Arthur Kwizera, I thank you so much.”