The University of Cape Town’s (UCT) African Paediatric Fellowship Programme (APFP) symposium, held on Wednesday, 24 August, bore testament to the programme’s commendable work in paediatric critical care on the continent. Dr Shamiel Salie, head of the Paediatric Intensive Care Unit (PICU) at the Red Cross War Memorial Children’s Hospital led a discussion titled, “A focus on Paediatric Critical Care in the APFP” on Wednesday, 24 August 2022.
Two former trainees and one current trainee from the continent had only praise for the programme. They shared their experiences in paediatric critical care training that is being championed by UCT’s APFP, in collaboration with the Red Cross War Memorial Children’s Hospital and other stakeholders.
Dr John Adabie Appiah, the head of the PICU at Ghana’s Komfo Anokye Teaching Hospital; Dr Jenala Njiram’madzi-Maleta, the head of the PICU at Malawi’s Kamuzu University of Health; and Dr Eziamaka Enemuo, a consultant paediatrician at the University of Nigeria Teaching Hospital, were unanimous in saying that the APFP’s training and post-training support had helped them improve critical care services in their respective home countries.
Welcoming the virtual attendees, the Red Cross War Memorial Children’s Hospital head of Paediatric Neurology, Professor Jo Wilmhurst, said: “It is a privilege to welcome our international guests who are not so international because as we say, once you’ve been with us, you never really leave us; you remain part of our family forever.”
In his moderating remarks, Dr Salie said that critical care doesn’t just happen in intensive care units (ICUs), but that the majority of critical care for children in Africa happens in emergency departments [and] paediatric wards, which aren’t very well resourced.
“Sometimes kids get cared for in adult ICUs and the highlight [for] our trainees is … [their] experiences, their challenges and their journeys to create critical care services for children in their countries.”
Dr Appiah shared his experience following his training, and said that he wishes to extend his sincerest gratitude to the APFP and to those [people] who ensure that paediatric critical care is extended to every patient who needs it.
He added that the training had equipped him with the requisite skills to be a better specialist. Furthermore, he expressed appreciation for the support of the APFP in having a core team of nurses trained in critical care in Ghana to help him implement what he had learnt. By the time he returned home, he said, he had had four nurses trained alongside him.
“The motivation behind every foreign graduate’s long journey to UCT [is] to acquire knowledge and skill.”
“The motivation behind every foreign graduate’s long journey to UCT [is] to acquire knowledge and skill that is not available in our respective countries,” Appiah said when speaking on why foreign graduates join UCT.
He said that from his experience in the APFP, he was able to assemble a critical care team in Ghana to manage a four-bed cubicle with one intensivist. He added that local regulatory bodies were receptive to his proposals because of his UCT APFP training.
During her presentation, Dr Njiram’madzi-Maleta said that after her medical school training, it took her a week at the Red Cross War Memorial Children’s Hospital to realise that paediatric work was exactly what she wanted to do.
The challenges, such as the high mortality rate among children, and the lack of resources and funding, had prompted her to get the training.
After returning to Malawi, she put her training into practice. “The best news is the new 15-bed high- dependency unit, which opened in November 2021, [and] boasts an improved patient–nurse ratio, admits patients [who] don’t fit ICU criteria, offers step-down from PICU and initiates improved ICU management. In summary, it’s been an amazing journey,” she said.
Dr Enemuo presented on “Building a PICU in a Resource-limited Setting: Experience, Challenges and Prospects”.
“The paediatric intensive care units were previously non-existent in Nigeria,” she said, adding that only a few private hospitals had well-established ICUs, which were run by overseas trained intensivists.
“My training at the Red Cross [War Memorial Children’s] Hospital has afforded me the opportunity to meet, interact and work with similar professionals from all over the African continent.”
She said that the biggest challenges to PICU were manpower, money and materials, but despite all the challenges, “We thank the APFP (which) has come through for us … It has provided part-funding for trainees who have come to the Red Cross [War Memorial Children’s] Hospital.”
Enemuo characterised the paediatric critical care training as intense, fast-paced, spontaneous and self-driven. “It has been a worthwhile experience.”
She echoed the sentiments of the other presenters about the benefits of the APFP training. “My training at the Red Cross [War Memorial Children’s] Hospital has afforded me the opportunity to meet, interact and work with similar professionals from all over the African continent.”
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