The Gambia – Swansea Vision 2020 Eye Link

By Sue Williams, Ophthalmic theatre nurse

Team: Stella Elliott, Mike Austin, Paul Lawrance, Bethan Edwards and Sue.

We had a very early start – 3am from Swansea, for a 7:30am check in at Gatwick.  Eventful M4 journey in the minibus with detours, getting lost and plenty of swerving! (and swearing)!  Arrived safely at Banjul airport and were met by Isatou and Musa, who managed to get Stella and her suitcase full of canes and Paul with his B scanner through customs without too much fuss.  On arrival at the Hotel Senegambia, we had a brief meeting with Isatou to discuss the timetable for the coming week.  We then went to our rooms to unpack, had dinner and an early night.

It is the first visit to the Gambia for Bethan and I, and we were both exited and a bit apprehensive about the coming week.

The next day Musa picked us up at 8:30am and drove us to SZRECC.  We met with the rest of the Gambian team and discussed our objectives for the week.  We then split up and went with our counterparts to our relevant areas of work.

I went with Alesana (the charge nurse in theatre) to meet the theatre staff.  Alesana said he was very pleased to meet me and that they were all excited that I had come over.  It was the first time since the link had been set up that they had had any theatre input.

The theatre staff are Alesana, Sory (staff nurse), 2 x HCSW Angelic and Alhagie, and 2 x orderlies Sulyman and Jarra.

First impressions – staff were all very warm and welcoming and keen to learn.  The theatre environment was very dusty and there was a lack of storage such as trolleys and cupboards.  There are 3 theatres, 2 of them are used every Tuesday and Thursday for their theatre lists, the third is kept as a ‘dirty’ theatre and used for infected cases.  The theatres are very spacious, they don’t have an anaesthetic room, but they have a small ante room where the retrobulbar blocks are done.

I quickly realized that the theatre nurses role in SZRECC is very different to the roles we have here in the UK.  They do not act as scrub nurses and the qualified nurses carry out expanded roles, e.g. Alesana administers all the retrobulbar blocks.  Many of the cataract surgeons are ophthalmic nurses with a diploma, who have done a further 1 years training with a 6 month internship.  There is no anaesthetist, but there is a nurse anaesthetist.  On the days when there is no theatre list the theatre staff all work in clinic.

The HCSWs have a similar role to ours in theatre, they prepare theatre for the lists and circulate for cases.  They also lay up the trolleys for cases and have to wash the instruments by hand in between cases.  There is no Central Sterile Supply Unit so all washing and sterilization of instruments is done in theatre in small autoclaves.  Many of the instruments were damaged and in need of repair/replacement. It made me realize how lucky we are in the UK to have so many support services and so many resources available to us.  It is apparent that all the staff work extremely hard and do good work with very limited resources.