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New research: The effectiveness of anaesthesia training in low-income settings

New research findings highlight the effectiveness of the Safer Anaesthesia from Education (SAFE) training programme in improving the knowledge and skill of anaesthesia providers in low-income settings.

kenya safe researchPublished in Anaesthesia 2020, the study assesses the educational impact of the SAFE Obstetrics training programme on anaesthesia providers in Kenya.

Maternal mortality rates in low-middle income countries remains high, with sub-Saharan Africa accounting for two-thirds of global maternal deaths. Inadequate staff training is one of the main contributors to anaesthesia related deaths.

To address this lack of training, the SAFE course was created by World Federation of Societies of Anaesthesiologists (WFSA) and the Association of Anaesthetists. With courses covering obstetrics, paediatrics and the operation room, SAFE training courses have been delivered to over 2,300 clinicians in 36 countries since its launch in 2011.

The study which brought together anaesthesiologists from Kenya, the UK and the US, sought to investigate whether SAFE training was translated into changes in clinical behaviours in the workplace. It aimed to explore the barriers and facilitators to the adoption of recommended anaesthetic care by providers who had been trained on a SAFE obstetric anaesthesia course.

Demonstrating positive outcomes from educational interventions, and understanding why such interventions do or do not lead to improvement, is crucial if programmes like SAFE are to improve the practice of health professionals and improve patient outcomes.

Researchers analysed the knowledge and practices of 103 anaesthesia providers from 66 facilities across Kenya who attended the SAFE course between 2016 and 2017. As part of the study, participants undertook knowledge tests and were observed at work to measure potential behaviour change engendered by the training.

Team communication and pre-operative assessment were identified as significant influencers on positive behaviour change amongst anaesthesia providers. Test results showed that SAFE training also led to sustained improved knowledge retention.

The study demonstrates that the SAFE obstetric course is relevant in the low-resource setting and leads to improved knowledge and clinical practice.

With the need to scale up the anaesthesia workforce in LMICs, the research recommends that all new educational programmes undergo the same rigorous evaluation as the SAFE courses to ensure effective use of resources and to demonstrate positive training outcomes.

Further resources

WHA73 Statement - The essential role of anaesthesiologists in the COVID-19 response

who imageIn line with WFSA's position as a non-State actor in official relations with WHO, the WFSA board have submitted the following statement under the 73rd World Health Assembly provisional agenda item 3 Address by WHO Director-General devoted to the COVID-19 pandemic response.

The essential role of anaesthesiologists in the COVID-19 response

The World Federation of Societies of Anaesthesiologists (WFSA) represents anaesthesiologists in 150 countries. We work with the WHO and other organizations to improve access to safe anaesthesia worldwide.

5 out of 7 billion people in this world do not have access to safe anaesthesia and surgery. Anaesthesia is essential for a well-functioning health system, as highlighted by WHA Resolution 68.15 on Strengthening Emergency and Essential Surgical Care and Anaesthesia as a Component of Universal Health Coverage.

Anaesthesiologists are medical specialists who are not just experts in the perioperative care of surgical patients; they are also experts in resuscitation, pain medicine and intensive care. During the COVID-19 pandemic, anaesthesiologists working in emergency departments, operating rooms, and intensive care units have played a pivotal frontline role in saving the lives of infected patients.
Unfortunately, in many low- and middle-income countries, there has been chronic under-resourcing of anaesthesia and intensive care. High-income countries have struggled to cope with COVID-19 and the pandemic is likely to have an even more devastating impact in countries with fewer resources.

WFSA welcomes efforts by donors to increase the supply of PPE and intensive care equipment to low resource settings. However, these donations risk being underutilized if there are not enough skilled and appropriately trained providers to use and maintain this equipment.
The WFSA calls on WHO member states and the donor community to:

  •  Address chronic workforce deficiencies in anaesthesia and intensive care;
  •  Provide and maintain essential equipment for resuscitation, anaesthesia and intensive care;
  • Adhere to the WHO-WFSA International Standards for a Safe Practice of Anaesthesia; 
  • Protect our most valuable resource, frontline health workers, by providing a safe working environment, including appropriate PPE.

Further links

17th World Congress of Anaesthesiologists rescheduled to 2021

WCA2021 baner logo 2In light of the ongoing COVID-19 pandemic, the WFSA Board and WCA Local Organising Committee have decided to reschedule the 17th WFSA World Congress of Anaesthesiologists. We made this decision after careful consideration of our first and overriding priority: the health and wellbeing of all Congress participants.

The event was due to be held in Prague, Czech Republic from September 5 to 9, 2020, and is now planned to take place from September 1 to 5, 2021 in the same location.

Most arrangements for the World Congress will remain the same - only the dates will change. The scientific programme already developed for September 2020 will form the basis of an updated programme that will reflect the new challenges faced by our speciality. Current arrangements, such as delegate registrations and abstract submissions, will be automatically transferred. The Congress Secretariat will shortly send detailed information to all partners, exhibitors, speakers and delegates.

WFSA will send guidance concerning the General Assembly, elections and other governance matters to National Member Societies as soon as possible, for their consideration and input.

We are so proud and grateful that anaesthesiologists all over the world have stepped up to be at the front line of the response to this crisis, often at great personal risk. It is impressive that so many of you take time to share your experiences with the rest of the global community to help them prepare and deal with the pandemic. You are all demonstrating our crucial role in healthcare.

We are optimistic that the new timing, exactly one year later than originally planned, will ensure that we can deliver a high quality scientific programme and give all of you the time and the space for rest and recuperation before we gather for the best ever World Congress of Anaesthesiologists.

Stay safe and we look forward to seeing all of you in September 2021 in Prague.


Dr. Jannicke Mellin-Olsen
President of the WFSA

Prof. MUDr. Karel Cvachovec, CSc., MBA
President of the Organising Committee of the WCA 2020

WFSA Statement on health care providers safety and wellbeing during the COVID-19 pandemic

A well-functioning health system is critical in any society and is crucial for both national economy and citizen wellbeing.

No health system can function without a sufficient number of healthy and competent health professionals.

Therefore, all countries must ensure that in the current pandemic, health professionals have sufficient provision of personal protective equipment (PPE) and other tools to prevent them from becoming sick and unable to treat their patients1.

Health professional wellbeing must be prioritised, regarding working hours, rest and other measures to counteract ill-health and burnout and non-functioning health professionals2.

The WFSA maintains a COVID-19 resource webpage with up-to-date information and can provide additional advice on request.

The World Federation of Societies of Anaesthesiologists represents hundreds of thousands of anaesthesiologists in over 150 countries with the mission to unite anaesthesiologists around the world to improve patient care and access to safe anaesthesia and perioperative medicine.

Worldwide, anaesthesiologists are playing an essential role in the critical care management and perioperative management of COVID-19 patients.

The WFSA is in official relations with the WHO.



Download this declaration (pdf)

Declaración de la WFSA sobre la seguridad y el bienestar de los profesionales de atención médica durante la pandemia de COVID-19

Un sistema de salud que funcione bien es fundamental en cualquier sociedad y es crucial tanto para la economía nacional como para el bienestar de los ciudadanos. 

Ningún sistema de salud puede funcionar sin un número suficiente de profesionales sanitarios sanos y competentes.

Por lo tanto, todos los países deben asegurarse de que también en la pandemia actual, los profesionales de la salud tengan una provisión suficiente de equipo de protección personal (EPP) y otras herramientas para evitar que se enfermen y no puedan tratar a sus pacientes1.

Se debe priorizar el bienestar de los profesionales de la salud en relación con las horas de trabajo, el descanso y otras medidas para contrarrestar la mala salud y el agotamiento y los profesionales de la salud que no son capaces de trabajar2 .

La WFSA mantiene una página web de recursos COVID-19 con información actualizada y puede proporcionar asesoramiento adicional a pedido.

La Federación Mundial de Sociedades de Anestesiólogos representa a cientos de miles de anestesiólogos en 150 países con la misión de unir a los anestesiólogos de todo el mundo para mejorar la atención al paciente y el acceso a la anestesia segura y la medicina perioperatoria.

En todo el mundo, los anestesiólogos están jugando un papel esencial en el manejo de cuidados críticos y el manejo preoperatorio de pacientes con COVID-19.

La WFSA mantiene en relaciones oficiales con la OMS.



Descargar esta declaración (pdf)

Déclaration de la WFSA sur la sécurité et le bien-être des professionnels de santé pendant la pandémie COVID-19

Le bon fonctionnement du système de santé est essentiel dans toute société et est crucial pour l'économie nationale et le bien-être des citoyens. Aucun système de santé ne peut fonctionner sans un nombre suffisant de professionnels de la santé en bonne santé et compétents.

Par conséquent, tous les pays doivent veiller à ce que, même dans le cadre de la pandémie actuelle, les professionnels de la santé disposent d'un équipement de protection individuelle (EPI) et d'autres outils en quantité suffisante pour éviter qu'ils ne tombent malades et ne soient incapables de traiter leurs patients1.

Le bien-être des professionnels de la santé doit être une priorité, en ce qui concerne les heures de travail, le repos et les autres mesures visant à lutter contre une mauvaise santé et un épuisement professionnel, ainsi que la prévention des arrêts de travail2.

La WFSA gère une page web de ressources COVID-19 contenant des informations actualisées et peut fournir des conseils supplémentaires sur demande.

La Fédération Mondiale des Sociétés d'Anesthésiologistes représente des centaines de milliers d'anesthésiologistes dans 150 pays et a pour mission d'unir les anesthésiologistes du monde entier pour améliorer les soins aux patients et l'accès à une anesthésie et une médecine péri opératoire sûres.

Dans le monde entier, les anesthésiologistes jouent un rôle essentiel dans la gestion des soins intensifs et la prise en charge péri opératoire des patients COVID-19.

La WFSA entretient des relations officielles avec l'OMS.



Téléchargez cette déclaration (pdf)

Declaração da WFSA sobre Segurança e Bem-estar das Equipes de Saúde durante a Pandemia por COVID–19

Considerando que um sistema de saúde em bom estado operacional é fator crítico para qualquer sociedade e crucial tanto para a economia nacional como para o bem-estar de seus cidadãos, e que nenhum sistema de saúde pode funcionar adequadamente sem um número suficiente de profissionais que estejam saudáveis e preparados para exercer suas atividades, a Federação Mundial de Sociedades de Anestesiologia -WFSA (sigla em inglês) vem pronunciar-se pública e oficialmente sobre a necessidade de que. 

Todos os países devem assegurar, como sempre e, especialmente, durante a pandemia em curso, que seus profissionais de saúde tenham a suficiente provisão de Equipamento de Proteção Individual (EPI), assim como outras ferramentas que se destinem a minimizar o risco de serem infectados e, em decorrência, afastados da força assistencial para tratamento dos pacientes1.

O bem-estar profissional deve ser priorizado, quer no que diga respeito ao número de horas e períodos de repouso, quer em outras medidas que sirvam para minimizar a incidência outros problemas de saúde, como a síndrome de burnout ou outras patologias que possam, causar dano no plano individual e redução do número de profissionais atuantes, no plano assistencial 2.

La WFSA mantém em seu portal uma página e informações atualizadas sobre a pandemia por COVID-19 e coloca-se à disposição para prestar consultas adicionais.

La Federação Mundial de Sociedades de Anestesiologia representa centenas de milhares de medicos anestesiologistas, em 150 países, com a missão de unir anestesiologistas em todo o mundo visando melhorar a assistência perioperatória ao paciente e o acesso global a uma anestesia segura. Em todo o mundo, a anestesiologia tem desempenhdo um papel especial, tanto na terapia intensiva, como na assistência perioperatória de pacientes acometidos pelo COVID-19.

La WFSA mantém relações oficiais com a Organização Mundial da Saúde (OMS).



Faça o download desta declaração (pdf)

A conversation with women in anaesthesia

Historically, women have always been underrepresented in medicine. Even though women make up 50% of the physicians in training and 78% of the medical workforce they still only account for a third of physicians within the workforce. Despite, anesthesiology seeing a steady increase in the number of residents who are women, there is still a significantly faster increase in terms of women graduating medical school than those becoming anaesthesia residents.

Gender disparity is not only about the number of women entering medical school but also in regards to career progression, academic advancement, women in leadership roles and pay.

Recognising this potential gender gap within anesthesiology, WFSA established the Ad-Hoc Gender Committee, in 2018 to increase women with WFSA leadership positions and facilitate participation in gender panels and forums.

For International Women’s Day 2020, WFSA interviewed notable women leaders and future leaders within anaesthesia including: Dr. Jannicke Mellin-Olsen (Norway), President of WFSA; Dr. Carolina Haylock-Loor (Honduras), WFSA Council member and Chairperson of WFSA’s Ad-Hoc Gender Committee; Professor Patricia Yazbeck (Lebanon), WFSA Council member and President of PAFSA; Dr. Karima Khalid (Tanzania), SAFE Tanzania Course Director; Dr. Gita Nath (India), VAST Hyderabad Course Director and Dr. Marjory Ayma Palacios (Peru), WFSA Pain Management Fellowship alumni.

What challenges do women face when becoming anaesthesiologists?

Carolina: Women in anaesthesia in some countries do face bias in their work but not because of anaesthesia but their surrounding responsibilities that make her a woman e.g. maternity, pregnancy and raising children. A lot of women face depression and burnout as a result. In some countries, they are very aware of what is going on and try to support women in their career. It’s a trending topic and you can speak up easier than before but women will need to keep struggling.

Karima:Numerically, there are no issues because there are a lot of women in anaesthesia and the medical profession overall in Tanzania. However, we face challenges making our voices heard. Women are normally the first to push things forwards for change etc. but they are put in the background. Men usually outshine us. Sometimes in a clinic even if you have tried your best someone will talk to the male nurse and not to the female doctor. It’s hard to progress in leadership/senior roles. I have observed how WFSA treats women and men equally and I appreciate that. You are expected to put 100% into your work, family and community, its draining and burnouts happen frequently. Sometimes you just need to narrow down what you want to do to realign your priorities and emotions.

Marjory:One of the biggest challenges has been breaking the stereotype that women are only able to look after their home, family and children and that we have lower job performance and more absenteeism. In addition, women have to break down gender gaps such as job hostility and the myth that they are less willing to face risks. I have managed to become an anesthesiologist because these cultural gaps and stereotypes have been breaking down in time and showing commitment to every step I take.

Gita: When I started off in the profession there were a lot of men and not that many women. Women are now about 50% of the workforce however most choose obstetrics/paediatric/pre-clinical to balance their home/work life.

Jannicke: I have been very lucky, in Norway, the gender balance is very good but you must acknowledge the difficulties, sometimes I had cases where people would address a junior doctor because he was a man and ignore me. Also, Norway is a country on top of gender equality but there are many unexpressed expectations. Men and women are on the same level but there are different expectations for things you can and can’t do.

Patricia:Personally I have not faced many challenges. Lebanon is a more open society but due to the persistent gender inequality it is not easy for all women to be represented in the workforce. Some hospitals won’t employ women anaesthesiologists and only hire male anaesthesiologists because they won’t take time out. We should continue to fight against gender discrimination and issues like Lebanese women physicians not having access to long maternity leaves should be addressed.

Why is it important to increase the number of women in anaesthesia?

Carolina:It is important to increase the number of women in medicine but also to ensure equity, in leadership, wages, and training, acting in a respectful and dignified way towards women. Women need a comfortable working environment, with access to maternity leave, areas for breast feeding, time off to raise children etc. Provisions must be made to support their potential or they’ll quit because they have no support. Research has shown women will drop out if the pressure in their residency programme/working is incompatible with pregnancy or child rearing.

Marjory:I believe women bring an important balance to professional life, we are resourceful and always look for alternatives ways. Our mission should be to change the perception of stereotypes and show that we are committed, capable of leading and cultivating resilience with the right support.

Gita:A lot of patients who come in for C-sections and other procedures and request a female anaesthesiologists, some women only want women around them due to cultural/religious reasons. I personally find women easier to connect with, for example when women are taking the VAST course I find them easier to network with. I feel women are more committed to their work, they aren’t trying to become heroes and are good for patients, and it’s not about how much risk they are willing to take. Women do basic everyday things safely. There is a difference in mindset between men and women.

Patricia:In a study of literature, patients who were treated by women had a different standard of care, they provide preventive care and they have good communication skills. Women can give a lot, they have patient centred communication.

Jannicke:It is important to note that in some countries women are the majority with around 80% entering medical school. There is an increasing balance.

Why do you feel WFSA's Ad-Hoc Gender Committee is important?

Carolina:It is very relevant and important to create awareness of inequality. We first observed it within WFSA leadership, there were 20% women and the rest were men. The Ad-Hoc Gender Committee had a summit in London last year, there was a lot of diversity and professionalism. Minority groups were represented and how to increase diversity, we are presently conducting a gender survey. In summary, our objectives are to try to create equal opportunities for every anaesthesiologist. We must bring equal opportunity regardless of gender/race/religion and give respect to human dignity.

What advice would you give women who would like to pursue anaesthesiology?

Carolina:I would encourage every woman to go after her dreams and fulfil her goals. Don’t give up, it’s a male world and we know it but we are slowly gaining step by step Try to have allies your friends, your husbands and family, this can make a huge difference to get into the field. Do your best. Chase your goals but also remember to pay good forwards.

Karima:You should always try to push ideas forward, take a seat at the table and make sure you are seen and heard. Don’t let anyone silence you. Do what you need to do and make a change in the world.

Jannicke:If you want to become an anaesthesiologist you should go for it and trust yourself, you can do it.

An appreciation of Dr Ruth Hutchinson

Ruth HutchinsonRuth Hutchinson was someone of whom you could truly claim “they don’t make ‘em like that anymore”.

My wife and I first met Ruth when she came over to Malawi in 1991. She had driven over from Parirenyatwa Hospital, Harare, to see our Clinical Officer Training programme and visit 16 district hospitals. At that time this was a troublesome journey as Mozambique was still in civil war and you had to cross from Zimbabwe with military escort.

Later she embarked on that most memorable achievement, organising the 1st All Africa Anaesthesia Congress in 1997. I still wear the T-Shirt, brightly coloured after 23 years; Ruth chose the maker wisely which was not easy then (or even now).

It may be less well known that her Zimbabwean head of department had just cleared off to Canada and ‘volunteered’ her for the job on 2 minutes notice. She had no previous experience of such events, used no professional congress organiser but rose to the challenge and did it singlehandedly, brilliantly, without antagonising anyone or wasting a penny. Her house on Charles Bullock Ave in Harare became the de-facto nerve centre, printing and storage facility preparing for the Congress. In her study she introduced me to a young man that she had just found ‘who knows about computers’ and could do the IT. She could delegate, had insight, superb judgement and above all humility. Plenty of lessons for us all there.

In my view the success of the 1997 AAAC remains unsurpassed and I like to think her earlier Malawi visit informed her down-to-earth approach to the event.

Our family visited her many times in Harare and she also came over to Malawi to see us, one time on her way through to Mozambique where she had village projects helping people in the neglected north eastern provinces. She drove her unwieldy long wheel base Landrover over terrible roads even in the wet season and always with her life-long friend and companion Margaret who died some years ago.

She also gave freely of her time as an external examiner on the Malawi Anaesthetic Clinical Officer training course.

Latterly, post Africa, she visited us in France and we saw her once in her retirement home on Hayling Island back in England. Margaret had been her neighbour there also. Before coming to Zimbabwe, Ruth had been a consultant at Poole General Hospital and I asked her once if this African adventure meant she had departed the UK for good. “Oh no”, she said, “old age care is much better back home”. And so it proved to be.

We corresponded but my recent emails to Ruth have gone answered, with no Christmas cards of late so the sad news of her death after such a long and eventful life was not a complete surprise.

Ruth surely deserves the premier place in the Anaesthesia Heroes Hall of Fame lest her great, significant but humble life be forgotten.

She showed us all how to do it.

Paul Fenton

Formerly in Malawi 1986-2001

How strengthening anaesthesia rebalances gender inequalities

IWD 2019 EN InFocus 960x450International Women’s Day is a welcome opportunity to both celebrate the achievements of women and identify actions to accelerate progress towards gender equality. Nowhere is this more relevant than in the area of global health and more specifically global anaesthesia and surgery. While advances have been acheived, much more needs to be done if we are to achieve true health care equality.

Major progress has been made towards realising Sustainable Development Goal (SDG)_3) and ensuring healthier lives for all at all ages. Millions of people now expect to live longer lives and there has been a reduction in maternal and child mortality rates. However with more than half of the population unable to access basic health care, including safe anaesthesia and surgery and with costs continually rising, we risk stalling this progress. This picture of a faltering advance is especially true for maternal health. 

Since 2000, the number of women dying in pregnancy and childbirth has fallen by a third but progress remains slow, with the rate of decline meaning SDG 2030 targets risk being missed. According to estimates 303,000 women a year die in childbirth or from complications arising due to pregnancy. This means every 2 minutes a women dies. Lower and middle income countries are hit hardest, comprising nearly 94% of maternal deaths worldwide. Obstetric violence, a term coined in Latin America refers to the degrading and cruel treatment women receive during pregnancy, childbirth and their postpartum period. The effects of this inhumane treatment has both short and long lasting implications on a woman such as unneeded suffering and pain, humiliation, ill-health, sterility and may even lead to death

The World Health Organization (WHO) highlights that women who live in rural areas, and women of colour are more likely to experience abusive treatment. This is not limited to lower and middle income (LMIC) settings, in the US maternal death have increased by  over 50%, with black women being  3 times more likely than their white counterparts to die while giving birth. The cost to prevent women dying in childbirth is increasing and is projected to increase nearly six fold by 2030.

Strengthening the anaesthesia workforce

As a response to this global need to strengthen obstetric care provision and help reduce the maternal mortality rate, the SAFE Obstetrics course was created to provide a three-day training course dedicated to strengthening the capacity of both physician and non-physician anaesthetic providers in LMICs.

SAFE Obstetrics focuses on the role of the anaesthesia provider in obstetric emergencies through clinical scenarios based on the conditions known to cause 80% of maternal deaths: haemorrhage, sepsis, eclampsia, obstructed labour, the complications of abortion and the complications anaesthesia. The course also provides training on new-born resuscitation.

Since its launch in 2016, over 40 SAFE Obstetrics courses in 16 countries have provided practical tailored training to over 600 anaesthesia providers. To ensure the sustainability of this course a further 318 facilitators have be trained to run their own courses. 

Gender pain gap

Gender inequality within the health care sector is not limited to obstetrics, research has shown the notion of a ‘gender pain gap’ noting that women are more likely to be left suffering for much longer in hospitals when complaining of pain. Most notably, an article published on the  Harvard Health blog states ‘women in pain are more likely to receive sedatives than pain medication for their aliments.’

To address this imbalance WFSA together is working with its members and partners to improve understanding and practices around how to treat and manage pain. The Essential Pain Management training programme is vital component of this work. Run in over 55 countries the course brings together health care workers to improve their pain knowledge, implement a simple framework for managing pain and address pain management barriers. The EPM programme is designed for any health worker who comes in contact with patients who have pain.

Global health leadership

With the majority of leadership in global health comprised of men, gender equality in health care is often not prioritised. Gender imbalance more often than not results in not enough women being present to influence policy decisions in regards to gendered issues such as sexual and reproductive health, which often end up falling through the gaps. Recognising this issue, WFSA established the Ad-Hoc Gender Committee in 2018, dedicated to ensuring gender balance within the WFSA and to devise and implement support for women anaesthesiologists to participate in leadership training programmes.

By strengthening the leadership, skills and numbers of anaesthesia providers, countries around the globe can deliver health services that are better placed to provide skilled care before, during and after childbirth, thereby improved the health outcomes of millions of women worldwide. 

Further resources

Euroanaesthesia 2020 postponed to 28-30 November

EA20 MYESADue to COVID-19 the ESA have moved Euroanaesthesia 2020 has been rescheduled to take place in Barcelone, Spain on 28 - 30th November.

Euroanaesthesia is one of the world’s largest and most influential scientific congresses for anaesthesia professionals, with a focus on education, knowledge exchange, and innovation in Anaesthesia, Critical Care, Pain and Perioperative Medicine, as well as a platform for global visibility for scientific research.

This international event gathers more than 8.000 participants, including a faculty of more than 400 key opinion leaders from all over the world. The world’s leading experts share their insights, up-to-date knowledge and experience during state-of-the art lectures, interactive sessions, debates, and courses.

By bringing together practicing physicians, academics, scientists, and clinical researchers, Euroanaesthesia offers a unique global forum for a free exchange of science and medical strategy.

Euroanaesthesia is truly an outstanding international platform to enhance knowledge, review innovative techniques, learn on ESA guidelines, and communicate, collaborate and network with representatives of a large international audience.

For more information, please visit the Euroanaesthesia website at or ESA's website at

If you have any questions, please contact ESA's Communication Manager, Jennifer Rose, at

Strengthening Anaesthesia Care in The Gambia

PHOTO 2020 01 22 11 57 57Access to safe, affordable anaesthesia and surgery should be a universal right, but in countries like The Gambia, there is a significant shortage of health personnel, which leads to a major obstacle in the provision of surgical and anaesthesia services. With less than one physician per 20,000 inhabitants, The Gambia falls well below the WHO African Region average of nearly five physicians per 20,000 inhabitants. Most notably, 80% of practicing physicians within the country are not Gambian nationals.

Anaesthesia in The Gambia, is primarily delivered by nurses and clinical officers, it is therefore important to ensure appropriate training is delivered in country. Recognising the need to build the capacity of health care providers within the country, WFSA in partnership with THET, visited The Gambia to support activities in November 2019.

Over the two day visit a taster Essential Pain Management (EPM) course was delivered to 39 nurse providers and 4 residents. EPM is a cost-effective, multi-disciplinary programme brings together local health workers to improve pain knowledge. Participants learn how to implement a simple framework for managing pain and address pain management barriers. The course has been designed for any health worker who comes into contact with patients who are experiencing pain.

Dr Omar Cham, Secretary General of Anesthetists’ Society of The Gambia (ASOGAM) said, “The training really lived up to its name, ESSENTIAL, because it covers an area that is somewhat a blind spot for anaesthetists in The Gambia. The blind-spot is created partly due to socio-cultural influences.”

Touching upon the cultural context surrounding pain Omar further added, “In certain cultures in The Gambia, people are expected to bear their pain, sometimes health workers also expect patients to live through some degree of pain. With this course, we are armed with the slogan pain is what the patient says, so we should try to control their pain and alleviate their suffering as much as possible.”

In conjunction with the EPM course, the WFSA also supported ASOGAM to hold their first inaugural congress. The aim of the congress was to provide ASOGAM members with up to date information on relevant scientific issues including anaesthetic management of eclampsia/pre-eclampsia and general anaesthesia for neurosurgery, as well as to discuss ways to increase and upskill the current anaesthesia workforce in The Gambia.

Dr. George Njie, President of ASOGAM said, “The timing couldn’t have been more perfect, due to our patients rising concern about pain management in hospitals. This training gives our members the knowledge to tackle these concerns head on and to at least ease the pain of our patients.”

In low-and middle income countries the rate of death and disability occurring from treatable surgical conditions remains unreasonably high with the delivery of timely and effective medical care hindered by the lack of infrastructure and a shortage of human and physical resources. We hope for the opportunity to conduct further training sessions in The Gambia and work alongside ASOGAM to improve anaesthesia care to patients.

Further resources 

WFSA in the media


Coronavirus - guidance for anaesthesia and perioperative care providers

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Access curated COVID-19 resources on:

Anaesthesia & COVID19

Low resource settings

Airway management


WFSA Member Society guidelines

Ressources en français

Recursos en español

Recursos em Português

WFSA is working with its global membership to curate, share and disseminate up-to-date and practical COVID-19 guidance for anaesthesia and perioperative care providers.  For ease of access this information is grouped by speciality, availability of resources and language.  

If there are other information resources which should be included in this section please contact Francis Peel .

Clinician wellbeing

Anaesthesiologists and other perioperative care providers are particularly at risk when providing respiratory care and tracheal intubation of patients with COVID-19. WFSA would like to draw anesthesia team attention to the importance of appropriate precautions when providing respiratory care and intubation for these patients. 

WFSA Statement on health care providers safety and wellbeing during the COVID-19 pandemic (pdf)

Guidance on anaesthesia and COVID-19

Guidance on Airway Management

Guidance on Obstetric Anaesthesia

Guidance for Low Resource Settings

WFSA have curated a wide range of information and guidance specificially for anesthesia providers working in a limited-resource setting. The page is a growing resource so please let us know if you have resources that we should be including on this page. Click here to access the Guidance for Low Resource Settings page. 

WFSA Member Society advisories / guidelines

 frenchRessources en français

Recursos en español

  • Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR) - Portal de información sobre coronavirus
  • Ministerio de Salud Español - Documentos técnicos para profesionales
  • Asociación de anestesiólogos - Información esencialespanol
  • CLASA - Guías para manejo de pacientes con COVID-19.
  • SCARE - Página de recursos de COVID-19
  • Sociedad Ecuatoriana de Anestesiología - Check list de seguridad para el manejo perioperatorio covid positivo
  • FUS & UIS - Aproximacion practica via aerea en pacientes pandemia COVID19
  • WFSA - Declaración de la WFSA sobre la seguridad y el bienestar de los proveedores de atención médica durante la pandemia de COVID-19

  • Recursos em Português

    Coronavirus - General Information 

    Phillip Bridenbaugh Obituary

    phillip BridenbaughThe WFSA is saddened to hear of the recent death of Phillip O Bridenbaugh on 21 December 2019 in Cincinnati, Ohio, USA. Phillip had been Professor and Chair in the Department of Anesthesiology of the University of Cincinnati Medical Center since 1977. Following training in Omaha, Nebraska, Seattle and Washington he had a long and distinguished academic career with a particular interest in Regional Anesthesia. He was President of the American Society of Anesthesiologists in 1977.

    Phillip was a keen advocate for global anaesthesia  and was involved in the ASA’s Overseas Teaching Program during the 1990s and 2000s. He became a member of the WFSA Foundation Committee in 2000, becoming Chair in 2004 and serving for a further 8 years. This committee, initiated by Michael Rosen and Richard Walsh, was set up to obtain increased funding for WFSA activities. In this role he also served on the WFSA Executive Committee where his considerable political experience and knowledge were of great benefit to the working of the Federation. During this time he initiated a series of projects to encourage medical and non-medical people to support the work of the Federation. In 2011, Phillip was awarded the first ever Nicholas M Greene Outstanding Humanitarian Award by the ASA in recognition of his personal commitment to teaching and collaboration which was exemplified by his Chairing of the ASA Overseas Teaching Program Committee from 1999-2008. Phillip was always a calm and considered spokesperson for our profession and his disarming smile was a great breaker of any tension.

    The WFSA mourn the loss of this considerable contributor and send our condolences to his wife and family. 


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