International Volunteer Anesthesia

The University of Pittsburgh Nurse Anesthesia Program Faculty and Alumni are involved with International Volunteer Anesthesia Initiatives. See photos and descriptions to follow.

Richard Henker PhD, CRNA, Vice Chair of the Acute and Tertiary Care Department at the University of Pittsburgh continues to do volunteer work through Health Volunteers Overseas in Cambodia and most recently in Bhutan where he is instrumental in developing a program to educate nurse anesthetists. Two students from our program joined him in Cambodia in 2007 as our first international clinical site and more students have participated in this experience. Dr. Henker received the HVO Golden Apple Award for his efforts in April 2009.

Chronology of University of Pittsburgh Nurse Anesthesia Program International Activities

Date	Hospital	Location	Faculty	Students
October 2010	Angkor Hospital for Children	Siem Reap, Cambodia	Richard Henker	Laura Barnes Jillian Klunk
June 2010	National Referral Hospital	Thimphu, Bhutan	Richard Henker
September 2009	National Referral Hospital	Thimphu, Bhutan	Raelyn Raver
August 2009	National Referral Hospital	Thimphu, Bhutan	Richard Henker
March 2009	Angkor Hospital for Children	Siem Reap, Cambodia	Kathryn Finney	Skye DeDi MaryThom Newcomb
November 2008	Angkor Hospital for Children	Siem Reap, Cambodia	Richard Henker	April Brewster Kristen Shubert
November 2007	Angkor Hospital for Children	Siem Reap, Cambodia	Richard Henker	Brian Read Sarah Johnson
March 2007	Angkor Hospital for Children	Siem Reap, Cambodia	Richard Henker
December 2007	National Referral Hospital	Thimphu, Bhutan	Richard Henker
February 2006	Angkor Hospital for Children	Siem Reap, Cambodia	Richard Henker
January 2005	Sihanouk Hospital Center of Hope	Phnom Penh, Cambodia	Richard Henker

Nice summary of the OR/anesthesia environment as well as the cultural experience in Cambodia.

A description of the May 2007 Bhutan Volunteer Anesthesia experience as described by Dr. Richard Henker:

We ran two operating tables in one large operating room. There were three providers to cover the two operating tables. The three anesthesia personnel included me and two anesthesiologists, which gave us the opportunity to take a break and lunch. We did all plastic surgery cases, which included: cleft lip and palate repairs, burn scar revisions, congenital defect repairs, and bear/bobcat attack scar revisions. Full and partial thickness skin grafts were done. A total of 72 surgeries were done in 5 days of operating. Ages included infants to geriatrics. Types of anesthesia delivered included: local MAC, general (endotracheal and LMA), and regional (infraorbital blocks). We were able to provide teaching and participate in cases together with an anesthesiologist from the capital city, who was there to observe and learn for the week. This anesthesiologist also brought an extra anesthesia machine as this hospital only had one. The only gas available to use was Halothane. There were two patients that received blood transfusions. The smallest patient we provided care to was 4 kg. There was no scavenging, no FiO2 monitoring, and no gas analyzer. We did have ETCO2 monitoring. Patients in recovery had to share the only available O2 tank outside the OR. This hospital was an OB hospital so when they had a D&C or C-section we had to complete our cases and allow them to have the OR back until they were done. We were able to meet the Queen of Bhutan during a dinner she provided to our group. We spent two days trekking in the Himalayas up to an elevation over 12000 feet. There is only one airport that people can fly into. Bhutan is in the Himalayas between Tibet and India. During dressing change day before departure children who need sedation for suture removal received IM Ketamine, Versed, and Robinul. We had a total of 26 volunteers for this trip with approximately ½ of the group having no medical background.

In November 2007 Dr. Henker again returned to Cambodia accompanied by two Nurse Anesthesia Program students, Sarah Johnson and Bryan Read. This was the first international clinical site developed for nurse anesthesia students.

In the words of Brian Read......."Traveling to Cambodia as a student anesthesia volunteer with the University of Pittsburgh Nurse Anesthesia Program was certainly one of the highlights of my anesthesia training. The opportunity to volunteer for the Cambodian community and to work with the local anesthesia providers during the two week clinical rotation in Siem Reap was an extremely beneficial experience that reinforced how diverse and rewarding our profession can be. It was truly an honor to be one of the initial student volunteers selected from the University of Pittsburgh Nurse Anesthesia Program to be part of Health Volunteer Overseas (HVO) ongoing endeavors."

In Rick's words...
My volunteer work this year (2006) was again through Health Volunteers Overseas but I taught and practiced at Angkor Hospital for Children (AHC) in Seim Reap Cambodia for 2 weeks in February. The anesthesia team for AHC consists of 3 nurse anesthetists. There is one OR and 3 inpatient units in addition to an emergency room (truly a room) and a pediatric ICU. There are also huge numbers of patients that are seen on an outpatient basis. Some patients travel for days to be seen at AHC. The goals for this trip were considerably different than last years volunteer trip to Phnom Penh. Angkor Hospital for Children is a resource to the hospitals in the provinces in the more rural areas of Cambodia. Many of the anesthesia providers in these provinces and nurse anesthesia students from Phnom Penh come to AHC for their anesthesia training. Much of my teaching focused on how to teach and precept anesthesia care providers and students. Laura Palmer and Sandy Sell helped considerably by supplying me with their lectures on teaching and precepting. I also gave lectures on some of the basics such as airway, opioids, respiratory physiology, and muscle relaxants.

In January 2005, Rick spent two weeks in Phnom Penh, Cambodia, at Sihanouk Hospital Center of Hope. While in Phnom Penh, he provided clinical instruction, clinical care, and 14 hours of didactic presentation on various topics including Airway Management, Respiratory Physiology, Anesthetic Pharmacology and Thermoregulation.

Scott Pearson, Alumni from the Class of 2005 has participated in several international activities.

Scott Pearson, an alumni from the University of Pittsburgh Nurse Anesthesia Program Class of 2005, has made volunteer anesthesia trips to Ho Chi Minh, Vietnam in 2005; Antigua, Guatemala in August, 2006; Paro, Bhutan in May 2007; and Uganda in February 2008. He traveled with Surgicorps www.surgicorps.com based in Pittsburgh which is run by plastic surgeon Dr. Jack Demos. Surgicorps coordinates entire medical teams which work with the local hospital staff. The team stays at local hotels and are able to explore the culture and night life after a hard days work in the OR. To follow are Scott's descriptions of these missions.

In February of 2008 I traveled to Uganda. We landed in Entebbe and then had to take small Cessna type planes to our final location of Mbale, Uganda. This involved landing on a grass runway, a 1^st for me. We worked at a CURE International hospital. They have two operating rooms their and allowed us to use one. This hospital mainly does neurosurgical type cases. We performed cleft lip repairs, burn scar revisions, and repaired congenital defects on all age groups. There were two CRNAs present to provide the anesthesia. We worked with and help teach CRNAs that worked there and also got to be involved with SRNAs that were rotating at this hospital. I was also able to give 3 lectures to current SRNAs at their school in Mbale. We discussed laryngospasm, Diprivan, and LMAs. Anesthesia providers there do not have access to Diprivan due to costs and had rarely used LMAs. We were also able to provide hands on training in the OR with Diprivan and LMAs. The level of poverty in Africa was definitely worse than any other place I have visited. The local hospital did not have anesthesia machines or any monitors. At the local hospital all they have is Ether machines, suction, a manual BP cuff, and an oxygen concentrator to provide anesthesia. At the conclusion of our trip we did travel to Rwanda to do some gorilla trekking. We took a guided trip and were able to trek to several gorilla families that live in the mountains.

The technology in Guatemala was excellent compared to Vietnam. The hospital was run by a church organization and well funded. In Vietnam, however, we had to deal with power outages and oxygen flow problems as well as having to contend with safety issues such as lack of auxiliary oxygen supply, waste gas scavenging, gas analyzer capabilities and functioning alarms systems. All equipment and supplies had to be packed up at a local warehouse and taken with us on the plane, with the exception of anesthesia machines. On most of the Surgicorps trips, they attempt to take a small side trip for R&R. During the Vietnam trip we went to Cambodia to see the temples of Angkor Wat. Having the chance to do some sightseeing is nice as most would not travel to a 3^rd world country for vacation.

Bill Wagner, Alumni from the Class of 1995 has participated in several volunteer missions through the MIMA Foundation. This organization sends volunteer medical specialists each year to Third World Countries that have limited or unavailable medical care for the indigent populations. In 2010 Bill decided to raise money for the foundation by riding a mountain bike on the Great Divide Mountain Bike Route from Canada to Mexico - the longest off-road bike route in the world (over 2700 miles long). His adventure is featured on this website - a fascinating journey - please visit......Bike For MIMA.