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Author: Dr Jeremy Purdell-Lewis, Clinical Fellow, Royal London Paediatric Critical Care Unit
It is now five weeks until I will be touching down in the Philippines for the first of, what I hope will be, many missions with the Operation HOPE team. As a trainee anaesthetist, and new recruit to the project in the Tarlac province, I am filled with excited anticipation of what the coming weeks will bring. I understand the original anaesthetics founders, who were part of Operation HOPE and the PAGES mission, were dubbed “the A team” and it is an honour to be joining an amazing project. I first went into medical school in 2003 with the aim of becoming a psychiatrist, so this is a slight change of plan.
After 6 years of university education and two more years as a hospital junior doctor I was still looking for my future speciality. It was not for failure of enjoying my chosen profession; I just liked the jobs I had done and found that choosing just the one was a difficult decision. I enjoyed medicine, surgery and loved emergency medicine. Unfortunately for psychiatry, however, that was now off the menu as I at least knew that I wanted to be a hospital based doctor. It was during my academic research job in the LIGHT facility affiliated with Leeds University that I was first introduced to anaesthetics as a viable career path. The research involved analysing the role of pre-operative cardiopulmonary exercise testing on surgical patients. It was then that I decided on anaesthetics as a career. That is to say, with a final 1 year detour via high dependency unit medicine and a further 6 months in emergency medicine, which, again, I loved.
Another two years later and I had completed my basic level competencies for anaesthetics and my primary anaesthetic exams, both of which are by far my proudest academic achievements to date. I am also lucky to say that I love my job. So what about The Philippines and international medicine? At medical school I also completed a Bachelor of Science degree in International Health. This allowed me to bring together my interests in the wider world with my fledgling healthcare knowledge.
Early university summer holidays were spent in Tanzania where I forged a relationship with a school near Dodoma, the country’s capital, and my old school in the UK, Birkenhead Boys School. The project was about education for both Tanzanian and British children alike, helping people understand each other, and helping those the most, who have the least. More latterly I have worked as a doctor on international trips to Kilamanjaro and twice to the Honduran jungle. So, international health and equality has always been something that I have valued greatly.
Towards the end of my novice anaesthetics training, Dr Chris Barringer, a British anaesthetic consultant, asked me if I would be interested in going to the Philippines to work with The Face Charity as part of Operation HOPE. To me, it was an absolute ‘no-brainer’. It was a metaphorical ‘pat on the back’ that I would be good enough for the job, but also a brilliant opportunity to help those in need. It gives me great pleasure to be part of a team and to make a real and tangible difference to people less fortunate than ourselves.
In the UK we are extraordinary lucky to have a healthcare system which is free at the point of care and allows children and adults alike to access lifesaving and life changing intervention. In most countries around the world this is not necessarily the case and I see it as my responsibility as a doctor to give those normally unable to access that life changing care, the opportunity to do so.
With the Operation HOPE trip on the horizon and nearing the end of my novice training in anaesthetics, I decided that I wanted some further exposure in paediatric care. With this in mind I applied for a 6 month Paediatric Critical Care Unit job in London which is now coming to an end. This again has been a job that I have thoroughly enjoyed. It has been a steep learning curve and was initially quite daunting, but it has been an invaluable learning experience and I hope this paediatric exposure will stand me in good stead for both the trip to The Philippines as well as my future anaesthetic training.
After Operation HOPE, and before finally settling down to complete my intermediate and higher anaesthetic training in the UK, I have a great job for 6 months as an air adult retrieval registrar for MedSTAR in Adelaide, Australia. I have always wanted to be a flying doctor and am looking forward to this job which involves the assessment and stabilisation of acutely unwell adults as well as the transfer of critically ill adults to tertiary care.
So, with only five weeks to go I look forward to meeting the team in the Tarlac province and hopefully playing a part in changing the lives of children who otherwise may never have had the chance for surgery.
On 23rd October, 2013, BACCES presented a cheque for £400 from monies raised from their 2012 pantomime production, “Aladdin”, to Mr. Tom Walker (Honorary SpR in Oral & Maxillofacial Surgery) of P.A.G.E.S. (Philippines America Group of Educators and Surgeons) within Operation H.O.P.E. (Help Other People Excel) at Great Ormond Street Hospital, London.
P.A.G.E.S. anaesthesiologist, Dr. Mark Catolico (Senior Registrar in Anaesthesia, Neonatal & Paediatric Intensive Care Unit, Great Ormond Street Hospital), who has been involved since 2007, explained,” Each corrective procedure takes between 35 and 45 minutes to complete, depending on its complexity. We average in the region of 200 hundred corrective surgeries per mission.”
I joined an American charity called PAGES (Philippine American Group of Educators and Surgeons) for a week from Feb 7th to 15th. This is the 24th year that this group has been coming to the Philippines; performing cleft lip and palate operations for those who are unable to get this care normally.
This year the mission was set up in a small community maternity hospital in Tagaytay City, in Cavite a province 50 miles south of Metro Manila. Before our arrival the advance team had set up the existing delivery and theatre area into our temporary theatre complex. Moving and unpacking theatre tables, anaesthetic machines and surgical equipment from the groups warehouse storage unit in Manila. This just left the set up, unpacking and checking of the anaesthetic and surgical supplies for us to carry out on our first day before operations started.
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Author: Dr Mark Catolico, Final Year Specialty Registrar, Great Ormond Street Hospital for Children NHS Foundation Trust
As a UK trainee we have the privilege of plentiful senior input comparative to other specialties. At this point my experience was nine months in general anaesthesia & paediatric anaesthesia with direct supervision only. What was I to do when faced with anaesthetising a paediatric patient in a developing country! This was the challenge that I chose to accept.
How I got involved
It was early December 2005, in the brand new state of the art Theatres at University College Hospital. I was the anaesthetist for the Paediatics Maxillofacial list. Whilst in the anaesthetic room, Mr Peter Ayliffe (Consultant Maxillofacial Surgeon) spoke to me. This can be quite difficult whilst attempting blind nasal intubation, but I proceeded multitasking and Mr Ayliffe started talking in Tagalog (native language of the Philippines). This threw me completely. I failed my blind nasal technique, and tried a more conventional approach.
By this time Mr Ayliffe told me his involvement with PAGES (Philippine American Group of Educators & Surgeons) and its annual medical missions to the Philippines. By the time I had transferred my patient to the operating theatre I had somehow agreed to go on the mission.
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