Professor David Pescod is Clinical Associate Professor at the University of Melbourne and Deputy Director at the Department of Anaesthesia, The Northern Hospital, Victoria, Australia. He is also a Council Member of the World Federation of Societies of Anaesthesiologists. Visiting Mongolia every year since 2000, Prof Pescod has led the transition to modern anaesthesia in Mongolia and collaborated in the training of Mongolian anaesthestists. Here he explains why the people of rural Mongolia need your help to bring safe anaesthesia to the countryside and the UK-based appeal Safe Anaesthesia Mongolia (www.safeanaesthesiamongolia.com) deserve your support.
Today, safe anaesthesia is accessible to all in the major cities and districts in Mongolia. But that’s not true for the one million people who live in the sparsely populated Mongolian countryside who face an unaffordable journey of up to five days to reach the nearest surgical care.
The result – as I have seen for myself – is a high level of unmet basic surgical need for easily treatable conditions such as appendicitis, open fractured bones, sepsis in obstetrics, bleeding from obstetrics and trauma.
Burns are a major problem in all resource-poor countries because of the widespread use of open fires, and are common in Mongolia even though parents go to incredible lengths to protect their children. When accidents happen, a nomadic herding family cannot afford to send a child thousands of kilometres to Ulaan Baatar, the capital city, currently the only place offering treatment. Without surgery, burns cause scarring, contracting a child’s hands for instance, preventing them from being able to dressed, get schooling and have a decent life.
The same is true for maternal deaths in rural Mongolia, which is twice the rate of that in neighbouring Russia and China. If a woman is at risk of a problematic labour they should be sent to a major hospital, but without access to a local operating theatre, there is no safety net available if the risk is missed. And the result, too often, is maternal and feotal death.
A further problem is trauma from industrial and traffic accidents, something that has recently escalated to become the second leading cause of death in Mongolia. This occurs as the countryside transitions from an exclusively herding and nomadic lifestyle to one more reliant on newly introduced mining and industry. Yet for thousands of workers, there is no access to emergency surgery.
This can change however,by providing anaesthesia machines, alongside training local doctors to provide anaesthesia and surgery locally, while avoiding the problems with charitable support for anaesthesia that I see in countries that I visit.
Firstly, Diamedica anaesthesia machines, chosen by the Mongolian Society of Anaesthetists, are robust, portable and can run without electricity or an oxygen supply and are therefore ideal for the Mongolian countryside.
Secondly, with Safe Anaesthesia Mongolia, each machine comes with an appropriate education package provided by global anaesthetists including myself, with the support of the Mongolian Society of Anaesthetists. After all, it’s not just pointless to provide equipment without an education package, it is actually dangerous to provide unknown equipment to people without education.
Safe Anaesthesia Mongolia is currently raising £20,000 ($25,650) – via the charity Safe Anaesthesia Worldwide – with £6000 ($7692) already raised. The money will buy five portable anaesthesia machines providing emergency surgery for more than 100,000 people in rural Mongolia. The charity aims to help rural Mongolia get the machinery and trained anaesthetists to provide anaesthesia for everyone.
To donate, visit https://secure.thebiggive.org.uk/projects/view/26739
