Sustainable learning
In the wake of the Anaesthesia Project, there were great expectations to the further development of the anaesthesiology department in Balkh and the extent to which the competence established with Dr Seddiqi could provide a platform for further competence enhancement at the hospital, so-called sustainable learning (7).
My investigations at Balkh Hospital in the autumn of 2013 indicated that a positive development had taken place at the anaesthesiology department over the previous twelve months in terms of material, routines and access to drugs.
Today, the department is operating at full capacity, and it has sufficient experience and routines to support six parallel surgical operations with general anaesthetics. The staff has access to the necessary consumables and drugs. The anaesthesia provided is based on Western guidelines and is documented according to Western standards. All the Norwegian equipment that was donated to the anaesthesiology department at Balkh hospital through the Anaesthesia Project, including six anaesthesia machines, is in use and functions as intended. Over the last year, written guidelines for maintenance of the equipment have been prepared. It is reported that these are being complied with.
Moreover, Dr Seddiqi has succeeded in obtaining additional anaesthetics equipment for his department through the hospital’s own logistics system and external funding. In many ways, the anaesthesiology department thus appears to be in a more robust shape than when the project was completed a little more than a year ago.
The personnel situation at the department, however, remains challenging. An increase in workload without an equivalent increase in staffing has put great pressure on the personnel. Dr Seddiqi has therefore prepared a plan for trainee positions in anaesthesiology at the department, and he is currently waiting for a response from the authorities regarding allocation of the necessary authorised posts.
In my opinion, the Anaesthesia Project has played a decisive role in the development of the present anaesthesiology department at Balkh Hospital, and the department appears to have undergone a positive development over the last year. Assuming that the efforts to establish trainee positions in anaesthesiology at Balkh Hospital succeed, there are good indications that the Anaesthesia Project has been able to establish a sustainable Afghan competence in anaesthesiology in Balkh.