The WFSA has had a productive year working with the World Health Organization on the Safe Surgery Saves Lives project, led by Atul Gawande which resulted in the Safe Surgery Checklist. Several WFSA member societies have championed the use of the checklist and in a number of countries, such as the UK , the checklist is being introduced to all hospitals. This work has now led on to the WHO Global Pulse Oximetry Project aiming to facilitate the provision of pulse oximeters and training in their use to every operating theatre in the world. Specifications have been produced for a low cost WHO oximeter, and it is hoped that following the tendering process an oximeter will be selected and tested. The WFSA have been particularly involved in producing training materials for the project which will be tested at the All Africa Anaesthesia Meeting in Nairobi in September. This educational work has been led by our President Angela Enright. Special thanks are also due to Isabelle Murat for the French translation of the WHO oximeter manual, Gonzalo Barreiro for the Spanish edition and to Rafael Ortega for his superb instructional video.

A major effort to raise the profile of this lifesaving project is required to ensure that demand for oximeters is realized in parts of the world where anaesthetists work without them. This will result in hospitals and ministries of health "oximeterizing" health systems and thus improving perioperative safety. Major donors will be sought to support the project. Please email iainhwilson@mac.com with any suggestions you may have to ensure the success of this initiative. Without doubt this project is the largest anaesthesia safety initiative ever started, and all WFSA societies will need to put energy into this project to ensure its success.

An account of the oximetry projects in Uganda, Vietnam, India and the Philippines run by a collaboration from the WFSA, AAGBI and GE Healthcare will be published in the journal Anaesthesia along with an accompanying editorial in October 2009. These projects did much to inform WHO of the practical aspects of the global programme.

The WFSA has also assisted the work of WHO through our contact Dr Meena Cherian of the Clinical Procedures Unit. We provided input into the new WHO guideline on the Clinical Use of Oxygen which details indications for oxygen, different ways to administer oxygen and how to monitor patients receiving oxygen.

Countries seeking advice about how to improve anaesthesia services will benefit from a joint WFSA / WHO blueprint describing the essential components of a national anaesthesia service. This will provide guidance in organizing a service, personnel who may provide anaesthesia, training recommendations, equipment required and ways of working to support safe practice. It is anticipated that this guideline will compliment the WHO Emergency and Essential Surgical Care (EESC) program. Improvements in training methods will be coordinated with WHO. The WFSA has some experience with training masterclasses run by Mike Dobson, Shirley Dobson and Lesley Bromley from the UK with their team – “Training the trainers”.

Following participation of WFSA members in a meeting organized by WHO Essential Health Technologies Department on anaesthesia equipment, WFSA and WHO have started work on generic specifications for anaesthesia machines that can operate reliably in resource poor areas of the world. This work is important as many anaesthesia machines in poorer countries remain unrepaired due to shortages of spare parts and maintenance facilities.


Primary Trauma Care (PTC)

PTC is supported by the WFSA and WHO and has run 34 courses during 2007-9 in different regions of the world. The WHO manual Surgical Care at the District Hospital includes the PTC material. The Chairman Douglas Wilkinson, and his international teams, are to be congratulated on this amazing achievement.

Publications Committee

The role of the Publications Committee is to further the work of the WFSA by providing appropriate educational materials for anaesthetists working without up-to-date published materials. The vision is challenging as clinical conditions vary from one country to the next, anaesthesia providers differ in their educational level and communicate in multiple languages. Modern texts which are almost exclusively written for advanced practice may be too expensive and impractical for some settings.

Update in Anaesthesia is the official CME publication of the WFSA. It is designed for anaesthetists working in resource poor settings and is edited by Dr Bruce McCormick. Each English edition is now translated into Russian, Chinese and Spanish. We are working to achieve French and Portuguese language editions. The Spanish edition is published on the internet, English and Russian editions are in paper format and on the internet.

In 2008 two editions have been produced – see www.anaesthesiologists.org  The second edition was a 200 page review of Basic Science applicable to anaesthesia. This was a significant undertaking for the editorial team and has received very positive reviews. We were extremely fortunate that the Association of Anaesthetists of Great Britain and Ireland (AAGBI) funded half the costs of production to assist the work of the WFSA. In 2009 we intend to produce another special edition – Emergencies in Anaesthesia.

WFSA Anaesthesia Tutorial of the Week was started in 2005 as an on-line weekly tutorial with a number of UK based editors. The tutorials provide material for trainees as well as experienced anaesthetists, and are particularly of interest for those anaesthetists working in isolation without access to CME, both medical and non-medical. The tutorials vary in complexity and are divided into basic science, general anaesthesia, paediatric, obstetric, regional and intensive care. The Tutorials are designed to encourage reflective learning by including questions and self-assessments and may be used for self study or teaching in the classroom. Tutorials are issued once a week and are currently hosted on the WFSA website, and are also sent out weekly to hundreds of anaesthetists by email. The archive on the website has around 140 tutorials at present containing a wide variety of material useful for the full range of clinical conditions which has proved popular for trainees in all countries. Since the system is based on the Internet, it is low cost and flexible, although limited where the internet is not available. The website www.frca.co.uk  also publishes ATOTW.

Book donation programs continued during 2008-9 to centres in sub-Saharan Africa, Thailand, Fiji, Pacific Islands, Mongolia and Moldova. We have been working collaboratively with the AAGBI, which has a major book distribution program, mainly in sub-Saharan Africa.

In particular Understanding Paediatric Anaesthesia (R Jacob) has been printed in India in both English (1000) and French (2000) and distributed widely by the WFSA. Special thanks go to Isabelle Murat for organising the French distribution.

During 2009 the American Society of Anesthesiologists is planning to fund and distribute a Spanish translation of this book – a fantastic gesture costing around $15k. In addition, the Association of Paediatric Anaesthetists of Great Britain and Ireland are planning to sponsor 1000 copies of the English version for distribution by the WFSA ($6000).

The AAGBI Overseas Anaesthesia Fund receives donations by members and supports a major book donation program which is hugely appreciated. An Obstetric anaesthesia manual “Anaesthesia for Obstetrics in Developing Countries” is currently being edited by Dr Paul Clyburn in UK and will become available for distribution in 2010. This is a joint venture between the WFSA, AAGBI and the Obstetric Anaesthetists Association. The manual will be published by Oxford University Press.


Dr Iain Wilson
Chairman WFSA Publications Committee

 Print Friendly