I was invited by the Grant Foundation and Management Board to visit between January and April 1997 in order to set up an in-service training programme for the anaesthetic nurses, not necessarily following western methods. The hospital facilities were far better than I have previously seen in developing world situations. The anaesthetic equipment consisted of two Ohio Heidbrink machines and another which is used as a source of oxygen. There is no thermocompensation and no way of measuring the concentration of inspired gases. There is a 'T'-piece for those under 15kgs.
Ventilation is by hand.
There are no mechanical ventilators, no Bain or Magill circuits, no drawover machines, EMO or triservice and no method of giving air except by using an Ambu-bag. There are two North American Drager modern electronic machines sitting in the theatre. They are totally inappropriate and have long since ceased to function due to lack of maintenance. A wide range of anaesthetic drugs are available including fentanyl, vecuronium, droperidol, propofol and dopamine whose use does not appear to be understood. There is lignocaine, marcaine and heavy tetracaine but neither pethidine nor morphine.