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Beijing’s’ ability to look after foreign visitors
who are accidentally injured will come
under close scrutiny.
We plan a return visit to Beijing in
October 2002.
Kunming
By a happy chance, the primary contact in
Kunming was Dr Xu Wang Bin. He has
worked for 6 years in specialist anaesthetic
and intensive care practice. A year ago, he
was one of two specialists given the position
of Director of the Emergency Department.
He is committed to improving the standards
of emergency care particularly in rural
Yunnan province.
The programme in Kunming ran
smoothly and we trained 24 emergency
medicine doctors. The PTC committee in
Kunming includes Dr Xu, a senior Army
doctor in charge of 17 trauma centres and
the medical director of the ambulance
service in Kunming.
Issues
PTC, ATLS and a lack of surgical
representation
It is not the intention of PTC to
exclude surgeons and it was unfortunate
that the one surgical instructor from Hong
Kong that we were able to recruit was
unable to take part as a result of other
commitments. We view the PTC and ATLS
programmes as mutually complementary.
The target audience for PTC is junior
doctors, registered nurses or health officers
working in a small remote hospital with
inadequate facilities whilst that for ATLS is
surgical, anaesthetic and emergency
medicine trainees and specialists in the
teaching hospitals of the larger cities. We
encourage ATLS to develop a programme in
mainland China.
Scenarios and small group teaching
These methods of teaching were unfamiliar
to our Chinese audience although they were
interested to use these techniques in the
future.
The future for PTC in China
We are optimistic that PTC is a useful
programme for the Peoples’ Republic of
China. We have gained strong acceptance
in Xi’an and Kunming and a level of
interest in Shanghai and Beijing.
The teaching material, slides, manuals
and instructor manuals have all been
translated into Chinese script and our
instructors in Hong Kong and at our
regional office in Australia will be the key
workers who will continue to support PTC
in China.
It is clear that emergency medicine is
the specialty that will take ownership of
PTC in China and a joint Australasian and
Chinese emergency medicine and PTC meeting
is planned for Beijing in October 2002.
Conclusion
We received lavish hospitality wherever we
went in China and were made to feel most
welcome. There is no doubt that modern
China is an outward looking country with
much to contribute to the rest of the world.
It is important that we develop friendships
with doctors in the Peoples’ Republic of
China. My three visits to China over the
last year have given me a much improved
knowledge and understanding of this large
and important country. I strongly
encourage other anaesthetists, who have not
done so to visit and teach in China.
Acknowledgements
This project was financed by the Australian
Society of Anaesthetists. Abbott Australasia
also provided financial support for the
preliminary visits to China in 2001.
References
The Global Burden of Disease Study.
Lancet 1997
The Neglected Epidemic: road traffic
injuries in developing countries. Vionand
M, Nantulga and Michael R Reich. BMJ
324, 11 May 2002, 1139-1141
22
The Department of Anaesthesiology,
University of Calabar, Nigeria
Dr Ini Abasi Ilori
Dr Sylvia G Akpan
University of Calabar Teaching Hospital
Nigeria
The city of Calabar on the south east coast
of Nigeria has given its name to a
variation of filariasis known as the
Calabar swelling (loa loa) and the poisonous
Calabar bean (Physostigma venenosum). The
latter was first described in 1846 by the
Scottish missionary, Dr William Freeman
Daniel, and was used for trial by ordeal. Its
local name is Esere, hence eserine for the
phyostigmine alkaloid.
Calabar is a quiet and tidy seaport with
only one access/exit road through the
surrounding mangrove swamps. It was at one
time the capital of Nigeria and has one of the
oldest secondary schools in the country. The
dominant local language is Efik and Efik
women have a reputation for being alluring
and lovable. The traditional dish they cook of
vegetables and dried fish is said to intoxicate
men such the Calabar is also known as the city
to Come And Live And Be At Rest.
The University of Calabar is one of the
third generation Nigerian universities. Although
the Teaching Hospital was formally established
in 1982 it grew out of St Margaret’s Hospital
that was founded in 1897. The hospital now
serves the 320,000 population of the city as
well as acting as a referral centre for the entire
Cross River and Awka Ibom states as well as
West Cameroon (formerly part of Nigeria). The
hospital has 508 beds and is managed by the
Federal Ministry of Health. From the main
theatre one can view the surrounding
mangroves and the Atlantic Ocean.
The Department of Anaesthesiology
serves the specialties of general surgery,
otorhinolaryngology, ophthalmology, burns and
plastic surgery, maxillo-facial surgery, urology,
orthopaedics and trauma surgery as well as
obstetrics and gynaecology. Unfortunately, as
the supply of water, electricity and medical
gases can be erratic we do not practice hi-tech
anaesthesia! Although we often have to
improvise, we practice subarachnoid and
epidural anaesthesia as well as 3-in-1 and
sciatic blocks to minimise blood loss. Ketamine
is frequently used for total intravenous
anaesthesia. We use a variety of muscle
relaxants but only have one volatile agent,
halothane. We have a 3-bedded intensive care
unit but it is only occasionally used. Our two
Blease ventilators, donated by the
Hammersmith Hospital, cannot be used due to
lack of spare parts. When we have to ventilate