As one of the first SAFE trainers in Uganda in 2011, Dr David Snell discusses the development of SAFE and how it has helped inspire and shape his career.
I have had the privilege of being involved in SAFE since its conception, delivering the first-ever obstetric anaesthesia course in Uganda in 2011. Life-saving surgical and anaesthetic care in some low and middle-income countries has stagnated or even regressed over recent decades. Obstetric anaesthesia remains especially pertinent given maternal mortality remains the largest discrepancy of all public health statistics; with 830 preventable maternal deaths occurring, globally, every day.
The magnitude of what the SAFE programme has accomplished is astonishing and not to be understated. It has become so much more than simply training and education in low and middle-income countries. And the reciprocal learning and experience gained from the visiting faculty is immeasurable; enhancing leadership and training within the NHS and other high-income healthcare systems from which visiting faculty came.
SAFE Obstetric, Paediatric and Operating Room courses have been run in 33 countries and across continents, delivering continued professional development in the safe provision of anaesthesia and surgery to colleagues who, without it, might have little or no ongoing supervision and training.
Reciprocal learning and experience gained from the visiting faculty is immeasurable; enhancing leadership and training within the NHS and other high-income healthcare systems from which visiting faculty came.
But it is also the advocacy and leadership skills that have been developed through the programme, further empowering trainers and delegates, once they return to their places of work. The friendships and communities that have been built during the courses are wonderful to witness and experience, and build a sense of camaraderie as well as formal mentorship that supports individuals and the discipline as a whole.
The success of the programme has relied upon local champions promoting a recognition of anaesthesia and critical care as specialities in their own rights. Along with the clinical and academic training, this has resulted in a snowball effect that is felt well beyond the walls of the SAFE courses, in-country and across country borders. It has, and continues to, improve the recognition and safety of anaesthesia and surgical practices, globally.
With the travel restrictions imposed as a result of the SARS-CoV-2 pandemic, the now international SAFE steering group and development team have worked tirelessly to create and deliver a remote training package. The adaptability of the SAFE programme has always been one of it’s greatest assets, and this is a reflection of how it continues.
From a personal perspective, SAFE has been a major part of my life over the last decade and has moulded me and the career choices I have made in ways I am very grateful for. I have spent three years living and working in sub-Saharan Africa with my family, practicing anaesthesia and critical care medicine and training physician and non-physician anaesthetists.
It has been an incredible journey in which I have learnt so much from some of the most inspiring and committed people I have ever met. Many have mentored me through my own training and in some challenging working environments. They have helped develop me in leadership and educational skills. And through SAFE, and the work I’ve done parallel to it, I have been able to cascade much of what I have learnt in my own mentoring.
Numerous lifelong friendships have been made and experiences shared, and I would encourage anyone considering this kind of work to pursue it. The personal and academic growth one experiences are boundless.
Dr David Snell, Anaesthesiologist, UK.