Newsletter November 2014

After what seemed like a lifetime the equipment kindly donated by Lovisenberg Hospital in Oslo and KeyMed Olympus UK finally cleared customs and the first month of ‘hands-on’ endoscopy training has now been completed.

The endoscopy room at the Raleigh Fitkin Memorial Hospital (RFMH) in Manzini, Swaziland could now truly be inaugurated. 20m2, multiple power sockets (some also connected to emergency power supply), wall-mounted suction and Oxygen, generous lightning, brand new air-conditioning and easy-to-clean surfaces – we were positively surprised.

RFMH is a well managed hospital of substantial size. It serves as a regional referral hospital but is also a secondary care centre for many Swazis. It covers most general medical and surgical specialties and about 600 outpatients are seen daily. There is a good climate between the management and the clinicians. The clinicians are dedicated although they are in our eyes strongly understaffed. The hospital activities seem well planned and the facilities although simple are kept tidy and clean.


Our first volunteer senior consultant GI endoscopist from Norway arrived as we were setting up the equipment in the unit. ‘Oscar’ from Surgical Innovations, Gauteng, South Africa, helped us go through all of the equipment and checked that everything was properly installed and working. He then briefed and trained the endoscopy nurses and trainees over two days on how to handle the equipment and especially the washing procedures with the TD-20 manual washer. We can only agree that the washer is brilliant, thank you! Oscar was invaluable in teaching the essential steps in how to maintain the equipment and handle mishaps.


During October we have trained one internist and one surgeon in diagnostic upper GI endoscopy and they have performed so well that we are now accepting one more trainee in the unit. The 180 gastroscope which was so kindly donated by KeyMed Olympus UK has enabled us to visualize pathology, in somewhat surprisingly, all of the referred patients examined till now. Although one cannot lift the patients out of their poverty we certainly experience their relief when we find a treatable cause for their complaint. The finding of disseminated cancer which may have been treated if diagnosed at an earlier stage also reminds us how valuable endoscopy is. We have even discovered some presumable rare conditions, which have only been briefly described in the literature. These may be conditions that are more frequent believed till now, only because underprivileged patients have not been examined before(?). We are currently working on assignments to publish data and case reports, which may be of interest to other professionals in the region or beyond. We are deeply grateful for the equipment donated by KeyMed Olympus, which may facilitate such discoveries.

The nurses dedicated to the endoscopy unit have performed very well too. In fact we are impressed by the speed in which they have acquired their skills in thorough washing, maintenance and tidiness in the unit. However, the day which Oscar from Surgical Innovations warned us of , did eventually come on last Wednesday. The gastroscope was immersed in Cidex without the safety cap attached. Fortunately the nurse informed us as soon as she discovered the mistake. We dried the scope and sent it straightaway to Surgical Innovations in South Africa. They kindly received it, dried it in their vacuum cabinet and the next day the scope was ready to use again – free of damage and free of charge! We can only approve and express our deepest gratitude to Lisa Blatch and the rest of the team in Surgical Innovations for this excellent service. With such good back-up how could this project not succeed?

We are now back in action in RFMH and will be training one more endoscopist until December. From January we will start the colonoscopy training and are very eager to start teaching with the brand new 180 colonoscope also so kindly donated by KeyMed Olympus.

It has been a true pleasure so far to work in a brand new endoscopy unit in the beautiful country of Swaziland surrounded by friendly staff, eager and fast-learning trainees, keen management and the brand new donated scopes. All keys to success are in place and now it is up to us to make sure that the staff aspire to sustain the unit. Our first trainee, who is also the head of the Dept. of Medicine, is a deeply passionate internist who is humbled by this opportunity. We have unanimously agreed that he will be the head of the RFMH Endoscopy Unit.

We are grateful to Lovisenberg Hosiptal for their funding (especially Head of Dept. of Medicine Anne-Marit Tangen) and the volunteers who are passing on their knowledge in endoscopy and gastroenterology to the local clinicians.

And we would like to thank Jamie Joint (CEO, Olympus KeyMed UK), for this wonderful opportunity he has given us, the staff at RFMH and the people of Swaziland!


Pasquale and Geir




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