Back at Kibagabaga

Travelling back to Rwanda with Lifebox for refresher training on the checklist and pulse oximeters, I have to confess that I was looking forwarding to revisiting one place more than any other. Sadly that wasn’t the wonderful Lil’ Vegas burger bar in downtown Kigali. Although without doubt the best place near the University Hospital to grab a working lunch while devising world-conquering checklist implementation strategies, reports of its sad demise had even reached as far afield as London.

No, the one place I was really looking forward to visiting was Kibagabaga district hospital on the outskirts of Kigali. A warm and friendly healthcare centre set amongst immaculately coiffured gardens, this small hospital occupies a special place in the heart of Lifebox. As the centre where our checklist implementation was first trialed in Rwanda, and where it has been most successfully embedded, I wanted to see with my own eyes how the team were getting on.

What my own eyes were not ready for was the taxi moto ride to the hospital. For those not familiar with the taxi moto concept, imagine taking your scariest theme park roller coaster ride, mounting it on a 2-wheel motorbike, and calling it a taxi. So most of this ride was completed with my own eyes tightly shut, only opening occasionally when either 1) another vehicle, pedestrian, animal or vegetable brushed against me while I was sat clinging white-knuckles on to the back of the bike, or 2) each time the taxi moto driver stopped to ask others for directions (having reassured me before we set off that, yes of course, he knew where Kibagabaga hospital was).

Note to self: when next talking to a taxi moto driver, speak more slowly so that the difference between instructing them to drive “slowly” versus “quickly” is more clearly understood prior to setting off.

My predecessor, Sophie Reshamwalla, had originally introduced the checklist here at Kibagabaga at the start of 2013, with a follow-up visit from myself at the end of last year, and more regular teaching from Charles “Beau” Bush, the current Paul Farmer Global Surgery Research Associate in Rwanda, who accompanied me on today’s visit. Would our confidence in this hospital’s work be justified?

Needless to say, it was well worth the harrowing journey to get here.

Not only did the long, motor bike ride with so many wrong turns and cross-country shortcuts eventually help abate my abject fear of untimely death by taxi moto, but the enthusiasm from the local hospital staff was something special.

We took time to chat with the theatre team, nurses and anaesthesia technicians. As a more ‘mature’ checklist hospital, with over a year’s post-implementation experience, I was keen to hear about their experiences. What had worked, what hadn’t, and what could Lifebox do to help?

But it’s lunchtime here now, so I will look forward to filing that report just as soon as we’ve found a new burger bar for our lunch!

Dr Edward Fitzgerald — Surgeon | Healthcare Consultant | Honorary Clinical Advisor, Lifebox Foundation

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