The SPECT Perspective 

Highlights of our work in 2015

• During 2015, SPECT volunteers spent a combined total of 30 weeks working in Madagascar.

• Christina, our educator and consultant, provided training on the principles of sterile processing to more than 60 health care supervisors and/or workers directly involved in sterile processing activities from 33 hospitals and clinics in Madagascar.

• Dan, our program coordinator/administrator, spent 2-3 weeks this past fall visiting 23 hospitals and clinics to assess their sterile processing practices. At the 15 locations that had sterilizing equipment, Dan used chemical and biological indicators to test the effectiveness of their equipment. Whereas in Canada, sterilizing equipment is tested daily, Dan was told these sterilizers had never been tested.

• Kayla, a nurse from Vancouver and SPECT’s first non-board volunteer, joined Christina in Madagascar this fall to assist in education sessions (thanks Kayla, we loved having you along!).

• With the support of a Grand Challenges Canada Grant, 30 Sterilization Packages have been produced. Each package includes a 21-liter pressure cooker, a stainless steel basket capable of suspending a basic set of surgical instruments, and a charcoal burning stove. 26 of these packages will be distributed before the end of this year to 3 urban hospitals and 23 rural health clinics.

• 10 new high-quality mattresses with covers were donated to the maternity ward in a hospital in Antsirabe to replace mattresses that no longer provided support, lacked covers, and were badly stained conduits of infection.

• As part of SPECT’s 3-year Memorandum of Understanding with Mercy Ships International, Christina assessed and provided recommendations to re-design the sterile processing area for the main hospital in Tamatave, the port city where Mercy Ships is based, and where they are assisting with a major upgrade of the main hospital, Centre Hospitalier Universitaire de Toamasina (CHUT).

• Over 70 people attended our first Calgary fundraiser and silent auction, held in June at Fort Calgary. As a result of donations of silent auction items, an array of arts and crafts from Africa, and the generous support of those who attended this event, we were able to raise over $9,000.

• Wendy Thiessen and Lyndon Raugust started volunteering with SPECT this summer. Wendy has since joined as a Trustee while Lyndon is taking on a fundraising role. Wendy replaces Lindsay Penner who juggles many roles (thanks for all your work with SPECT Lindsay!). Meanwhile Chanel Aries, a new volunteer specializing in communications and marketing, recently joined SPECT and will be reviewing and upgrading SPECT’s website. Watch for changes in the coming months.

• Ongoing promotion of SPECT's work was conducted through television interviews, radio interviews, and online publications. Click the button below to view our Media page. 

Training

Between mid-February to mid-May, Christina offered a comprehensive 6-week training course for 3 sterile processing technicians at CHUT in Tamatave. Dan joined her in March to offer training support and to accompany her to Antsirabe (Madagascar’s 3^rd largest city) to meet with Rasheika, a Peace Corps Volunteer working in community health. Together they formulated plans for a fall training session for up to 25 physicians working in rural health care clinics.

In September/October, Christina and Kayla conducted a 3-day workshop for 39 staff from 12 hospitals in Antananarivo (Tana), Madagascar’s capital city. Following this, they provided a 1-day workshop in Antsirabe providing training on SPECT’s sterilization packages for 20 of the rural physicians mentioned above. 

Here is what a few of our Tana trainees had to say…

• “Everything we have learnt during the training is important.”

• “I will share with my colleagues and we will apply it in our work.”

• “The course is near perfection. I like the tests after each subject because it helps me to retain what is essential. I want concrete materials to facilitate comprehension."

Sterilization Packages

For the benefit of those who are hearing about SPECT for the first time in this newsletter, in April 2014, SPECT was selected to receive a grant from Grand Challenges Canada to promote an “innovate idea” in health care. Our idea was to see if we could use a simple pressure cooker fitted with a specialized basket that could suspend surgical instruments and then be heated using a non-electrical source; all with the objective of providing developing countries with a low cost, simple, and effective method of sterilizing surgical instruments. In Mar/April, Dan went to Mada to explore local markets in search of materials to manufacture the baskets and locate suppliers of pressure cookers and heating sources. 

Hospital Sterilization Equipment Testing

As mentioned in the highlights above, Dan spent several weeks using chemical and biological indicators to test sterilization equipment at 15 hospitals and clinics. At 11 locations, the equipment passed the test, whereas 4 failed. One of the locations that failed was the leading Pediatric Hospital in Madagascar where 4/5 of their dry heat sterilizers failed. The Director was astonished to see these results as most of their equipment was fairly new and the hospital was very proud of their standards and their partnerships with international funders. After reviewing with them their temperature and time settings and suggesting they increase both the temperatures and times, subsequent indicator tests passed. This hospital was sterilizing assorted items on a daily basis and so this simple test offered them a much better assurance that sterility was being achieved. 

Hospital Mattress Distribution

Although purchasing and distributing hospital mattresses is not a SPECT focus, when Christina and Dan visited a hospital in Antsirabe in April and toured the maternity department, both were shocked to observe women just out of delivery lying on foam mattresses that offered little support, had either no covers or extensively ripped covers on them, and which had been badly stained with bodily fluids. 

What’s Next?

• Distribution of the sterilization packages – unfortunately the shipment of pressure cookers from India took longer than planned and upon arrival in Mada, they faced an extended delay in customs. However, in early November they were released and are now in a warehouse in Tana, ready for distribution. We are currently working on translation of the operating instructions that came with them and then plan to distribute 26 of the units before the end of the year.

• Christina is planning to return to Madagascar in February 2016 to visit the hospitals and clinics that received the sterilization packages and to gather feedback on their use. She will also spend several weeks working with Mercy Ships on the hospital upgrading project in Tamatave and ensuring that staff there are trained to use the anticipated new sterilization equipment.

• Final reports for Grand Challenges Canada will need to be prepared by February 2016. Beyond that, we are optimistically hoping that further funding will become available to significantly scale-up our sterilization “innovative idea”.

• Two brothers who operate a manufacturing company near Calgary, Alberta have begun work on developing a new prototype instrument basket designed to be lighter, cheaper and more functional than our current one.

 
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