EQUIPMENT SUPPLY
‘Before’ and ‘after’ photos taken at the Menelik II Hospital in Ethiopia.
countries to do the job of a local surgeon in one of our partner countries; instead, we support the local team to deliver truly exceptional care. We believe this model creates viable and integrated healthcare systems that are respectful to the incredible people already working in these countries.
Working alongside local Ministries of Health
Working alongside Ministries of Health, transnational bodies (such as West African College of Surgeons, or The College of Surgeons of East, Central and Southern Africa) and other stakeholders, we identify countries most in need of support, and prioritise locations where a dedicated OR for children would make the most difference. For example, one of the first countries we chose to work in was Burkina Faso, a nation of 20 million people, over half of whom are children, yet lacking in a single dedicated paediatric operating room. The West African nation’s first paediatric OR, located in its largest city, Ouagadougou, is just one of 29 ORs in 14 countries that Kids Operating Room has delivered since 2018.
That means that in the space of three short years we have provided the facilities, delivered the tools, and, in many cases, trained the teams, that have gone on to provide over 30,000 operations. Together, those operations represent a model that has saved children’s lives, averted needless pain, and prevented an estimated 509,238 years of disability.
Only ‘scratching the surface’ Alongside our partners and supporters, we’re incredibly proud of delivering that impact. Given the scale of the problem, however, we’ve clearly only just begun scratching the surface. That’s why – by the end of the decade – we’ve set out ambitious, but achievable, plans to deliver 120 ORs, 120 surgeons, and 120 paediatric anaesthesia providers, in the continent of Africa. The immediate outcome of that strategy will be 10 million years of disability prevented, as some 635,000 children access emergency and essential care. The economic benefit to partner
54 Health Estate Journal September 2021
nations will go on to be an estimated $5.6 billion. We’re also in the midst of developing similarly goal-orientated plans for Latin America and South Asia. Delivering at this scale and pace puts logistics at the centre of our operations. When it comes to sourcing, for example, we act as a for-profit business would, seeking out the best value, driving down the price through economies of scale, and exploring global markets to work directly with manufacturers. Cost is the key variable within this operational matrix: the more efficiently we can deliver our operating rooms, the more operating rooms we can deliver. Things are never quite this simple though, and there is always a balance to be struck.
Maintaining the highest standards The starting point in that balancing act is committing to never providing anything that we wouldn’t be happy providing to a hospital in the UK. Each piece of the OR jigsaw must meet the highest functional, technical, and regulatory requirements. Importantly, this also means that each piece of equipment – all the theatre equipment we buy, and subsequently supply is new – must be fit for purpose within the location it will be used. Given that we are working in low-income countries, this always means more resource-deprived locations. The practicalities of this are illustrated in the supply of anaesthetic machines (one of over 3000 pieces of equipment within
each OR). In the UK the default anaesthetic machine is likely to be driven by oxygen. The machine we provide, however, comes with an in-built air-compressor which uses medical air to drive the machine, thereby using less oxygen. From our point of view this is a more expensive option. For the recipient hospitals, however, it’s more economical, and means that they never have to limit the number of operations or, worse, choose not to use the machine should there ever be a shortage of oxygen.
Anaesthetic expectations Anaesthetic expectations and requirements in low-income countries also reveal other key differences that we must take into consideration. In a UK hospital, or most hospitals in high-income countries, we would expect to find a pre-theatre anaesthetic room where patients are ‘put under’ before moving into an operating room. Yet, in our partner countries you’re highly unlikely to ever encounter this. A pre-operative room would require more equipment, more resources. and more space. So, while we work to improve the environments that each surgical team works in – from the OR itself, to waiting and recovery rooms – it would be wrong to impose our standards and expectations on them, and we always respect the hospital’s input into that process. Of course, for the children being operated on, not having the luxury of a pre-operative room can potentially add to the terror and trauma of the procedure itself, and that’s where KidsOR’s animals come into play.
Brightly coloured walls
A young girl ‘post-op’ at the Muhimbili National Hospital in Dar es Salaam.
The distinct graphic animals you’ll find on the walls of our operating rooms have become a huge part of who we are and what we do. The bright colours make them instantly recognisable, and while they look amazing, they also serve a special purpose. They are designed to offer reassurance and a colourful distraction for children about to undergo surgery. The animals are the last thing a child sees before falling asleep with the anaesthetic. We’ve been told time and time again from nurses and surgeons of the difference they make to a child’s
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