Graduate student assists with anesthesia in Madagascar

Meghan Duggan, a senior graduate student in the UTC School of Nursing’s Nurse Anesthesia Program, spent two-weeks aboard a Mercy Ship at the Toamasina Port in Madagascar this past October. She spent the majority of her time aiding in the administration of anesthesia for various surgeries on the ship for the local Madagascar population.  

Mercy Ships is a nonprofit organization that hosts a hospital aboard a ship with the mission to “provide lifesaving surgeries for people where medical care is nearly non-existent.” It is a rare opportunity for any student to be invited or allowed to serve aboard the ship, but Duggan applied to accompany UTC Assistant Clinical Professor for the Nurse Anesthesia Program, Ray Alonge, MSN, CRNA, and was accepted. Alonge has volunteered on Mercy Ships for the past 10 years, cultivating a trusting relationship with the organization.

Duggan raised the money for the medical mission trip through a fundraising site and charity events. Several of her fellow graduate students in the program helped her with a bake sale at Erlanger Hospital. Family, friends, professors, local hospital staff, and alum of the program all donated to make the trip possible. The UTC Graduate Student Association contributed funds as well, because Duggan conducted some research as part of the trip.  

“It was definitely a community effort. And, my clinical schedule at the hospitals in Chattanooga had to be adjusted. Everyone was really accommodating. I knew I had to represent Chattanooga and UTC well, because in a way, this mission trip was a group effort,” Duggan said.

Duggan’s daily schedule started at about 7:00 A.M. and ended after a case (an individual surgery) was finished, usually by 6:00 P.M., but sometimes as late as 8:00 at night. She was also on-call a couple of nights a week—some of those nights she had to return to the surgery deck at midnight or later for an emergency procedure.

Some of the common surgical procedures Duggan assisted with in an anesthesia assistant capacity included removing maxillofacial tumors. Though they are benign, they can fatally obstruct the airway if not removed. Orthopedic surgeries to correct bone deformities such as severe bow-leggedness were also common. Correcting cleft palates was another frequent surgery performed on the ship. These procedures are not otherwise available to the people of Madagascar—so the Mercy Ship stationed at Port Toamasina fills a glaring medical need, and people travel across the country in hopes of getting medical attention from those on board.

Pre-surgery, Duggan worked with medical translators who aided with informed consent for patients and explained how the anesthesia would work. While there, Duggan took notes about how the pre-surgery intake form that includes a patient’s medical history varies depending on the population you are serving as a medical provider.

“You have to ask questions in medical histories in Madagascar that you might not need to here in the States. Knowing the types of questions to include depending on the culture and environment you’re in is a key component to being a good medical care provider. Right now I’m working on comparing how our typical intake form would be modified for the people in Madagascar,” Duggan said.

Duggan highlighted how the medical team on the ship worked with the resources immediately available. She said one of her favorite aspects of her time in Madagascar was seeing how the healthcare providers on the ship often donated their own blood for patients and were even “on-call” for donating. This is known as a “Walking Blood Bank”. She said she saw people carry their own blood immediately after donating straight to the patient in need. She added “You would never see that in the U.S.—it was very moving to witness.”

“I learned so much,” said Duggan. “Every Wednesday morning we would have anesthesia meetings where I was able to hear about interesting cases and anesthesia-related topics from around the world.”

During her downtime, Duggan studied for her UTC Anesthesia coursework in the library or in the Starbucks on the ship. She will be sharing some of her research and more about the trip at the UTC Graduate Research Symposium on April 14, 2016.

[slickr-flickr search=”sets” set=”72157664535031425″]