Professor Kokila Lakhoo, Mr. Richard Stewart (paediatric surgeons) and Mr. Philip Henman (orthopedic surgeon) representing the Royal College of Surgeons in England are partnering with Dr. Vrisha Madhuri along with the departments of general surgery, anaesthetics, and nursing at the Christian Medical College in Vellore, India to teach a Provider’s Course for Children’s Surgical Care in secondary hospitals.

This pilot initiative in June 2017 lead locally by Professor Sukria Nayak, and Professor Vrisha Madhuri was attended by 24 staff from two government hospitals and three mission hospitals.

  • Broadwell Christian Hospital, Fatehpur, Uttar Pradesh
  • Baptist Christian Hospital, Tezpur, Assam
  • Christian Fellowship Hospital, Oddanchatram, Tamil Nadu
  • District Hospital, Tumkur, Karnataka
  • KCG Hospital, Malleshwaram, Karnataka

The course ran over three days with lectures, scenarios, interactive sessions and live operating held at the Paul Brand building and the Chittoor campus.

Day 1 gave an introduction to the management of a sick child followed by skill stations on airway management, chest drain insertion, vascular access, splinting and analgesia which were energetically participated in. After lunch CPR was practiced on infant and child manikins lead by the local emergency and ICU teams. The program for the day was concluded with case discussions on what to refer and what to treat locally and a very energetic exercise on transport where the teams were made to compete with each other in keeping their patient alive.

On day 2 Orthopaedics and anaesthesia traveled to the Chittoor campus where there was a surgical demonstration of the application of eight plate, for deformity, and practice applying plaster casts on a club foot model, followed by a demonstration of soft tissue release.  Simultaneously the anesthetic teams evaluated anesthetic techniques, equipment, fluid management, analgesia and recovery. The General surgical and nursing teams remained on the main CMC campus where the surgeons participated in case discussions on paediatric urology, intestinal obstruction and haemangioma management as well as a fascinating lecture on snake bites. In parallel the nursing team had interactive sessions on nutrition, pain management, care of a child with burns and stoma care.

Day 3 was a half-day allowing participants time to travel back to base. The first half of the morning was speciality specific the orthopaedic teams discussing cerebral palsy, sepsis and joint infections; the general surgical team discussing spina bifida and abdominal wall defects; the anaesthetic teams discussing tips & tricks, foreign body managment and decision making; and the nursing teams participating in skill stations on cast care, gastrostomy management and NG feeding. The course finished with a common session on safety and the WHO checklist using locally made video’s, starring the CMC team, demonstrating bad practice and how it should be done, which caused much amusement.