In “UAM: Supporting Nurse Anesthetists on the Frontlines of Obstetric Emergencies—A Perspective from Tanzania,” two anesthesia providers working at health care centers in southeast Tanzania share their first-hand experiences on how the Universal Anaesthesia Machine (UAM) and Gradian’s simulation-based training have helped them better care for women giving birth. Grounded in the experiences of nurse anesthetists Peter Sylvester Mayyo and Miriam Milanzi, the film shines a light on the often neglected but crucial role of anesthesia providers in saving the lives of women and newborns during childbirth emergencies and Caesarean sections. The trainings Peter and Miriam attended at the Kilimanjaro Christian Medical Centre where anesthesia providers learned to operate the UAM with confidence while strengthening existing anesthesia skills.  

Note: A version of this film—Heroes Unmasked—was selected as a finalist in the nurses and midwives category for the World Health Organization’s 2020 Health for All Film Festival.

Watch the video to learn more about their experience:


Video Transcript:

Peter Sylvester Mayyo, Nurse Anesthetist, Nkowe Health Center, Tanzania: “I saw the challenges faced by pregnant women when it came time to give birth and they had to be referred to the district hospital just because they didn’t have an operating theater.”

Dr. Ellen Mkondya Senkoro, Mkurugenzi Mtendaji, Benjamin William Mkapa Foundation: “Many women cannot access a facilities very close or nearby. They have to walk almost 50 kilometers or more.”

Miriam Milanzi, Nurse Anesthetist, Likombe Health Center, Tanzania: “We were creating a risk for mothers, we were creating a risk for ourselves. So we worked like this until we finally got the Universal Anaesthesia Machine (UAM). Which enabled us to work without worry.”

Dr. Karima Khalid, Anesthesiologist, Muhimbili Orthopaedic Institute, Tanzania: “C-sections are important in improving maternal mortality in rural Tanzania. Because we know that if they are performed [in a timely manner], with people who are well-skilled, with the right equipment needed to perform the C-sections, they can be life-saving when we have complications related to childbirth.”

Peter Sylvester Mayyo: “Anesthesia is an important aspect of maternal health services, especially for mothers requiring [emergency C-sections]. Because when it comes time to perform the operation the mother needs medication to ensure they are not in pain.”

Dr. Karima Khalid: “But C-sections are intricate procedures. Many facilities lack the human and physical resources to be able to deliver anesthesia safely.”

On-Screen Text: “Caesarean sections are recognized as one of three Bellwether procedures that indicate a health system has the ability to provide essential surgical services, but only when they are available safely, reliably, and consistently.”

Dr. Ellen Mkondya Senkoro: “The good news is that we had went into partnership with Gradian Health to see how best can we utilize the UAM machine in these rural health centers where we’ve been constructing some of the theaters.”

On-Screen Text: “The Universal Anaesthesia Machine (UAM) is the world’s first CE-certified anesthesia machine designed to work without electricity and medical oxygen.”

Dr. Karima Khalid: In Tanzania, the nurse anesthetists play a critical role because they are the ones who are providing the anesthesia. And it is imperative that they receive the training, they receive the supplies that they need, to make sure they can provide safe anesthesia to these women who are giving birth.”

Peter Sylvester Mayyo: “Gradian Health Systems understood that we needed instruction to be able to use the machines. But it wasn’t just instruction that we received, it was actual training conducted at Kilimanjaro Christian Medical Centre on the Universal Anaesthesia Machine (UAM). It helped demonstrate how we could care for an actual patient.”

Miriam Milanzi: “Simulation is not very different than the reality with a patient. For example, if their vital signs are increasing or decreasing, if their saturation is going down, it’s the same in a real patient. Therefore, when you learn using simulation, and then you return to reality, you find the same things.”

Peter Sylvester Mayyo: “Once I returned to the facility and had the machine, I was able to use it easily. We are grateful, and we know we need to expand.”

On-Screen Text: “Gradian’s trainings help healthcare providers operate Gradian technology with confidence and serve as a platform to strengthen existing clinical skills.” 

Miriam Milanzi: “We’ve been able to save many mothers because now we can do more than 40 C-sections per month. Whereas before than was not possible.”

Peter Sylvester Mayyo: “Now we can handle any problem, it’s not like it was before

Miriam Milanzi: “We’re safe, and the patients are safe, mothers and their children are safe.”


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