Moldova
IATC-MD
International Anesthesia Teaching Center Moldova
The International Anesthesia Teaching Center in the Republic of Moldova (IATC-MD) was the starting point for the IATC initiative and has existed since 2007. IATC-MD is closely working together with the Society of Anesthesiology of Moldova (SSARM) and the European Society of Anesthesiology (ESA). The IATC projects aim at reducing anesthesia related mortality of children and adults, and also aim at generally improving comfort for the patient. Other goals are to reduce transmission of infections from HIV, Hepatitis, Tuberculosis and other common diseases via anesthesia equipment in hospitals by improving standards in the field of anesthesia in Moldova. The objective of the main IATC project “Safe Anesthesia, Safe Surgery” is to provide Moldovan anesthesiologists with the means to establish European standards of care.
Anesthesia related mortality rate of children and adults in Moldova can be only roughly estimated, exact statistics related to anesthesia complications are not available. Taking into account that technology in Moldovan anesthesia has mostly not been upgraded over the past 20 years, anesthesia mortality might be as high as 20-30 years ago in Germany. Other countries with low standards of anesthesia technologies and lack of training do have mortality rates of up to 1:125. Fatal outcome of anesthesia is certainly less in Moldova, but comfort of patients and the threat of “almost disasters” due to a lack of full monitoring are worrisome. By improving the safety in anesthesia and surgery, the project aims at lowering significantly the mortality rate in children and adults.
Modern anesthetic devices have improved anesthesia and especially monitoring in Moldova
With the help of our partners and supporters, 25 modern anesthetic machines (6 new and 19 used ones) together with numerous anesthesia monitors have been brought to Moldovan hospitals and around 200 anesthesiologists have already been trained in IATC courses since 2007. The project has received immense support from various actors. Techniques like Sevoflurane anesthesia and ultrasound guided regional anesthesia have been introduced for the first time in Moldova by IATC. Foremost, the German Federal Ministry of Health has been supporting the project since 2008 in the framework of its political bilateral relations with Moldova.
Using the new anesthesia mashines
The IATC-MD has in 2009 conducted a survey about the actual need of anesthesia equipment in Moldova: the outcome reveals that about 240 modern anesthesia machines (and the same amount of anesthesia monitors) to replace long-time outdated and dangerous old anesthesia machines are needed (costs about 12 m. Euro). The financial and economic crisis which the government of Moldova is currently facing has mostly made upgrading of anesthesia equipment impossible. Budgets for hospitals are so tight that even anesthesia drugs are lacking. For a start, IATC-MD has therefore developed a 2 step concept to deal with this problem:
1. The Euro-Center for used anesthesia equipment: Call for donation of good and fully functioning second hand anesthesia machines in European countries and hospitals. Most anesthesia machine dealers still discharge and destroy fully functioning anesthesia equipment after replacing it with new equipment. Instead of doing so, the used equipment will be evaluated, transported, tested and used by IATC-MD for teaching in daily clinical routine. Only safe and fully functioning equipment will be accepted.
2. Secondly, IATC supports partner hospitals in gradually replacing used IATC equipment with new anesthesia machines and monitors. IATC is calling upon governments and the EU to show responsibility and solidarity with anesthesiologists who cannot buy this expensive equipment on their own.
Next steps
As IATC-MD is currently in the process of organising itself as an official association in the Republic of Moldova (as a sub-group to the Medical Foundation), cooperation within the IATC network will be strengthened. In the coming year, further equipping with anesthesia machines as well as teaching opportunities will be provided. In particular, short-term fellowships and visits of young Moldovan anesthesiologists in German and Swiss hospitals and training of anesthesia technicians are envisaged.
While cooperation has thus far been limited to a number of hospitals in the capital Chisinau, the IATC-MD aims at expanding its efforts to the broader region, including Transnistria.
In order to find ways for tangible improvements in conducting anesthesia in Moldova, Moldovan anesthesiologists will write a “Handbook of Pediatric Anesthesia” with the support of international experts of IATC. The book is meant to assist in the day-to-day work of anesthesiologists in Moldovan hospitals.
IATC-MD is inviting enthusiastic professionals to come to Moldova to teach and to share experiences in the field of anesthesia and intensive care medicine.
Discussing and exchanging knowledge and experiences is an important aspect of the IATC work
Contact:
Dr. Ruslan Baltaga, MD email: ruslan.baltaga[at]iatc.eu
Dr. Markus Schily, MD email: markus.schily[at]iatc.eu
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