A Cross-Sectional Study of Anesthesia Safety in Wad Medani, Sudan: A Pre-war Status Indicating a Post-war Crisis

Alaa I Mohamed; Mohammed S Bashir; Sami M Taha; Yassir M Hassan; Raid M Al Zhranei; Ahmad A Obaid; Abdulrahman M Albarakati

doi:10.7759/cureus.56725

A Cross-Sectional Study of Anesthesia Safety in Wad Medani, Sudan: A Pre-war Status Indicating a Post-war Crisis

Cureus. 2024 Mar 22;16(3):e56725. doi: 10.7759/cureus.56725. eCollection 2024 Mar.

Authors

Alaa I Mohamed^{1

2}, Mohammed S Bashir^{1

2}, Sami M Taha^{3

4}, Yassir M Hassan^{5

6}, Raid M Al Zhranei^{7

2}, Ahmad A Obaid^{1

2}, Abdulrahman M Albarakati^{1

2}

Affiliations

¹ Department of Anesthesia Technology, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
² Research Office, King Abdullah International Medical Research Center, Jeddah, SAU.
³ Department of Urology, University of Gezira, Wad Medani, SDN.
⁴ Department of Urology, Gezira Hospital for Renal and Urological Surgeries, Wad Medani, SDN.
⁵ Department of Obstetrics and Gynaecology, University of Gezira, Wad Medani, SDN.
⁶ Obstetrics and Gynecology, Wad Medani Maternity Hospital, Wad Medani, SDN.
⁷ Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.

Abstract

Background: As the surgical burden grows, increasing patient safety during anesthesia and surgery becomes a major global public health priority. Anesthesia can be safely administered in higher-income countries, yet it is more challenging in third-world countries. This study focuses on Sudan, a third-world country, and its unmet anesthetic needs before the current war and how these needs might compromise the post-war status.

Aim: The aim of this study is to compare Sudan's outstanding anesthesia requirements to the World Health Organization's safe anesthesia practice standards in terms of workforce, medications, equipment, and anesthesia conduct.

Methods: This study was carried out in four hospitals (Wad Medani Teaching Hospital, Wad Medani Maternity Hospital, Gezira Centre for Renal and Urological Surgeries, and the National Centre for Pediatric Surgeries) in Wad Medani, two of which were referral and two were state-run. Each hospital from every category was identified using a convenience sampling technique. The World Health Organization-World Federation of Societies of Anesthesiologists International Standard and earlier regional African publications were used to determine the minimum predicted safe anesthesia needs.

Results: The results of our study demonstrate that overall, the hospitals surveyed fulfilled the minimum standards set by the World Health Organization and the World Federation of Societies of Anesthesiologists (WHO-WFSA) for safe anesthesia practice by 73% with no significant difference in the safety of anesthesia practice between state and referral hospitals.

Conclusions: The state of safe anesthesia care in Wad Medani hospitals surveyed fell well short of the expected minimal criteria due to important requirements such as patient monitoring indicators, the inaccessibility of life-saving facilities such as defibrillators, and difficult intubation instruments. More importantly, the conduct of anesthesia was far below the standard.

Keywords: health care system; health workforce; low-income countries; safe anesthesia practice; war in sudan.