FullSoul, SPECT, and Rotary Club of Mukono are Partnering to Provide Medical Kits and Training on Surgical Instrument Sterilization to Nurses and Midwives in Uganda

In Canada, when women labor in hospitals they have trust in the healthcare system to use sterile supplies for safe delivery. In Uganda, chronic underfunding has left many health facilities without adequate medical supplies. Very often, pregnant women arrive at hospitals with their own medical tools and must pay for their own delivery supplies. If they cannot do either, they are turned away. In addition, shortages of consumables means that disposable items often get reused between patients, potentially increasing the spread of dangerous infections. To reduce post-delivery complications and deaths, FullSoul and Sterile Processing Education Charitable Trust (SPECT) are partnering to provide medical kits with reusable surgical instruments and training on proper sterile processing techniques to midwives and nurses.

FullSoul, a Canadian non-profit organization co-founded by Christina Hassan, implemented the Maternal Medical Kit (MMK) program in hospitals in Uganda. The program provides hospitals with toolkits containing artery forceps, scissors, kidney dishes, needle holders, and dissecting forceps that can be sterilized and reused.

With funding provided by a Global Rotary Club Grant, SPECT will provide training and mentoring in sterile processing practices to help ensure instruments provided through the MMK program are safe for reuse between patient procedures. In partnership with the Rotary Club of Mukono, SPECT and FullSoul will provide sterilization equipment, including instrument baskets, dressing drums and autoclaves where needed. The added tools, as well as SPECT training, will equip nurses and midwives with an essential understanding of the importance of sterile processing practices. SPECT’s research has found knowledge of effective sterilization practices motivates healthcare workers and decreases the risks present in the birth environments for mothers and babies.

“FullSoul’s number one priority has always been safe births for mothers, babies and healthcare providers. With the help of SPECT, we will make sure that our tools reach the highest attainable level of sterility so no one is left behind.” says Christina Hassan. “Thanks to Avenue’s Top 40 under 40, we came to know about SPECT and all the great work this Calgary-based organization does around the world. It is always great to meet people doing wonderful things in our global community, but even better when we find those connections at home in Calgary.”

Christina Fast, founder of SPECT, established the organization after visiting hospitals in Sierra Leone and learning that sterilization of surgical tools was absent in the hospitals she visited. Fast is an experienced sterile processing educator who has been teaching healthcare workers since 2011, both in Calgary and internationally. SPECT has worked in 7 countries in Africa, including Guinea, Republic of the Congo, Madagascar, Cameroon, Ethiopia, Tanzania, and Benin. SPECT’s involvement and connection to numerous countries in Africa makes them suited to work together with FullSoul to improve healthcare in Uganda.

For more information on FullSoul please email info@fullsoul.ca. For more information about SPECT please email hello@spectrust.org.

Exciting News from Cambodia!

On February 7th two of our SPECT team members met with Safe Surgery team members at Calmette Hospital in Phnom Penh, Cambodia.  This meeting was ground-breaking for so many reasons, but most importantly, it signals the beginning of SPECT’s expansion into South East Asia. As you can see from the photo, participating members of the Cambodian hospital leadership welcomed us with open arms and are just as excited to get started as we are!

From left to right, Professor Lem Dara - team lead for SS2020 at Calmette; Dr. Koy Vanny - Director of Clinical Department; SambathSochivy Lon - SPECT Research Assistant/Translator; Dr. Olive Fast - Chair of SPECT; Dan Fast - SPECT Program Coordinator; Kith Rathamony - Assist International Country Director.

My Reflections Working with SPECT

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When I started working with SPECT as a research assistant in Tanzania, I was given the opportunity to challenge myself and expand my knowledge into many new areas. Professionally and personally my experience is with environmental issues, as I have my Bachelor of Environmental Studies, so it was interesting for me to learn more about the healthcare sector. Since my time with SPECT I have become increasingly interested in healthcare, particularly because I had such a wonderful learning experience. Over the course of the summer, my primary duties were to help with translating between English and Swahili and assist SPECT facilitators with training activities for both the Fundamentals of Sterile Processing course and the Training of Trainers course.

During our time in Tanzania, SPECT has made a significant impact on the ten hospitals that we worked with in the Mara and Kagera Regions. One nurse told me: “Staff members are happy with the visible results and changes that have been made since the training”.

As I was visiting the hospitals, prior to assisting with training sessions, I observed many sterile processing practices that I learnt were putting staff at risk of causing infections to patients and themselves. A few of the situations and stories I found most interesting, which I’d like to share with you are as follows:

  • Often, staff would store food and sometimes take tea in the sterilization room. Most rooms were not well organized since sterilization staff did not have the training to know that poor organization increased the risk of infection. I also found sterilization staff did not realize how important their positions were in the hospital.

  • Big brushes that would be used to clean floors, walls or clothes were used to clean instruments.

  • Clothes used to wrap instruments had lint and holes in them. The lint would stick on the instruments during sterilization and the holes allowed microbes to contaminate the sterilized instruments before use. Gauze was also used to tie wrappers, increasing the potential of contaminating the instruments.

  • Instruments looked clean on the outside but had rust on the box locks and serrations. There were also many instruments that were not functioning. 

  • There was no one way flow of instruments, increasing risk of cross contamination and infection.

  • The sterilizer chambers and the rooms (walls and floors) were seldom cleaned.

After assisting SPECT with their sterile processing training, I visited the hospitals again for follow up assessments. I was impressed by the changes that had been made by staff.  One nurse told me “Instruments appeared clean, shiny and attractive compared to the previous; even the doctors and other staff members are impressed”. Other changes that I’m pleased to share include:

  • Some hospitals had stopped using Chlorine to wash instruments and were using just water and soap and had also trained other staff working in the operating theater.

  • Sterilization staff were using smaller brushes (like toothbrushes) to wash instruments and big brushes were now used to wash clothes, walls and floors.

  • Instrument packages were neatly tied for sterilization and storage.

  • Sterilization staff were now following processes learned in SPECT training, cleaning decontaminating, sterilizing and storing instruments in an organized fashion.

 
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During my time with SPECT, I was able to witness significant changes this training program had on hospital staff. Firstly, the training reminded staff that their jobs are important. The course emphasized the importance of sterile processing and this helped to communicate the importance of the staff’s role in this process. Secondly, it renewed their sense of fulfillment in their positions. I noticed staff worked hard to initiate these changes during our follow up assessments and were proud of what they accomplished. Lastly, I was able to recognize a shift in mindset focused on keeping patients and staff safe. It was apparent that hospital staff looked favorably on their training and were ready and willing to make changes to positively impact the safety of patients, themselves and other staff members.

Theresia Maduka, SPECT Research Assistant

Lifebox and the Sterile Processing Education Charitable Trust (SPECT) Launch Partnership to Improve Surgical Instrument Sterilization Globally

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Calgary/New York/London, November 29, 2018 – This week, Lifebox and Sterile Processing Education Charitable Trust (SPECT) launched a partnership to improve surgical safety in low-resource countries through training in appropriate cleaning and maintenance of surgical instruments. Lifebox, the international non-profit dedicated to improving the safety of surgery and anesthesia around the world and SPECT, the Canadian-based non-profit established to improve instrument decontamination and sterilization processes in resource-constrained countries, are piloting the training course in Ethiopia and Central America.

Founded in 2011 by four leading global health organizations and chaired by Dr. Atul Gawande, Lifebox utilizes tools, training, and partnerships to help improve the delivery of safe surgery and anesthesia globally. Lifebox developed “Clean Cut” -- a team-based approach for reducing surgical site infections -- with the support of the GE Foundation and Assist International through the Safe Surgery 2020 initiative in Ethiopia. The Clean Cut program in Ethiopia has seen significant results, including a 78 percent improvement in the confirmation of sterile instruments and a 35 percent improvement in proper timing of prophylactic antibiotic administration -- both known measures for reducing surgical site infections.

Founded in 2013, SPECT is a charitable organization that provides education, training, and mentoring on instrument decontamination and sterilization techniques for health care workers in hospitals and clinics in resource constrained countries. With the support of the GE Foundation and Assist International, SPECT, to date, has trained over 530 individuals in 8 countries, including 110 individuals in Ethiopia, with an aim to decrease the risks of unsafe surgery and bring sterile processing practices closer to international standards worldwide.

“Lifebox and SPECT are natural partners,” stated Dr. Thomas Weiser, surgeon and Lifebox clinical advisor. “We met in Ethiopia working side by side with operating room teams to address the causes of deadly surgical infections through practical techniques and effective teamwork. By working together, we enhance our capacity to improve the outcomes of life-saving surgery around the world.”

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Lifebox and SPECT are currently piloting a joint training module in Ethiopia that combines the two organizations’ expertise in sterile processing, instrument maintenance, and surgical teamwork. With support from the IZUMI Foundation, the SPECT-Lifebox training module will next be implemented in Central America in partnership with the regional anesthesia society group Federación de Sociedades de Anestesiología de Centroamérica y Caribe (FESACAC).

"SPECT is thrilled to be partnering with Lifebox to expand our combined global impact and increase surgical safety in resource constrained countries,” said SPECT’s Chair Dr. Olive Fast. “Together we can make a bigger impact.”

For more information contact: Marco Carraro (Communications Officer) -marco.carraro@lifebox.org, phone (+ 44 (0)203 286 0402)

Our work on instrument sterilization processing has been contributed to by -- Mr Mahmood Bhutta,Tom Brophy, Lauren Anders Brown, Christina Fast, Mr Ed Fitzgerald, Jared Forrester M.D. , Nichole Starr M.D. , Tom Weiser M.D. , Dr Iain Wilson.

First Avenue’s Top 40 Under 40, Now WISE’s 50 Over 50

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You may recall Christina Fast’s nomination for Avenue Magazine’s 2017 Top 40 Under 40 last fall. Based on her work with SPECT and dedication to the sterile processing field, this time last year we were celebrating Christina’s ground-breaking work as our fearless founder, educator, and consultant.

Well, with a new year comes new achievements and SPECT has once again been nominated for another distinguishing award in our Canadian community. The WISE 2018 50 Over 50 Award highlights seniors in business - specifically senior entrepreneurs – and acknowledges the unique struggles seniors face in today’s business market.

Originally, Dan Fast was nominated for this award, but after hearing SPECT’s story, we are pleased to announce that our whole team will be receiving this very celebrated award. Not only are we honoured to be recognized for the work of our entire team, but we are immensely grateful for the assistance this award will provide moving forward. We see the WISE 50 Over 50 Award being monumental in promoting our work to a completely new demographic, but in addition, we are excited to benefit from the business consulting that WISE grants to all recipients.

As a non-governmental organization focused on truly making a difference, it can sometimes be difficult to navigate the business landscape required to make our operations successful. Because of this we are immensely grateful for the opportunity to develop our business skills and receive guidance moving forward as an organization. To read more about our nomination and WISE, please visit https://www.50over50awards.ca/project/dan-fast-sterile-processing-education-charitable-trust-spect/#

Renata Mrema                                                                                                                         SPECT Volunteer       

Education and Empowerment

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To me, this picture expresses a perfect moment. It was the moment when this nurse realized he can clean his instruments to a higher standard, and against all odds, it is possible.

So often, we forget that knowledge is power. If we’re always taught to follow blindly with what we’re told, and not encouraged to think outside the box, why would we ever change the way we’ve always done things? I’m sure all of us can relate this this. We’ve all had that job where we were basically told to just do what we’re told.

During my management studies, the term ‘growth-mindset’ came up again and again in discussion. The term describes an optimistic and encouraging way of thinking that encourages the development of basic skills and knowledge through hard work, dedication, and the belief that growth is possible. Quite simply, if you think you can do something, you are far more likely to take steps to succeed.  Whereas, if you (or someone else) tells you that you can’t do something, then you’re far less likely to achieve those very same goals. Think back to when you were faced with a difficult task. Sitting in the corner and complaining about the situation probably did you little good. But taking a deep breath, telling yourself you can handle this, and planning a course of action to tackle the situation probably turned out quite well! Perhaps even, at the end of the day, the task may have ended up being far less daunting than you originally thought. In my personal experience, a growth-mindset is not only empowering – it works!

This week, I assisted SPECT with delivering Sterile Processing Fundamentals Training in Bukoba. Thirty-eight nurses from across the Kagera region of Tanzania attended the five-day training course that was grounded in theory, supplemented with demonstrations and in-class activities. As someone who isn’t educated in the health care industry, my role was to support the educators by completing daily administrative and financial tasks, while assisting with the general organization and coordination of the event. Working behind the scenes allowed me the perfect opportunity to really observe the course, educators, and participants in a truly authentic and unedited manner.

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This brings me to this perfect moment. It’s rare to witness the exact moment someone feels empowered. The moment their perspective changes and you can see their entire outlook transform. I suppose educators often witness these moments, but this was the first time I was fortunate enough to observe such a perfect moment in real life.

Christina had just completed a demonstration on proper cleaning techniques when Cletus volunteered to replicate the demonstration. After explaining the set up, he grabbed a needle holder from the surgical set (pictured on the left) and began cleaning it. It’s certainly worthy to note that this particular surgical set came directly from a local hospital’s sterilization department and had already been cleaned, sterilized, and approved for surgical use. Quickly, Cletus set to work following a newly introduced 3-step cleaning process, complete with proper tools and techniques. Every swipe of his brush removed more and more debris, and little by little the instrument began to shine like new. As the enthusiasm in the room grew, he completed his 3-step process and proudly held up the finished product (as pictured on the right). Sitting silently away from the crowd, it was easy to see the light in Cletus’ eyes grow and the smile escape from deep in his soul. He took an instrument that he’d used so many times before and improved it to a standard he had never considered possible three days ago. As the rest of the participants cheered, his smile grew, his pride in his work grew, and undoubtedly, his confidence in his professional abilities grew.

As a strong advocate for education in all its many different forms, I’ll leave you with this quote from a man that is wiser than I could ever hope to be.

“Education is the most powerful weapon which you can use to change the world” – Nelson Mandela

Renata Mrema                                                                                                                             SPECT Volunteer                                                                                                                             

Achieving Good Health and Well-Being Together

When I first approached SPECT with my interest in volunteering in Tanzania, I never could have imagined just how much I would learn during such a short period of time and the extent to which my experiences on the ground would not only inspire me to remain involved in the organization but also make me feel proud of the tasks I was able to help with, no matter how small they felt at the time.  

For those who don’t know me, my name is Renata Mrema and my professional skills certainly aren’t based in the health care field. I’ve lived many lives, flipping between industrial operations, to the corporate world, and finally resuming my role later in life as a management student. Through my studies and life experiences I’ve found my passion in environmental, social, and cultural sustainability, with a focus specifically on tourism.

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Through my university studies I was introduced to the United Nations Sustainable Development Goals (SDG) and undertook a seminar to promote these goals as a SDG ambassador. While I think we can all agree there are many global challenges that numerous organizations are working tirelessly towards finding solutions for, the complexity and gravity of these challenges can be overwhelming to say the least. The SDG’s aim is “to set of goals to end poverty, protect the planet and ensure prosperity for all” – a end goal I’m sure we can all get behind (https://www.un.org/sustainabledevelopment/sustainable-development-goals/). One tactic that the SDG team encourages is for the public to select a goal that resonates with them, and to take steps, no matter how small, to help achieve that goal. In the past, I’ve always selected goal #13: Climate Action because I felt that I can wholeheartedly take steps towards achieving this goal in my personal life and I felt confident in my abilities to make a difference with this goal. As someone who is not educated in the fields of infrastructure, education, health care, or engineering I felt I was unequipped to contribute towards any of the skills-based goals and that they were simply out of my reach. It wasn’t until after my time volunteering with SPECT that I realized I can take steps to help with other goals too.

During SPECT’s Training of Trainers (ToT) course and regional hospital tours in the Mara Region I realized that SPECT is very much aligned with the SDG’s and fighting tooth and nail on a daily basis for goal #3: Good Health and Well-Being. As a long-time follower of SPECT’s work, what I failed to recognize is just how crucial the organizations work is to the sustainable development of not just specific countries, but to everyone globally. Their work affects everyone – people of all ages, all genders, and all socioeconomic backgrounds.

I’d like to share two of the UN Good Health and Well-Being targets with you and I’m sure you’ll see the obvious alignment between SPECT’s mission and what the UN SDG’s are trying to achieve:

  • Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States
  • Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks

For more information on this goal, I urge you to explore the UN Sustainable Development Goals website as listed here: https://www.un.org/sustainabledevelopment/health/.

I realize that by volunteering with SPECT I have only contributed a small fraction to the overall SPECT story, but for myself, this experience has had a profound effect that I believe I am just beginning to grasp. It has opened my eyes to the impact team work can have and that there is really a role in this organization for everyone. While I may feel that I cannot contribute much beyond organizational and administrative duties, knowing I can take this task off the shoulders of those who are more equipped to directly impact the health care of a community is a worthwhile cause that I cannot downplay. We all have unique strengths and abilities, and when we work together we can make improvements in leaps and bounds in areas we couldn’t have imagined possible on our own. Volunteering with SPECT has truly made me believe that with hard work, dedication, and team work, no goal should ever be seen as off limits or unachievable.

Renata Mrema                                                                                                                              SPECT Volunteer

Follow-up in Cameroon after MercyShips/SPECT Training

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In October 2017, Mercy Ships & SPECT provided a Sterile Processing course for 20 healthcare workers from 5 hospitals in Douala.

The subjects covered during this 5-day course included Microbiology, Infection Prevention, Cleaning, Disinfection, Surgical Instrumentation, Sterilization, Sterile Storage and Safe Transport.

After the course, we held a 2-day Training of Trainers (ToT) program for 10 participants who demonstrated leadership skills, had positive attitudes and excelled on their pre-and post-tests. Throughout the ToT course, participants were given an opportunity to build on their educator skills by working in small groups to teach competencies and receive constructive feedback from their peers.

Two weeks ago, roughly four months since the training, I returned to Douala to offer further mentoring and support, as well as to follow-up on goals that had been set by the ToT’s to advance their hospitals instrument reprocessing methods.

The improvements that had made within such a short amount of time were truly astounding.  

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One hospital jumped right into action and within a matter of days following the training they had made some major improvements to their decontamination and sterilization areas; including installing A/C units to keep the temperature low, which will help prevent microorganisms from rapidly growing. They had a stainless steel 3-sink set up built so that they can properly clean their surgical instruments and created labels/signage throughout the department so that all staff who enter are aware of the one-way flow from dirty to clean and understand the importance of protecting themselves and the items around them. They also had new doors installed to help control unauthorized staff from walking in and out of the department which will reduce the risk of cross-contamination.

Some of the hospital staff who were not in attendance of the training informed me that they’ve seen a noticeable difference in the cleanliness of surgical instruments. But what was more noticeable to them was the positive change in attitude and quality of work coming from the sterile processing staff. 

Another hospital completely removed Javel (bleach) from their instrument reprocessing practices (which causes instruments to rust, stain, break etc.) and has now replaced it with a safer, more superior product, that has been available to them for a while, but they didn’t understand its purpose until the training. Now, staff understand that if instruments aren’t cleaned well first, then sterilization won’t be effective. They commented that the training they’ve received has given them full confidence in knowledge and makes them feel good knowing that when they’re teaching students and other trainees, they’re now assured that they’re teaching the best and safest practices.

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At this hospital alone, they’ve already provided training for 32 staff members on the new methods they’ve learned. They also collaborated with Suzanne Veltjens, a volunteer nurse with Mercy Ships, to create a manual of procedural write-ups for 11 of their instruments sets, which will help maintain quality and reduce the risk of instruments going missing.

During my last day of follow-up I had an opportunity to see some direct results of the training in action. I was invited by the general secretary to attend a quarterly meeting for all head nurses from each department. During this meeting, I stood in the back and observed while three ToT’s from our course presented on the proper steps of cleaning surgical instruments. It was one of my proudest moments, to see these individuals who only four months ago were hesitant to embrace these new concepts, to now, where they were the ones teaching their colleagues with confidence and flawlessly answering the same questions that they had asked not long ago. It was a moment that myself and many others working in Medical Capacity Building rarely get to witness. A moment of true affirmation that the knowledge we’re imparting through education and training is being well comprehended and passed on to others in the hospital, leading to ultimate change and support of safe surgery in Cameroon.

Christina Fast                                                                                                                              SPECT Founder 

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The 2017 SPECT Perspective

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3 countries, 62 Healthcare Centers, 140 Staff Trained


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New Partner: Assist International

Under the GE Foundation Safe Surgery 2020 Initiative, Assist International awarded SPECT with a sub-contract to work with 12 hospitals in Ethiopia.

What's New in 2017

Top 40 Under 40

Our founder, Christina Fast, was honoured to be selected as part of Avenue magazine's Top 40 Under 40 Class of 2017. 

Read More Here

First Publication

Now available in the British Medical Journal, Global Health: An analysis on limited sterile processing capabilities in the Republic of Congo, Madagascar and Benin.


2017 Timeline

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SPECT receives a sub-contract from Assist International

In 2017 SPECT partnered with Assist International to provide education and training in surgical instrument processing to employees from 12 hospitals in Ethiopia as part of the Safe Surgery 2020 (SS2020) Initiative funded by GE Foundation. 

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Throughout this sub-contract we have provided education and training to 24 hospitals in Ethiopia, resulting in over 200 healthcare workers who have increased their skills in effectively cleaning and sterilizing surgical instruments to support safe surgery. 

SPECT Volunteer Michelle Webb

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"My time with SPECT was one full of learning, growth and hands on experience. It brought me great joy to witness hands-on sustainable change while seeing such positive engagement and collaboration between the SPECT team and the participants. It was a privilege to journey alongside the participants as they implemented their new skills and engaged in action plans in their own communities and hospital environments. Their excitement to share was tangible. Through my time with SPECT it was evident they are a passion- filled, motivated team that has a desire for safer surgeries and improved patient outcomes in every country that they collaborate with. SPECT is truly remarkable!"

Michelle Webb RN

SPECT Volunteer Benin/Ethiopia 2017