Timelines and Development
January - SPECT's program coordinator went to Madagascar to obtain feedback on the impact of the sterilizer packages and to conduct advance preparations for a Canadian TV film crew arriving at the end of January.
Jan/Feb - SPECT's educator and a TV film crew from Global TV in Calgary, Alberta travelled to Madagascar to conduct interviews and shoot footage in hospitals and clinics where SPECT has been working.
February - SPECT-US was officially established.
May - SPECT-US was granted charitable status.
Between Feb-April, SPECT's educator spent 12 weeks in Madagascar teaching a comprehensive sterile processing course to technicians employed at the main hospital in the port city of Tamatave where the Mercy Ship was based. SPECT's program coordinator also travelled to Madagascar during this time for 5 weeks to offer support in training and to develop the sterilizer innovative idea.
Aug/Sept - the program coordinator returned to Madagascar to assess the sterile processing practices at 11 hospitals and 12 clinics around the capital city of Antananarivo and to assist in preparing for an upcoming training course. Sterilizing equipment at 15 hospitals and clinics were tested with chemical and biological indicators. An agreement was reached with a local manufacturer to oversee development of 30 stainless steel instrument baskets.
Sept/Oct - two SPECT educators put on a 3-day sterile processing course for 39 staff from 11 hospitals in Antananarivo. Following the course, the educators visited staff members at their workplace to provide further one-on-one mentoring. The educators also put on a workshop in Madagascar's 3rd largest city, Antsirabe, training 20 doctors who work in rural clinics in this region.
Dec - SPECT distributed 27 sterilizer packages to clinics and one dental hospital in Madagascar. The clinics were selected based on number of procedures, staff receptivity to a change in practice, and lack of electricity.
March - a SPECT educator returned to the ROC to conduct sterile processing training for 37 staff from the 5 hospitals previously visited.
April - SPECT was awarded a Grand Challenges Grant of $Can 112,000 administered by Mercy Ships Canada.
Christina returned to this same hospital in Guinea early in 2013 and was delighted to discover that the department "looked just like I left it 6 months earlier". Realizing that the staff had taken her seriously and had followed her instructions inspired Christina with the idea that providing education, even when staff were told there was no money for supplies and equipment, was something she could share with people who were willing and enthusiastic to learn. It was also here that SPECT's innovative idea for decreasing the risk of surgical site infections began. A local clinic was being established to do minor surgeries, however they had no way of sterilizing their instruments. Christina, together with an anaesthetist on the Mercy Ship, used a pressure cooker with a kitchen colander inserted to hold instruments above the water. They were interested in seeing if high enough temperatures could be reached to adequately steam sterilize instruments. Their test results proved this simple method of sterilization could work and they introduced this method at the clinic.
July - SPECT (Canada) was registered as a legal entity in Canada.
Soon after SPECT (Canada), along with Mercy Ships Canada, SEChange International and AMREF Canada applied for a Grand Challenges Grant. The proposal involved educating medical staff in developing countries on the basics of sterile processing and to trial an "innovative idea" of using pressure cookers, a specially designed surgical instrument basket, and a non-electric heating source to sterilize instruments in local settings.
August - SPECT (Canada) was granted charitable status.
Sept/Oct 2013 - a SPECT team joined the Mercy Ship in The Republic of Congo (ROC) and spent 6 weeks assessing the sterile processing practices at 5 hospitals in the port city of Pointe Noire.
In the fall of 2012, Christina Fast re-joined the Africa Mercy Ship in Conakry, Guinea with an even greater determination to make a difference, although still without a clear definition of "how". She decided to start by taking a team of volunteers from the ship to the local hospital where they were joined by the staff. With the use of bleach and hard bristle brushes the sterilization areas were cleaned from top to bottom - something that had not been done anywhere near as thoroughly since the hospital was built 20 years previously. Before leaving the hospital, staff asked Christina what else they could do to improve things. She left them with 4 simple instructions - keep the surgical instruments off the floor, wipe down the counters at the end of every day, safely dispose of sharps, and take out the garbage daily.