The video shows the special needs young people attending to the crops in Fatima Mission. African Mission paid for the irrigation system and thanks to this and to the hard work of the young people there has been an excellent crop of onions, tomatoes, garlic, chomolia, cabbage and sugar beans. Farming skills are an important asset in such a rural setting and the vegetables grown help provide the young people with a healthy diet.
The following video shows six of the young people staying at Fatima Mission playing an instrument called a Marimba. Three things to note: (1) most of these young people are blind, (2) this video was filmed after the young people had been given ONE DAY’S instruction on how to play this instrument and (3) the building in which they are playing was paid for by African Mission donors.
To see the video please click HERE
Dr Towey was interviewed about his work in Africa by Dr.Mike Dobson for his podcast series ‘Anaesthesia Compass’.
The resultant three podcasts can be found on Spotify, or wherever you get your podcasts:
- Podcast one – ‘Intensive Care in rural Africa’ (1 of 2)
- Podcast two – ‘Intensive Care in rural Africa’ (2 of 2)
- Podcast three – ‘Tetanus’
International research that Dr Towey has contributed to:
Essential Emergency and Critical Care – a consensus among global clinical experts (March 2021)
Globally, critical illness results in millions of deaths every year. Although many of these deaths are potentially preventable, the basic, life-saving care of critically ill patients can be overlooked in health systems. Essential and Emergency Care (EECC) has been devised as the care that should be provided to all critically ill patients in all hospitals in the world. This study aimed to specify the content of EECC and additionally, given the surge of critical illness in the ongoing pandemic, the essential diagnosis-specific care for critically ill patients with COVID-19.
Intensive care management of snake bites (July 2020)
Intensive care medicine in rural sub-Saharan Africa (Jan 2017)
Intensive care management of snakebite victims in rural sub-Saharan Africa: An experience from Uganda
Background. Antivenom is rarely available for the management of snakebites in rural sub-Saharan Africa(sSA).
Objective. To report clinical management and outcomes of 174 snakebite victims treated with basic intensive-care interventions in a rural sSA hospital.
Methods. This cohort study was designed as a retrospective analysis of a database of patients admitted to the intensive care unit (ICU) of St. Mary’s Hospital Lacor in Gulu, Uganda (January 2006 – November 2017). No exclusion criteria were applied. Results. Of the 174 patients admitted to the ICU for snakebite envenomation, 60 (36.5%) developed respiratory failure requiring mechanical ventilation (16.7% mortality).
Results. suggest that neurotoxic envenomation was likely the most common cause of respiratory failure among patients requiring mechanical ventilation. Antivenom (at probably inadequate doses) was administered to 22 of the 174 patients (12.6%). The median (and associated interquartile range) length of ICU stay was 3 (2 – 5) days, with an overall mortality rate of 8%. Of the total number of patients, 67 (38.5%) were younger than 18 years.
Conclusion. Results suggest that basic intensive care, including mechanical ventilation, is a feasible management option for snakebite victims presenting with respiratory failure in a rural SA hospital, resulting in a low mortality rate, even without adequate antivenom being available. International strategies which include preventive measures as well as the strengthening of context-adapted treatment of critically ill patients at different levels of referral pathways, in order to reduce deaths and disability associated with snakebites in sSA are needed. Provision of efficient antivenoms should be integrated in clinical care of snakebite victims in peripheral healthcare facilities. Snakebite management protocols and preventive measures need to consider specific requirements of children.
H-J Lang, St. Mary’s Hospital Lacor, Gulu, Uganda
J Amito, St. Mary’s Hospital Lacor, Gulu, Uganda
M Duenser, Department of Anaesthesiology and Intensive Care Medicine, Kepler University Hospital and Johannes Kepler University, Linz, Austria
Raymond Towey, St. Mary’s Hospital Lacor, Gulu, Uganda
Full Text available by clicking HERE
Cite this article
Date published: 2020-07-30
Dear African Mission supporter,
first of all I would like to thank you for all of the the support you have given to our work to date.
We are all living with the impact of Covid 19 and the huge upheaval it is causing to our lives. As I write the death rate caused by the virus stands at 18,500 (ONS figures in the week up to the 10th April) here in the UK. The pandemic has yet to fully impact on Africa but when it does the numbers of death are expected to be very high. We have a short window of opportunity where we can provide some vital equipment to St Mary’s Hospital in Uganda that will help in the fight against this deadly disease.
Please click HERE to see an appeal from Dr Ray Towey, who has worked in St Mary’s Hospital since 2002. Any help that you can give at this time would be very much appreciated and could well be literally life saving.
The quickest way to give is online at https://cafdonate.
Thank you for considering this request.
African Mission Administrator
Download the Christmas 2018 newsletter (pdf)
The young people in the video below are those who are receiving an education at Fatima Mission. Of the 21 young people residing at Fatima, 10 are deaf & unable to speak, 7 are totally blind, 3 are partially sighted (one of whom who is also partially deaf) and 1 is physically handicapped.
Before coming to Fatima many of these young people led very isolated lives and were faced with a bleak future. Thanks to the education they are receiving and the fact that they are living in community with others, their confidence and ability to relate with others is growing as you are about to see …
Intensive care medicine in rural sub-Saharan Africa
M. W. Deunser1,2 R. M. Towey3 J. Amito4 and M. Mer2,5
1 Senior Consultant in Intensive Care, Department of Anesthesiology, Peri-operative Medicine and General Intensive Care Medicine, Salzburg University Hospital and Paracelsus Private Medical University, Salzburg, Austria
2 Global Intensive Care Working Group, European Society of Intensive Care Medicine, Brussels, Belgium
3 Consultant, 4 Anaesthetic Officer, Department of Anaesthetics and Intensive Care, St. Mary’s Hospital Lacor, Gulu, Uganda
5 Consultant in Intensive Care, Intensive Care Unit, Charlotte Maxeke Johannesburg Academic Hospital and University of the Witwatersrand, Johannesburg, South Africa
We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was
highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2.0%). Intensive care unit admission following surgery (333/1431; 23.3%), medical conditions (327/1431; 22.9%) and traumatic brain injury (233/1431; 16.3%) caused the highest number of deaths. Of all deaths in the hospital, (1431/11,357; 12.6%) occurred in the intensive care unit. Although the proportion of hospitalised patients admitted to the intensive care unit increased over time, from 0.7% in 2005/6 to 2.8% in 2013/4 (p < 0.001), overall hospital mortality decreased (2005/6, 4.8%; 2013/14, 4.0%; p < 0.001). The proportion of intensive care patients whose lungs were mechanically ventilated was 18.7% (961/5147). This subgroup of patients did not change over time (2006, 16%; 2015, 18.4%; p = 0.12), but their mortality decreased (2006, 59.5%; 2015, 44.3%; p < 0.001).
This study is the first to offer a comprehensive insight into the epidemiology and outcome of critical illness in a rural sub-Saharan African setting. As the ICU is the only facility in the study hospital where critically ill patients are cared for, and because the study hospital is the only inpatient facility in the region, our study population is likely to represent the true spectrum of critical illness for a large rural sub-Saharan African region. Furthermore, the virtual absence of financial barriers preventing patients from entering the ICU, which may be the case in other ICUs in low-income countries [1, 2], eliminates an important selection bias from this study.
In conclusion, our study gives a comprehensive overview of the epidemiology and outcome of critical illness in a large sub-Saharan African ICU population. It represents the first and largest study from a rural ICU in sub-Saharan Africa, and serves as an important reference for a region where there is an paucity of data, offering a greater understanding of the practice of intensive care in such areas. Although only hypothesis-generating, these results support the role of intensive care medicine as a life-saving medical specialty, even under difficult conditions and with limited resources, as well as the need to foster and grow such services in these regions.