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Managing the pain

Researchers seeking to improve pain management practices in Rwanda.

Queen’s professors Elizabeth VanDenKerkhof and Rosemary Wilson (School of Nursing) as well as David Goldstein (Anesthesiology and Perioperative Medicine) recently travelled to Rwanda to learn more about pain management techniques used in hospitals in Kigali and Butare.

Rosemary Wilson and Elizabeth VanDenKerkhof collect data at University Central Hospital of Kigali.

Their research is part of a larger project headed by Queen’s researchers Joel Parlow (Anesthesiology and Perioperative Medicine) and Ana Johnson (Public Health Sciences), supported by a Canada-Africa Research Exchange Grant from Universities Canada, and the Canadian Anesthesiologists’ Society International Education Foundation.

“Pain care lives with the nurses and they need to own it,” says Dr. Wilson. “We want to help them build their confidence and knowledge and also work with patients’ families to help them understand the nurses play a vital role in pain management. It’s a tough lesson to teach as families look more to the physicians for assistance.”

Dr. VanDenKerkhof says the research in Rwandan hospitals highlighted the importance of education.

“The health-care workers in Rwanda need to be better informed about who does what and that really goes back to educational programs. It’s no different than here really – education and policies are important,” she says.

Gaston Nyirigira explains the study, consent and questionnaire to nursing staff on the general surgery ward at University Central Hospital of Kigali, with Rosemary Wilson looking on.

Drs. VanDenKerkhof, Wilson and Goldstein worked with frontline health-care staff in Rwanda including nurses, nurse anesthetists, surgeons, anesthesiologists and trainees. They also consulted locally to refine and distribute questionnaires designed to better understand pain management practices and what drugs are available to alleviate pain.

Gaston Nyirigira, an anesthesiology resident in Rwanda, explained the study and questionnaire in Kinyarwanda, the local dialect.

“We really appreciated having someone on the ground,” says Dr. VanDenKerkhof. “We don’t speak the local language nor do we have the same appreciation of the culture. Thanks to his efforts, we collected 147 surveys, which is more than we expected.”

Drs. Wilson, VanDenKerkhof and Goldstein are back in Canada to examine the results and devise an education and policy implementation strategy with the assistance of Drs. Parlow and Johnson and the local Rwandan health-care providers. The research team is also welcoming Dr. Nyirigira to Queen’s University in the fall as part of the project. While here Dr. Nyirigira will also develop his research skills so he can conduct other studies upon his return to Rwanda.