Safer surgery and pain-free treatment
Catching up with volunteer anaesthetist Jonty Dean on his latest training placement in Malawi.
Throughout medical school, Dr Jonathan Dean – ‘Jonty’ – knew emergency medicine appealed to him. In fact, he worked as a paramedic before studying to become a doctor.
“As a junior doctor, I was also looking for a specialism that gave the flexibility to travel with my skills,” he says. “Most doctors have clinics and long-term commitments to cover. But anaesthesia is generally about treating the patient in front of you – whether that’s in theatre or intensive care – and responding to what comes up in the moment”.
Teaching and learning
From their UK base, Jonty and his paramedic wife Emma balance a busy life of three months’ work, followed by three months’ travel or volunteering. “It’s our chance to give back, but also learn – I’m always picking up new skills and techniques,” he says.
Skilled anaesthetists like Jonty are vital for our patients’ safety and comfort at every stage of their cleft surgery. They help evaluate patients’ health beforehand, administer anaesthesia safely, respond to any emergencies during the operation and help alleviate pain in recovery.
Jonty’s first placement with Operation Smile in 2023 was a memorable one. As well as ensuring our patients’ safety during cleft surgery at the Queen Elizabeth Central Hospital in Blantyre, he trained staff on new equipment and techniques, treated survivors of a major cyclone and developed a new nurse-led pain relief protocol for patients in the hospital’s burns unit.
No ordinary day at work
It’s the variety that he loves. “It’s a hive of activity – you turn up and get immersed in everything that’s going on,” Jonty explains. “I love the teaching, forming close working relationships with fellow medics and seeing improvements in the service we give to patients.”
At Queen Elizabeth Central, a typical day starts with the morning handover and training, followed by helping with difficult surgical cases and seizing any opportunity to teach more. On recent visits, Jonty has been training clinicians to use an ultrasound scanner to fi nd veins on burns patients – something that’s otherwise extremely difficult when their skin has been extensively burned. It ensures patients get the vital fluids and medication they need to heal.
In Jonty’s experience, junior doctors in Malawi lack the consultant-grade supervision and advice found in UK hospitals. So it’s important to him to give trainees some of the same guidance that he thrived on during his own studies.
“From first meeting everyone and understanding the culture and challenges, to the final meal together celebrating at the end – that’s the joy of teaching,” he says.
The relief of being pain-free
When we caught up with him in May, Jonty was about to finish his third placement in Malawi. This included a surgical education programme in Zomba, further teaching in Blantyre and a rewarding stint at Kamuzu Central Hospital in Lilongwe, training the pain-relief protocol he had successfully introduced in Blantyre.
“It’s distressing for everyone when a child is in extreme pain,” he says, standing outside the ward where he has just supported nurses to administer oral ketamine for the first time. “This work is about removing pain from dressing changes, but also removing the painful psychology that can build up around the procedure. It’s a great sign when the ward is silent. It’s just wonderful.”