In 1849 John Snow, already the leading anaesthetic practitioner and innovator of his day, made a historic contribution to the epidemiology of infectious disease by his famous study of the distribution of cholera around the area of Broad Street in London. We report on our experience as anaesthetists in a field hospital, dispatched as part of the international rescue effort to Goma, Zaire, to help combat the effects of cholera among the Rwandan refugees.The experience of a medical team dispatched to field hospitals in Goma, Zaire, as part of an international rescue effort to combat the effects of a cholera epidemic among Rwandan refugees illustrates the importance of planning and collaboration. The mission included 5 pediatricians, 4 general practitioners, 2 anesthetists, 2 general surgeons, and 1 orthopedic surgeon. The team's goal was to function as a walk-in clinic for sick and dying refugees and as a regional hospital providing laboratory, x-ray, and surgical facilities. Through a strategy of cooperation with primary care clinics, the team was able to prioritize the treatment of the sickest patients in need of intravenous therapy. Anesthetists had a prominent role in both performing major and central venous cannulations and instructing other physicians in the procedure. Surgery was confined to pregnancy-related procedures and trauma cases. In the 2 weeks of this mission, 1200 patients were treated, most of whom were in severe shock. Where possible, bolus spinal anesthesia was used to minimize the need for postoperative respiratory support. Recommended, in future missions, are baseline electrolyte measurements, a laryngeal mask airway, portable ventilators, and monitoring of end-tidal carbon dioxide.

Infection, bacterial Anaesthetist, activity Anaesthetist, role

priority journal refugee Democratic Republic Congo preoperative evaluation fluid therapy Rwanda Article history of medicine epidemic cholera peroperative care anesthetic equipment human anesthesist emergency health service