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Open Letter from Your Friends in Rwanda for World Anaesthetic Day, 16 October 2019

Dear friend,

I am an anaesthetist in a low resource country. I am so glad you want to come to my country and support me, and my department’s, work. We are both doctors and though some of our struggles are very different we have so much already in common.

We both want to take our patients safely through surgery without pain and develop our skill set to be the best to serve our population. I am delighted you want to work with us to help us achieve this. Before you come there are a few things I would like to share.

Sometimes it is hard for anyone to take advice, however useful or well meant, when we feel we are already trying our best. This may be especially hard when the advice comes from someone we have only known a short time and who may not stay with us for very long. Please consider our department an extension of your own, separated only by geography, and treat us how you would want a visiting colleague to treat your own department.

As with any team and any hospital there will be interpersonal politics and strains in my department. It is hard to change people; please do not think we have not tried. Remember some things are easier said than done as much as we may all want to get along and work together. If you reflect on your own department you will see that even in the best places this is not always possible. Please remember we are all just people.

If we are not so quick to rush and respond to an emergency as you would be at home please remember that we have seen so many emergencies and often not been able to respond as we would like. It is hard to maintain such energy when you know that patient presentation and diagnosis delays often mean that it is already too late when we first meet the patient in theatre. Please remember how hard we have worked for so long.

You have so much value to bring to us, so much knowledge experience and skill to share. I hope we will meet and work together soon.

Your friend,


Anaesthetist, Rwanda.

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