Healthy lungs for life events

Building spirometry in Kilimanjaro

Following on from the Pan African Thoracic Society (PATS) spirometry training which took place last year, 2018, at Kibong’oto Infectious Diseases Hospital (KIDH) in Kilmanjaro, Tanzania we were able to use our newly achieved spirometry skills to host our first Healthy Lungs for Life event in the country.

On Saturday 29 June 2019, the European Lung Foundation (ELF) with the Pan African Thoracic Society (PATS), with Kibong’oto Infectious Diseases Hospital (KIDH) (national referral hospital for tuberculosis and other lung diseases) under the leadership of Dr Stellah Mpagama, Siha District Hospital (SDH), under the leadership of Dr Abdul Msuya, and Kilimanjaro Christian Medical Centre (KCMC), represented by Dr Ronald Mbwasi came together to offer free spirometry testing to the community. The event was advertised in the community by flyers at the market, word of mouth and by two radio announcements.

The Siha District Commissioner, the Honorable Mr. Onesmo Buswelu, was present to bless the event. Each organisation involved was able to share their vision and current work on improving lung health in Tanzania. In the spirit of the event the Hon. Buswelu went on to have his own lungs tested.

Following careful screening of more than 150 people, 96 participants underwent spirometry testing. Simultaneously, Body Mass Index (BMI) and Blood pressure (BP) were checked and Tuberculosis (TB) and HIV testing. From the screening tool used, 1 case of severe uncontrolled hypertension was dealt with using the onsite emergency kit and 2 further participants were referred to KIDH for further TB evaluation. All abnormal cases were counselled, given their results and referred to KIDH for further assessment.

It was a beautiful day in a field in the Siha district of Kilimanjaro, Tanzania where the PATS goal of awareness and improvement of lung health has been raised and assistance provided to those who need it the most.

Thank you to every one of the 25 volunteers who willingly came to give of their time and expertise to make this event possible. An extra special thanks to Dr Stellah Mpagama who works tirelessly to improve lung health in Tanzania. Looking forward to the next time!

Lindsay Zurba
30 June 2019

Spirometry kicked off at the 5^th KISLHC in Nairobi with a very well attended 1-day spirometry workshop. Two local Kenyan spirometry experts, Dr Sammy Gitonga and Dr Salim Masoud together with myself facilitated a successful workshop for 45 participants on 25^th June 2019.

The workshop was the precursor to a jointly facilitated European Lung Foundation (ELF), Pan African Thoracic Society (PATS) and Kenyan Association for TB and other Lung Diseases (KAPTLD) Healthy Lungs for Life event on the 26^th and 27^th June 2019 at the Nairobi Hospital and Conference Centre. Our aim was to provide free lung function testing for at least 100 members of the local community over 2 days. With posters banners and leaflets in and around the hospital to tell people about the event we had no shortage of people coming who were queuing up to know about how their lungs were functioning. 114 hospital staff and conference delegates were tested and counselled on their results.

The event was extremely well received and enjoyed by all. Very special thanks to the Pan African Thoracic Society and the European Lung Foundation for their sponsorship of the event and to Prof Chakaya and his wonderful teams from KAPTLD and the KISLHC for working with us to promote lung health and awareness and their efforts to make this the exciting and well run event that it was.

Durban, South Africa has seen a plethora of respiratory health focused meetings take place this April.

The joint congress between the Pan African Thoracic Society (PATS) and the South African Thoracic Society entitled “siza iAfrika iPhefumule: Help Africa Breathe” took place from the 12^th – 15^th April. This was an exciting event for PATS that brought together health professionals from many African countries to address the challenges for child and adult lung health on the continent. Respiratory disease is a major cause of death, disability and morbidity in Africa, where there is a double burden of infectious diseases including pneumonia or tuberculosis and non-communicable diseases such as asthma and chronic obstructive pulmonary disease. The congress offered the opportunity to critically discuss these challenges and to work together to strengthen initiatives to improve care, build capacity, strengthen research, training and advocacy for better lung health in Africa.

Immediately following the PATS / SATS congress 11 African countries were represented by 14 partners at the The International Multidisciplinary Programme to Address Lung Health and TB in Africa “IMPALA” meeting also in Durban 15^th – 20^th April. This four-year collaborative programme funded by the UK National Institute for Health Research has established an Africa-focused NIHR Global Health Research Unit on Lung Health and Tuberculosis (TB) at the Liverpool School of Tropical Medicine (LSTM) that will generate new scientific knowledge and implementable solutions for these high burden, under-funded and under-researched health problems.

These events have presented the perfect focus for lung health advocacy in our communities alongside these events. We are delighted to report 7 Health Lungs for Life free spirometry testing events over the 10 days in and around the communities of Durban which were funded and supported by the PATS Spirometry program.

Each of the 7 Healthy lungs for life events included free spirometry testing for the general public. Events were held in various venues in and around Durban including the hotels in which congress delegates were staying as well as outside pharmacies and in shopping centres around the city. Our technician team of 4 tested 313 people in 7 days, at the same time adding data to the Paediatric and Adult Spirometry (PAAS) Study which is collecting  lung function data in  healthy South Africans to generate much needed local reference values.

Another positive outcome of the Durban meetings was that 10 IMPALA partners from Benin, Cameroon, Ethiopia, Ghana, Kenya, Nigeria, South Africa, Sudan, Tanzania and Uganda were presented with ERS / ELF donated spirometry equipment to take back with them for use in their research clinics. Lindsay Zurba of Spirometry Training Services Africa said “This equipment is essential to diagnose asthma, chronic obstructive pulmonary disease (COPD) and other conditions that affect breathing. The loaning of this equipment by PATS and LSTM to these in-country partners will have a hugely positive impact on their research objectives, and the treatment received by those that visit their clinics”

One of the specific aims of PATS is the promotion of education and training initiatives to strengthen respiratory health across Africa. In line with this, the Durban respiratory week saw the launch of the PATS / IMPALA international standard foundational spirometry training programme available for all Africans working in any setting. The first courses were piloted in Uganda and Ethiopia in 2017

The spirometry training takes a minimum of 2 months to complete and has 3 stages which include:  online self-study, three days of face-to-face training and a portfolio of evidence workbook. The training materials are available for free online at http://panafricanthoracic.org/training/spirometry-training/spirometry-training-manual

Africa is a continent of challenges. It is also a continent of positive change. There are yet many rivers to cross, but we are making progress together. Thank you to each and every person and organisation who has worked together to create change. We are seeing it now unfold before our eyes. Respiratory health and advocacy is on the rise in Africa!

Africa – Part of a Global Team

World Spirometry Day (WSD) is an awareness campaign that offers people the chance to test their lung health. Health professionals around the world organise lung function testing events for the general public, known as spirometry events. During the first WSD, on 14 October 2010, a total of 102487 lung function tests were performed globally with only 12 tests carried out in all of Africa.

The idea

With the 2012 World Spirometry Day (WSD) campaign coinciding with the Olympic Game and the aim being to encourage people to exercise and look after their lungs regardless of their age or physical ability, what better time and place to stand up on behalf of Africa and get involved but from the expo of the Comrades Marathon. The biggest and best ultra-marathon in the world where 18,000 runners ran 89 kms from Pietermaritzburg to Durban on 3 June.

Getting started

On finding one major sponsor for the initiative an impassioned plea for voluntary assistance from like-minded medical professionals working the field of spirometry was sent out via chat lines, word of mouth and the via grapevine.

The response from medical professionals and companies involved in respiratory healthcare from all over the country and neighbouring African countries was immediate and overwhelming. Suppliers, technicians, operators and individuals rallied forming a committed and professional team from the outset.

Planning

The weeks and last days leading up to the event were frenetic. 32 Spirometers, syringes and accessory equipment had to be sourced and verified through serial numbers, model and make. All equipment had to be signed off by the suppliers as calibrated and in good working order. Transportation arrangements, accommodation and meals planned and organized for all involved from outside Durban – without a budget. Each professional involved needed to provide all personal details as well as proof of qualifications and current registration. Disposables were estimated and sourced on a very limited budget. Again, all companies represented came through with donations of filters, mouthpieces, and hand wash. Plans for training commenced – venues, manuals, refreshments, equipment and disposables for practicing. Medical forms for screening clients and operational plans were created. Guinness World Record pre-planning documentation was completed and plans made for the setting of the record. Tens of tables were drawn up listing and organising each and every facet of the training, testing and for a successful Guinness Record attempt.

World Spirometry Day Training

In order to ensure that the highest standards of excellence would be evident in every area of the initiative a Certificate of Competence in Spirometry Training commenced in the days leading up to the event in which 40 of the 60 involved professionals attended. The availability of the training was a draw card to many of those who had come to get involved, as many could not afford to undergo spirometry training under normal circumstances.

We spent three days reviewing all theory and practical aspects of Spirometry testing. The days were long, 7am until 5:30pm in order to be ready and since the event each participant has written theory & practical exams and have handed in portfolios all of which prove their Competence in Spirometry.

Finally at 8am on Thursday 3rd June testing on the public commenced. Right from the outset there were queues of people who wanted their lungs tested and who wanted to be part of a global initiative for the good of all. The operators selflessly worked barely breaking from 7am – 7pm. Some members of the team were on duty giving information about the event and the testing to passersby, some assisted with queuing and filling out of paperwork, some did screening blood pressure, others height and weight. Machines were calibrated and records filed every 2 hours. The first day approximately 750 individuals were tested. On the second day approximately 880 individuals were tested.

Setting up

On the 2^nd June set up at the Comrades expo commenced.  This was a whirl of activity, bodies, technicians, IT specialists, equipment and disposables.  Various problems were encountered and overcome but the most troublesome being setting up the spirometers onto new laptops and with new printers.

Guinness World Record Attempt

The Guinness World Record judge arrived from the UK on Friday 1st June bringing about the final plan and last minute additions and changes for the Guinness World Record attempt operations – all whilst hundreds of persons were still being tested in honour of World Spirometry Day.

The Guinness World Record judge arrived from the UK on Friday 1st June bringing about the final plan and last minute additions & changes for the Guinness World Record attempt operations – all whilst hundreds of persons were still being tested in honour of World Spirometry Day.

Finally on Saturday 2nd June at 9am after a final team meeting and in an atmosphere filled with anticipation excitement and pride the truly South African Vuvuzela was blown loud and clear marking the start of the record attempt for the Most Spirometry Tests Carried Out In Any One Event In Eight Hours.

Activity was immediate as each person in the queue was marked and brought in to the testing area. Again, height, weight and blood pressure were measured together with a screening questionnaire before each client underwent the spirometric lung function test. The client blew until three acceptable and repeatable tests ensuring that the data collected was valid both medically speaking and for the record attempt. After the first two to three hours the initial chaos died down to a buzz with all machines, systems and processes in place and working well.

The operators faithfully and systematically continued testing all day under the watchful eye of three very experienced spirometrists acting as Independent Witnesses and quality control managers for the Guinness World Records. Except for random technical problems and machines that stopped working due to overuse, testing went well with each member of the team carrying their individual roles with great responsibility.

At 17h00 the Vuvuzela sounded the cut off for testing numbers to clapping and cheers. The final result was well over the minimum target set with over 600 tests recorded of which 424 were considered acceptable and repeatable. WOW!

The final day

The World Spirometry Day activities concluded the following day with the team having moved all equipment and setting up once again in a tent right at the finish of the Comrades Marathon to offer a final day of free testing opportunity for the general public. To our amazement even some runners having just completed running 89kms came to get tested!

Looking back

What an awesome, memorable ride! The first thing that comes to mind is how unbelievably proud I am today to have had the privilege of leading a group of truly professional individuals through a once in a lifetime journey in carrying out spirometry testing for the first time in our country on over 2000 people over 4 days including the successful setting of a Guinness World Record attempt.

I am completely blown away by the support that has been shown by so many companies and organisations and I am humbled by the personal sacrifices that were made from so many individuals on all levels to successfully carry out this initiative. There were many times in that week of flat out 12 hour plus days that I looked at each volunteer work with all sincerity and with all they had to offer on a voluntary basis, overcoming frustrating technical and other issues.

Personal issues were put aside including deaths in the family, illness and other real and serious crisis’s in order to see the project through. There were times when some were falling asleep in their 5 min breaks – that was for those who actually took breaks. I cannot thank each one enough or more sincerely.

I have never been more proud of the standard of spirometry in this country and to be a South African healthcare professional.

Here’s to the next time!

With a vision and mission to improve Respiratory Health in Africa and in support of the Healthy Lungs for Life Campaign the BREATHE team, lead by Lindsay Zurba, in collaboration with associated organisations spent time in Malawi recently teaching a variety of spirometry courses. Time in the country was maximized with the additional offering of two free Healthy Lungs for Life initiatives.

A free one day Foundational Asthma Training Workshop was presented for 30 health care personnel who wanted to know more about asthma. This workshop facilitated by South African Spirometry expert, Lindsay Zurba and UK Paediatric Pulmonogist Abigail Whitehouse took place at the Malawi Liverpool Wellcome Trust in Blantyre, providing the essential background information needed to enable a health care professionals to understand asthma and communicate effectively with patients.

A healthy lungs community event approximately 1.5 hours outside of Blantyre at Gumba Full Primary School, Kavalo Village in Traditional Authority (TA), Kasisi, Chikhawa. As much as the initiative was driven by the desire to create awareness about lung health, so too were these concerned professionals offering their expertise for the day with  free lung tests, respiratory related games and quizzes and interactive question & answer sessions about lung wellness.

Village head Kavalo said the initiative would help people to know more about the diseases that affect them. With the district hospital being 100 km’s from this village, people can die before reaching the hospital in the event of a health issue. Teaching people how to prevent disease is therefore a good thing. 

The old African Proverb “If you want to go quickly, go alone. If you want to go far, go together.”

Where street vendors offered them “mice on a stick” as a snack on the way home! Pop up dining wherever you go!

Who was there?

• Bill Smith, company president
• James Jones, keynote speaker and successful entrepreneur
• Lisa Brian, advertising guru
• 1,000+ employees from the Marketing division

What was the event about

• Event Tagline: “From Good to Great: Turning a Mediocre Campaign into a Home Run for Your Client”
• Memorable information:
  • Meet the unspoken needs by going the extra mile to discover what your client really wants but is afraid to ask for
  • When you think you’re done, let it sit on the shelf for a day. Then go back and make it even better.
  • Don’t ask whether your client will like what you’ve done; ask yourself if you would purchase the product based on the advertising you’ve provided

Where did the event take place?

on 28^th July 2016.

When did the event take place?

• Speakers and presentations: 12pm–4pm
• Q&A Session: 4pm–5pm
• Dinner with the presenters: 5pm–7pm

Why was the event scheduled?

• To inspire our company to give our absolute best to our clients
• Quotes from attendees:
  • “I feel a new sense of purpose towards the campaign I’ve been assigned. I’m motivated to do more than just get the job done; I want to create a campaign that I would be passionate about as a consumer.”
  • “It was great to hear about the common pitfalls of marketing executives and know that I’m not alone in making a few natural mistakes! I feel much more confident about avoiding errors in my future projects thanks to the advice given today.”
  • “I loved the advice about meeting unspoken needs. I’m ready to get back to work tomorrow and investigate how I can better serve my client.”