Who is Dr. Emilia Miquidade?
Dr. Miquidade currently holds many roles. She is the Director of Pain and Palliative Care Unit in Maputo Central Hospital (Mozambique), President of the Mozambican Association for the Study of Pain, Vice Chairman of Maputo Central Hospital’s Opioid Commission, Focal point on Palliative Care in the National Cancer Program of the Ministry of Health, and Invited Professor at the Faculty of Medicine of the University of Porto (Portugal). She specializes in anesthesiology and holds a Master in Pain Management. She is also currently a PhD Student. IASP talked with her about her research and clinical practice.
What is Dr. Miquiade’s Specialty?
Her clinical practice is focused on postoperative, neuropathic, and cancer pain. She is at the referral hospital in the country, the only hospital in the country that has more than 6 techniques for pain relief, and the only one that occasionally has oral morphine solution for cancer patients.
She became an IASP member because she is responsible for both the Association and the largest Pain Unit in her country. The only way they have to learn is to be connected with the experts in the field, to see how they do it, to ask for opinion, and to try to adapt it to their reality. She is an IASP member because she will only grow in this area if I stay connected with experts from IASP.
What is the aim of the Program?
This program was for educational courses for physicians, nurses, and anesthesia technicians. It was held at Maputo Central Hospital, meeting room for theories and practices in the operating room. During this program participants would have learned about the concept about Pain and its classification, Pathophysiology of Pain, Acute Pain Management, Pain assessment, Post-operative pain management, Preventive analgesia, WHO analgesic scale, Side effects of opioids, Routes and drug´s administration for postoperative pain. The course assessed performing techniques in the operating room to control postoperative pain and for prescriptions for analgesics made to postoperative patients both in the operating room and in the wards and measured daily clinical practice and postoperative pain intensity.
Were the two tests conducted before and after the course indicate learning? How?
Yes, they could improve in some aspects, but the some difficulties prevailed because the participants did not always have the drugs available and most of the time they had to prescribe what really existed, which was not always satisfactory for pain relief. This is significant because most of the times they opt for regional techniques, or local infiltrations for pain control dependent on the surgery that was performed.
What was the result? How can this project be improved if redone?
What limited participation for this course was the pandemic period and the limitation of professionals in each room, both for meetings and for practices in the operating room. To improve it, it should be done in a period with fewer restrictions or possibly through an online training. The online alternative would prevents practices in the operating room as a result.
Plans for the future?
Regarding the follow-up plans, an anesthesiologist (trainer) was placed in the maternity unit, central operating room and pain unit, to be available to support all technicians, physicians and nurses in these places for pain control before, during and after the surgery.
In the long term, they will carry out another questionnaire to assess postoperative pain in the wards to assess whether or not there has been a change in attitude towards the approach to patients.
She would like to repeat the course because health professionals are in constant rotation in the hospital, residents, once they graduate, are transferred to other hospitals and gradually new residents from different specialties are entering and they have no notion of pain control. At the selected hospital it was possible to comply with the proposal. The setbacks they had were not related to the amount of money, but rather to the pandemic period and internal bureaucracies.