June 21, 2017
AHS pharmacist Sharon Falk, left, shares a happy moment with a patient and a colleague aboard the Africa Mercy, a hospital ship anchored in Cotonou, Benin, in West Africa, where she served as a humanitarian volunteer.
The Africa Mercy, a hospital ship anchored in Cotonou, Benin, in West Africa, where AHS pharmacist Sharon Falk served as a humanitarian volunteer.
Story by Gregory Kennedy
When Calgary pharmacist Sharon Falk found herself on a hospital ship off the coast of equatorial West Africa, she soon realized she badly needed help from an old friend — Bugs & Drugs — Alberta Health Services' (AHS) homegrown guide to fighting infections.
“The infections we have seen have been extremely serious and I was really surprised to encounter so many multi-drug-resistant bugs,” says Falk, who was given leave from Peter Lougheed Centre Inpatient Pharmacy to perform her humanitarian work.
But even as the crow flies, it’s a long 11,232 km from Calgary to Cotonou, Benin, where Falk was serving aboard the Africa Mercy — the world’s largest hospital ship with 84 beds and five operating rooms that treats the locals for free — and the charitable nature of the service meant there was no budget to pay for this prized AHS resource.
Despite the spotty Internet service, Falk decided to write home for help — to AHS:
“I heavily relied on Bugs & Drugs as a reference prior to coming here, and I feel virtually lost without it! We have a few very old references inherited by other pharmacists that have volunteered before us, but it is not ideal.”
Hoping for a deep humanitarian discount or, better yet, a donated copy, Falk added: “We have a pretty limited budget (and by limited I mean LIMITED)!”
Much quicker than the crow flies, her email plea landed on the Edmonton desk of Rob Vretenar, Executive Director, Provincial Operations, Pharmacy Services for AHS.
“Sharon couldn’t access our website off the coast of Africa,” says Vretenar, “so we provided her with app redemption codes for herself and her colleagues, so they could download the Bugs & Drugs app onto their devices for free.”
Available as a website, or as an app for iOS or Android smartphones, “it’s a comprehensive, yet easy-to-use antibiotic-reference guide: ‘If you have this infection, here’s what you use to treat it.’”
“Bugs & Drugs collects and evaluates all the latest evidence out there — the literature, the guidelines, expert opinions and more — and condenses it down for users, whether within AHS or in the Alberta community,” says Vretenar. “Our users include physicians, pharmacists, nurse practitioners and dentists — in short, anyone who can write prescriptions for antibiotics.”
Living nine months in the port of Cotonou — Benin’s biggest city with an estimated population of 1.2 million, and a hub of West African commerce on the Atlantic — Falk discovered “the access to medications is largely unregulated here, so oftentimes patients will self-medicate with antibiotics unnecessarily at various doses, whenever they feel a little bit under the weather. There’s also a significant amount of overprescribing by medical professionals.”
Overprescribing has led to the “antimicrobial resistance that’s become a major threat to the successful treatment of many infectious diseases,” says Vretenar. “Bugs & Drugs is an antimicrobial stewardship tool that helps limit antibiotic resistance through the judicious use of antibiotics.”
Serving with two other Canadian pharmacists on the Africa Mercy, along with about 400 other volunteers from 44 countries who live and work on the ship at any given time, Falk says: “We’re part of an incredible community; we get to be involved in so many different aspects of patient care and actually become friends with our patients. I’ve seen patients with massive tumours undergo such dramatic positive physical and emotional transformation.”
Over 10 months of field service each year, almost 2,000 surgeries are provided free to regional residents, many of whom travel a great distance for their healthcare. On shore, there is also the Hospital Out-Patient Extension (HOPE) Centre nearby, where patients can live before and after surgery, for nutritional support or wound care, for example.
“Our healthcare system in Alberta rocks,” says Falk. “We have no idea how blessed we are to have free, accessible, safe healthcare.
“Here in Africa, something that could be treated easily becomes life-threatening without access to medical care. For example, I met a woman who had a goiter for so many years it became a nearly three-kilogram mass that was impairing her breathing.”
For Vretenar, helping Falk on behalf of AHS is a privilege.
“Hers is a great story that shows what AHS is all about,” he says.
“One of the reasons we do things like (Bugs & Drugs) is to have a positive impact on our patients — regardless of whether they are in Alberta or on a hospital ship in Africa.”
For Falk, who comes home to Alberta this month, she’s missed one thing the most.
“I miss being outdoors, especially the mountains,” she says. “We are so spoiled in Alberta with such an amazing ‘backyard’.”
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