Two teams from the UNMC Department of Anesthesiology recently returned from a global health outreach trip to Lusaka, Zambia, where each team spent two weeks working alongside local faculty and trainees at the University Teaching Hospital (UTH).
In addition to providing hands on and didactic clinical training to the residents of UTH, this annual departmental trip provides medical and cultural education to UNMC residents, fellows and faculty.
Led by faculty anesthesiologist Jeffrey Songster, MD, the second team included residents Hayden Brodersen, MD, and Zach Egr, MD, and cardiothoracic anesthesiology fellow Annie Yao, DO. This marked the second trip for Dr. Songster, who said he was surprised to be greeted with recognition and warmth by residents he had mentored two years prior.
“It was fantastic to see the growth they’ve had during that time,” Dr. Songster said.
Dr. Songster mentored one of the residents in her quality improvement project assessing patient satisfaction with perioperative care to assess the competence of the anesthesia and surgical services.
“In this severely resource limited situation I am always impressed with their desire to improve where they can and find ways to support their requests for medications or equipment to their government with local data and evidence,” he said.
The team’s clinical contributions focused on practical anesthesia techniques using tools and supplies already available at UTH. These included point-of-care ultrasound, peripheral nerve blocks, intraoperative management concepts and fiberoptic intubation, an advanced airway skill.
After teaching a few fiberoptic intubations, Dr. Songster was humbled at the request of other Zambian residents to come and teach them the same skills.
“I was impacted in two ways: first by how much they want support and knowledge, and second that in only a few experiences together we were able to develop a relationship of trust where they felt comfortable asking for help,” Dr. Songster said.
Dr. Yao described how the team worked closely with the residents and OR staff in Lusaka, building relationships and tailoring their teaching to individual interests and needs. “Our focus was to teach skills with the supplies they had so they could continue honing those techniques after we left,” she said.
In one example, a Zambian resident sought help with a post-op block unfamiliar to Dr. Yao. Dr. Yao asked Dr. Songster to assist, allowing both her and the resident to learn the procedure together. “It was a great moment of collaboration and shared growth,” she said.
The team encountered stark differences in available resources compared to U.S. operating rooms, limited medication supply, reliance on oxygen tanks and creative adaptations in the absence of continuous infusions or advanced monitoring tools. Epinephrine was the only available vasopressor, and propofol supplies sometimes ran out by the end of the day.
“They rely heavily on regional anesthesia to conserve general anesthetics and opioids,” Dr. Yao said. “Their resourcefulness and commitment to patient care was inspiring.”
These challenges underscored the importance of planning, flexibility and resourceful practice, lessons the UNMC teams brought back with them.
Residents from both institutions formed close working relationships during the trip, with UNMC trainees stepping into teaching and mentoring roles. Dr. Songster praised the calm, clear-headed leadership demonstrated by each of them, recalling several moments where their support prevented potential harm during complex cases.
“They recognized when Zambian residents weren’t supported well enough in high-risk clinical situations,” he said. “In each case, they either intervened directly or got help and those moments became valuable teaching opportunities.”
For Robert Guidangen, MD, who was part of the first team, the experience was a full-circle moment. He had previously worked in Kenya conducting public health research and supporting humanitarian aid projects as a pre-med student and returned to Africa more than a decade later in his final year of residency.
“Our shared love of anesthesiology cuts across any differences in culture, language, national border, or economic circumstance, and I think there is something special in that,” he said. “We read the same textbooks and share the same excitement over difficult airways and complex physiology. That connection makes me proud to be a steward of this specialty.”
Dr. Broderson agreed, noting that the Zambian residents’ eagerness to learn was matched by their clinical capability and resilience. “They consistently delivered high-quality care with fewer resources and less support than we are accustomed to in the U.S.,” he said.
The trip wasn’t without light-hearted and cultural highlights. Dr. Songster recalled the generosity of others who shared their staple food, nshima, during cafeteria meals and how he later learned to make it himself, bringing corn meal home for his family. Another highlight was a traditional Zambian meal called kapenta (little bite-sized whole fish), and fried caterpillars prepared by a woman who worked at the team’s apartment complex.
In a gesture highlighting the spirit of service and connection, Dr. Songster shared that Dr. Broderson literally gave the scrubs off his back to a young Zambian surgeon in need.
All members of the team said they would recommend the experience to others.
“Absolutely,” Dr. Egr said. “Global health trips offer a unique opportunity to teach, learn and gain perspective, all while fostering meaningful human connections.”
“It was an incredible privilege to be welcomed into their anesthesia team,” Dr. Yao said. “To know that they’ll continue using what we taught, even after we’ve left, is deeply fulfilling.”
Dr. Egr added this experience has influenced his perspective on global health as well as his approach to clinical care, saying, “It deepened my commitment to education and reinforced how global collaboration strengthens our specialty by fostering shared learning, respect and innovation across borders. I hope to continue to perform more global health trips as I advance through my career.”
UNMC/Nebraska Medicine team members were:
Team One
- Kyle Johnson, MD, assistant professor
- Sara Linza-Moscati, DO, CA3 resident
- Robert Guidangen, MD, CA3 resident
- Noah Svec, MD, CA3 resident
- Kristin Wakin, MD, associate professor
Team Two
- Jeffrey Songster, MD, associate professor
- Hayden Brodersen, MD, CA3 resident
- Zach Egr, MD, CA3 resident
- Annie Yao, DO, cardiothoracic anesthesiology fellow