Sharing our knowledge and expertise worldwide: Meet Dr. Asma Salloo, Johannesburg, South Africa

Dr. Asma Salloo, Clinical Fellow, Critical Care Medicine, is one of five South African fellows currently training at SickKids supported through the SickKids International/NMCH Initiative. Asma is about to complete her year of subspecialty training in paediatric extra corporeal life support (ECLS) at SickKids. She shared her story with us and what the opportunity to learn at SickKids has meant to her. Asma also describes the impact her experience at SickKids will have upon her return to Johannesburg in contributing to improving the health care of children in South Africa.

What is your role back in South Africa?

Prior to starting my fellowship here at SickKids, I was practicing as a qualified Paediatric Intensivist for the last five years. I work at Chris Hani Baragwanath Academic Hospital (Bara), an academic hospital based in Johannesburg, and one of the hospitals that will refer patients to Nelson Mandela Children’s Hospital (NMCH).

Can you tell us more about your subspecialty?

I am doing the Extra Corporeal Life Support (ECLS) Fellowship here at SickKids. ECLS is a subspecialty of paediatric critical care which includes extra corporeal membrane oxygenation (ECMO), an advanced modality of life support. ECMO is a term that is probably more familiar to most people.

Explain to us a little more about ECMO and describe the current situation involving ECMO services in South Africa?

Traditionally, ECMO in paediatric practice in South Africa has been limited to post- operative cardiac patients. In South Africa, cardiac surgeons are typically the only people with expertise in managing these patients. Currently, formalized ECMO subspecialty training programs are non-existent in South Africa and as a result the expertise and capacity is insufficient. However, as the South African public health-care system aligns with trends in ECMO utility internationally and with NMCH offering ECMO to patients, there is both a need and tremendous opportunity for paediatric intensivists to increasingly use ECMO for both cardiac and respiratory indications.

As I began reading and learning more about ECMO, I realized that in order to run a high quality ECMO program that contributes to excellent patient outcomes, one needed to get good training and experience to utilize this mode of therapy optimally. The opportunity to contribute to an enhanced level of care for children receiving ECMO in the public service prompted my interest in applying for this education initiative.

I was thrilled at the chance to be able to do the ECLS fellowship at SickKids because of their vast experience in ECMO. SickKids has had an ECMO program running for 30 years. To be able to learn from experts in such a well-established facility is truly an honour.

What learnings will you take away from this fellowship experience at SickKids?
During the time that I have been here, I have had extensive exposure and learned a vast amount about managing a variety of ECMO patients, both cardiac and respiratory.

In addition to my ECMO focus, I have had a keen interest in medical education and simulation, even prior to coming to SickKids. During my time here, I have had the opportunity to enhance my knowledge and experience in these areas as well.

As part of my scholarly project, I am creating an ECMO workshop for the fellows at SickKids and will be taking this back with me with the intention of delivering similar workshops back at home.

Aside from my ECMO training, I have also spent a considerable amount of time in both the Paediatric ICU and Cardiac ICU here at SickKids. Coming with prior experience has allowed me to appreciate broader issues, like management systems, staffing, quality and safety initiatives, educational approaches and interdisciplinary team contributions. These are all lessons that I will take back with me and hope to share and implement.

That leads nicely into the next question! What impact do you expect this to have upon your return to South Africa?

I am looking forward to returning to South Africa equipped with this newly acquired knowledge and eager to share it with my colleagues and apply my learnings with the goal of enhancing the overall paediatric ECMO care and related outcomes in South Africa.

group of people stand around a table working together on a paper puzzle
SickKids, together with NMCH and the support of donors, has made it possible for South African-trained and qualified paediatric specialists to have the opportunity to come to SickKids and engage in fellowships. Currently, four other fellows are training here in the areas of neurology, neonatology, urology and anesthesiology. This training has allowed our horizons to be broadened and to gain skills and expertise in areas that required further development and experience that one could only receive from being immersed in a dedicated children’s hospital like SickKids. Upon my return I will spread the word and advocate for others to consider applying for this tremendous opportunity.

The strength of this program is that we are a diverse range of fellows with different backgrounds and specialties and are at various levels within our career paths. This opportunity allows for a unique exposure running concurrently but with a focus on separate subspecialties. I think the African proverb, “it takes a village to raise a child” and the saying “a whole is greater than the sum of its parts” really apply in this situation. So, looking ahead as we all finish our training at SickKids and return to South Africa, our combined learnings, pooled together will allow for a valuable contribution, not only for NMCH and the larger paediatric academic network, but the broader South African paediatric health-care system.

We are eternally grateful to the donor and other individuals that have allowed this endeavor to reach fruition. I would like to send a special thank you to all the people at SickKids for their eagerness in teaching, mentoring and guiding me through my fellowship.

For an overview of SickKids International's current projects, visit SKI's Projects page. To learn how you can get involved in these exciting projects, contact Lutfi Haj-Assaad, Executive Director, SickKids International.