For those individuals who do not know what an autoclave is….. it is a device used to sterilize medical and laboratory instruments by subjecting them to very high pressures with saturated steam above 212 degree Fahrenheit or 100 degrees Celsius. It is like a pressure cooker but the one for the clinic is the size of a large old fashion microwave oven (2 feet by 2 feet by one foot)and it weights about 35 pounds.

In cleaning out the various store rooms for the clinic, I found this new, unused autoclave still surrounded by the manufacture’s bubble wrap. I could not believe my eyes…. I was wondering how to improve the sterilize process for the various pieces of equipment the staff use to clean wounds, change dressings or when we would need to suture a patient and then remove the stitches. I found a perfect spot for the autoclave but many of the staff had never seen an autoclave or one this small and so it was an opportunity for learning…

I read the manual to discover that not any tap water would do but a certain kind of de-mineralized water must be used. and not any wate…. so my search was on and I finally after a number of trips to Masaka I found a place where I could buy a 5 litre jug. Now, I could test the autoclave and see if it would work. The manual was passed around and various individuals who are responsible for the maintenance agreed that we could trial it….. but all that took time and the clinic was without its use. In the meantime, I ordered the special autoclave tape which indicates the process worked and had drapes or large wraps made from hospital standard material I had ordered from Kampala. I was not able to do a trial run before I left for Canada in August but immediately after my return, I was given permission to do a trial run… It was on a Market Monday when the autoclave was set up with water and a set of instruments to be sterilized. Within a few minutes, the device was off and I had over loaded the generator…… now. how do I or can I use the autoclave?…….. After a numerous of discussion, it was decided that we would attempt a second trial at lunchtime… between 1 and 2 pm. The generator would be turned off to the rest of the compound and the only power would be for the clinic. We had success… the process took just over 60 minutes and the autoclave functioned perfectly.

WOW!!!!!!!!!!!!!! We were in business….. Joyce, one of the nurse’s spent the next week cleaning all the various forceps, scissors and cutting gauze making up 10 packages ready for sterilization.

The plans for this past week were to sterilize each afternoon until all 10 packages were through the process…. Tuesday, everything went well, Wednesday I noticed that the device turned off and had not completed the process…. in fact it had overloaded the generator or so that is what it looked like to me. The maintenance men arrived to discover that the wall socket had been blown. Thursday, the socket was replaced and on Friday we tried one more time… without success. It could be a number of things including the wiring to the clinic…..the wiring may not be able to handle the power surge. It is going to take some time before anyone knows for sure the cause…..

Some one in the past years gave a very expensive gift to the clinic. Something which is needed and can be used….. in the meantime…. there are more questions then answers.

BUT I AM STILL GOING TO TRY AND FIND AN ANSWER……. in the meantime, back to the old method of cleaning equipment.