Practice spotlight: volunteer pharmacists in sub-saharan Africa.

Armed with knowledge, textbooks, medical supplies, and mosquito repellant, Canadian pharmacists depart each year for international volunteer experiences in different areas of the world. Sub-Saharan Africa is a common destination for health care professionals, because of the high prevalence of disease and shortages of health care workers. In recent years, pharmacists and student pharmacists have been working with local African organizations to optimize the distribution and provision of pharmacy-related services in this region. These volunteers bring particular knowledge, skills, and attitudes that can positively contribute to humanitarian efforts. Although many different types and durations of volunteer projects are available, this article focuses on pharmacists who take on mediumto longer-term assignments (minimum 4-week placements) in clinic and hospital settings. The need for optimizing pharmacy-related services in developing countries has increased with worldwide improvements in access to medications. Major challenges facing these countries include health worker shortages, limited opportunities for training and continuing education, prevalence of counterfeit medications, traditional noncollaborative practice settings, and limited access to drug information resources and literature. As with any organization encountering challenges, external consultation and assistance can be of great value. Volunteer pharmacists and student pharmacists from countries such as Canada can offer knowledge and experience to assist local organizations as they attempt to improve services, advance practice, and maximize positive patient outcomes. Practice sites for volunteers in sub-Saharan Africa range from large urban teaching hospitals to small rural clinics. One example of a large urban institution is Mulago Hospital in Kampala, Uganda, a 1500-bed public tertiary care hospital that serves as a teaching hospital for the medical and pharmacy schools at Makerere University. It is a hub of academic, research, and service collaborations with universities and health institutions in other African countries, as well as Canada, the United States, and the United Kingdom. Its distinctive environment affords volunteer pharmacists and student pharmacists the opportunity for a rich interactive learning experience. The hospital is currently served by 7 full-time pharmacists and up to 60 pharmacy interns. These pharmacists are respon sible for dispensing services, as well as ward rounds and clinical services in their respective areas. They also play critical roles in general pharmaceutical management activities focused on ensuring availability of medicines, providing patient-focused services, and meeting the drug information needs of other health care providers. Every day, these highly knowledgeable and motivated pharmacists face many challenges, including high patient loads, staff shortages, limited access to reference materials, and inconsistent medication supplies. Volunteer pharmacists can have major sustainable impacts in this setting by initiating interventions (such as clinical training of pharmacy interns), facilitating case-based therapeutic discussions with pharmacy staff, developing and co-presenting drug information rounds to medical teams, and attending ward rounds with pharmacists to help prioritize and focus drugrelated problems. By working directly with members of the hospital’s pharmacy team and focusing on education and training, volunteers can ensure that their interventions become sustainable. At the other end of the spectrum is Nsutaman Polyclinic, a small rural health centre located in the town of Nsuta in the Ashanti Region of Ghana. This publicly funded clinic serves the