Anaesthetists Jeremy Young and Raj Palepu with Melita Macdonald, the manager of Wellington Regional Hospital's simulation service, and the scoby. Photo: Te Whatu Ora - Health New Zealand
Inside Wellington Hospital is a team brewing kombucha so its gelatinous by-product can be used as a stand in for human flesh and skin.
Scoby is the cellulose layer that forms on top of the fermented tea drink, it consists of bacteria and yeast. It was also known as 'mother'.
And Wellington Regional Hospital's simulation service manager Melita Macdonald told RNZ's Nights programme it's a great replacement for human tissue.
"Without you know freaking people out, it looks and feels like skin or even muscle... we've looked at it under ultrasound and it looks more like a human than a blob of gel."
Two and a half years ago they heard people in Canterbury were using scoby to practise suturing skills, Macdonald said.
So she went down the road to KB Kombucha on Taranaki Street.
"I think he thought I was mad, but he gave me a starter with some scoby in it, which I took back to the hospital on the bus and we started from there."
Now anaesthetists, emergency department clinicians, medical school trainees, and nurses use scoby grown in the hospital to practice not just stitches but cricothyroidotomy (an incision to create a emergency airway), intravenous cannulation, and lumbar puncture (or spinal taps).
Macdonald, known as the 'Scoby Mother', said it was a great replacement for the non-biodegradable products that were used previously.
"They're made out of silicon or rubber or foam, which just doesn't look and feel like a real person," she said.
The plastic, rubber or foam would end up in the landfill, could be expensive, and the scoby was also often more realistic.
"If they're fresh in the tea, they are slimy. We actually use them once we've dried them out for a number of hours, sort of 12 to 20 hours depending on what we're doing with them, at that stage they're quite pliable, you could think it's the fat off a piece of meat, it's that kind of texture."
They've also been trying to grow things in the scoby to replicate nerves and fascia.
The more realistic the material, the better people will learn, Macdonald said. "It's a place where people can make mistakes and no patients are harmed."
But they don't drink the kombucha. Macdonald said she had never even tried it.
"We're putting our fingers and all sorts of things into this stuff, I wouldn't be drinking it.
"My office is right next to the scoby farm and yeah, there's a distinct whiff of vinegar when we open the door."
More than just scoby
An occupational therapist by trade, Macdonald had worked in health for more than 30 years and said she loved the innovation of her role.
"This is a fun part of my job. The rest of my job, I suppose, is more strategic, but it is really aligned to improving patient outcomes and staff safety as well."
And it's not just the scoby the simulation team had to help people practice and learn.
"We have a birthing mannequin, one of the few few mannequins in New Zealand that gives birth to another mannequin."
That allowed obstetricians, midwifes and anaesthetists to practice emergency procedures, she said.
There was also an aeroplane fuselage where flight teams, ICU, and Nicu staff could practise working in a confined moving space.
And volunteers who came in and pretended to be a patient or a family member to practice the communication and emotional aspects of medicine.
