CSA stands for Centrale Sterilisatie Afdeling, which is Central Sterilization Division in Dutch. While the widely known Operation Room Assistant gives the helping hand during the surgery itself, the CSA is a division that remains unknown behind the curtains of any hospital, albeit it supports the Surgery Operation Room before and after the surgery.

Largely unknown to people outside, often it is traditionally looked down as "tweezers washer" instead of a full profession that requires not only skills in knowing, naming and setting the instruments of every specialism on surgeries faultlessly, but also knowledge about deseases, bacteria, sterilization methods and conditions in order to destroy the desease germs while at the same time carefully preserving the instruments from decay (caused by contamination such as blood, part of bones, fat layers, albumen, acid and desinfection chemicals) as well as to create surgically clean and safe condition for both the surgeon and the patient themselves. A small burr or bramble on a micro surgical instrument, for example, can already lead to unwanted bleeding of the vein which is not ment to be cut and thus creating larger problems and complications on the patient. This applies evenmore to unclean condition of the instruments used.

It is not a bad idea, though, when everyone involved in the health care branch show up at least once in their medical life at the CSA to gather some information how things are going on in here. At least to prevent some misunderstanding like the other day - told by my own Division Manager - when a group of surgeons pay a visit to the CSA and was surprised to find out that the tray of instruments is packed before it gets sterilized and not after the sterilization (the clue for those who does not get the idea: how can you maintain its sterile - that is bacteria free - status if one packs the instruments after being sterilized?). Well, you can not blame them for being the end users, but a little bit basic knowledge of the matter is not a bad thing, either.

It is in fact a more profession than just "tweezers washing" only. Working at the division myself I know that the study for this profession is quite heavy and needs a clear logical mind to understand almost about anything that's going on the medical world, beside the possession of accuracy and precise mentality to do the work. It is a job of large scale of responsibilities, with one rewarding aspect always stays behind one's head: you do a commitment to help others who are in health needs. Maybe someday you will need the care yourself, too, and it is a soothing idea to depend on others whose accuracy and responsibility you can count on.

   Jim Rais Photographs | Home front cover next