Is it Possible to Train Surgeons for Rural Africa? A Report of a Successful International Program

Pollock, Jonathan; Love, Timothy P.; Steffes, Bruce C.; Thompson, David C.; Mellinger, John D.; Haisch, Carl E.

doi:10.1007/s00268-010-0936-z

Cited by 71 publications

(53 citation statements)

References 23 publications

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“…23 Countries in sub-Saharan Africa generally have few skilled workers able to perform surgery -including caesarean sections -and most of their qualified doctors live in urban areas. 22,24 In the present study, caesarean delivery rates were extremely low among both the richer and poorer women who lived in rural areas, where structural and workforce constraints may be the most important barriers to access.…”

Section: Discussionmentioning

confidence: 94%

Trends in caesarean delivery by country and wealth quintile: cross-sectional surveys in southern Asia and sub-Saharan Africa

Cavallaro

Cresswell

França

et al. 2013

Bull. World Health Organ.

206

183

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Section: Discussionmentioning

confidence: 94%

Trends in caesarean delivery by country and wealth quintile: cross-sectional surveys in southern Asia and sub-Saharan Africa

Cavallaro

Cresswell

França

et al. 2013

Bull. World Health Organ.

206

183

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“…18 Others possible reasons may include invitation from institutions in developing countries, desire to reach out, and institutional collaboration. 6,7,19,20 These were reflected in the published programs.…”

Section: Discussionmentioning

confidence: 99%

“…7,10,11,13,15,20,22,23 In all the types of programs, the visitors, including those on international health electives and surgeons on training in foreign medical institutions, achieved valid educational experiences, and expressed feelings of fulfillment. 6,7,10,11,13,14,17,19,21,[24][25][26] The weaknesses expressed by the articles were difficulties with target definition, lack of ethical considerations in areas of supervision, patient protection, proper audit, inappropriate allocation of already scarce human and financial resources, and poor follow-up of cases. [7][8][9][10][11][13][14][15][19][20][21][22][23][24][25]27,28 On the other hand, the long-term outcome may be more difficult to assess due to ill-defined duration of the missions, lack of sustainability, and the difficulty with defining measurable outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,5 As a result of these disadvantages, substantial disparity exists in the surgical care and outcome in this setting and the developed countries. 1,4,6 To address this discrepancy and elevate the level of child surgery standards in some of these countries, strong efforts have been expended over the past decades through a variety of international partnership programs. [6][7][8][9][10][11] Some of these programs have been published in medical literature, but a review of the programs is rarely reported.…”

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confidence: 99%

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The Current Status of International Partnerships for Child Surgery in Sub-Saharan Africa

Ekenze

Onumaegbu

Nwankwo

2014

International Surgery

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Disparity still exists in the surgical care between sub-Saharan Africa and developed countries. Several international initiatives have been undertaken in the past decades to address the disparity. This study looks at the impact of these programs in child surgery in Sub-Saharan Africa. Review of electronic databases Medline and African Index Medicus on international partnerships for child surgery in Sub-Saharan Africa was undertaken. Four types of international initiatives were identified and consist of periodic medical missions; partnerships between foreign medical institutions or charities and local institutions; international health electives by surgical residents; and training of individual surgeons from developing countries in foreign institutions. The results of these efforts were variable, but sustainability and self-reliance of host nations were limited. Sociocultural factors, dearth of facilities, and lack of local governments' commitment were main impediments to effective local development or transfer of modern protocols of surgical management and improvement of pediatric surgical care at the host community level. Current initiatives may need improvements with better understanding of the sociocultural dynamics and local politics of the host nation, and improved host nation involvement and commitment. This may engender development of locally controlled viable services and sustainable high level of care.

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“…9 The presence of educational facilities and a tradition of education along with the potential for integrated and cooperative training with the general surgery residents can be synergistic. Collegial relationships formed while training together may lead to general surgeon and family medicine teams being sent out to practice together, preventing burnout for both, and extending the reach of the fully qualified general surgeon.…”

Section: Medical Residencies In Paacs Hospitalsmentioning

confidence: 99%

Starting and resourcing family and internal medicine residency programs as integral mission

et al. 2016

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Graduate medical education is an excellent means of building the capacity of health care systems in low and middle Income Countries (LMIC) and a growing way for physicians in the U.S to get involved in integral mission – the proclamation and demonstration of the Gospel. This white paper purposes to provide a “best practices” recommendations on family and internal medicine (“medical”) residency program development in majority world settings. An expert panel of residency educators convened in November 2015 at the Global Missions Health Conference (GMHC) in Louisville, Kentucky and through an iterative process identified themes that were then further defined and clarified by medical residency faculty unable to be present. Participants largely agreed that integration and cooperation with the country’s Ministry of Health (MOH) is essential for sustainable residency development. Recognition of family medicine as a specialty will enable graduates to succeed in the country’s physician job market and health systems leadership. Recognition by the national church of the unique needs of their mission hospitals’ educational programs to control their revenue in order to fund their programs’ growth and development exemplifies the common wisdom to provide authority and resources where responsibility for good outcomes is expected. Co-training of general surgeons and medical residents who can provide essential surgical call coverage may lead to on-going synergies. Teaching by medical and surgical subspecialists is essential in medical residencies to provide the depth of instruction residents need to develop as excellent clinicians. Dependable scheduling of their specialty instruction allows residency program directors to assure inclusion of their content in the residency curriculum. In summary, participants agreed that teaching in medical residency programs in LMIC present excellent opportunities for national and expat Christian physician educators interested in integral mission.

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Is it Possible to Train Surgeons for Rural Africa? A Report of a Successful International Program

Abstract: The PAACS has provided rigorous training for 18 African general surgeons, one of whom has also completed pediatric surgery training. To our knowledge, this is the only international rural-based surgical training program in Africa.

Cited by 71 publications

References 23 publications

Trends in caesarean delivery by country and wealth quintile: cross-sectional surveys in southern Asia and sub-Saharan Africa

Trends in caesarean delivery by country and wealth quintile: cross-sectional surveys in southern Asia and sub-Saharan Africa

The Current Status of International Partnerships for Child Surgery in Sub-Saharan Africa

Starting and resourcing family and internal medicine residency programs as integral mission

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