Training Local Doctors as Hotshots in Response to the Global Surgery Crisis

February 14, 2019
By Lidia Shafik, Key Correspondent for the Irish Forum for Global Health

Surgery is often seen as a luxury in the developing world. For Deirde Mangoang, Director of the RCSI/COSECA Collaboration Programme speaking at the Global Health Exchange conference this week in Dublin, surgery is, “The neglected red-headed step child of global health.” There is a crisis in global surgery in the developing world or, rather, the lack of it.

An estimated 5 billion people don’t have access to safe, affordable, and timely surgical and anaesthesia care. To put things into perspective, compared to Ireland’s 50 specialist surgeons per 100,000 population, there is only 1.8 per 100,0000 in sub-Saharan Africa. Overall, there’s a serious lack of hospitals, equipment, medical personnel, and transport access to hospitals for locals in many of the world’s poorer countries.

We can see the effects of this crisis, such as that of Salome Karwah, an Ebola fighter in Zambia. In 2014, when the epidemic was in West Africa, she lost many family members to the disease. She even contracted it herself but was one of the few who developed immunity. A rare survivor, she went back to work in the Ebola centre helping countless numbers of people. However, I’m sorry to say she died this year from post-operative complications of a caesarean section. She was in her 20s, a skilled nurse, wife and mother, yet died of something so simple that could have easily been prevented with adequate surgery resources.

RCSI have partnered with the College of Surgeons of East, Central and Southern Africa to help deliver a ‘college without walls’. They train local surgeons in these countries as a solution to alleviate the surgical workforce crisis. Funded by Irish Aid, this is a steadily growing programme currently running in more than 100 hospitals, in 15 countries, across Africa.

One example of a success from this initiative is the case of Bupe and Mapalo. These siamese twins, who shared the same liver and bowel, were born to parents Lydia and Moses. In February 2018, Dr Bruce Bvulani, thanks to the training by COSECA, was able to successfully conduct this milestone surgery in Zambia. The twins are now healthy and well. Instead of hotshot doctors flying in from first world countries this programme is building the hotshot local doctors in countries that need them most.

6th November 2018

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