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Surgery and Anesthesia Capacity-Building in Resource-Poor Settings: Description of an Ongoing Academic Partnership in Uganda

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Abstract

Background

Surgery and perioperative care have been neglected in the arena of global health despite evidence of cost-effectiveness and the growing, substantial burden of surgical conditions. Various approaches to address the surgical disease crisis have been reported. This article describes the strategy of Global Partners in Anesthesia and Surgery (GPAS), an academically based, capacity-building collaboration between North American and Ugandan teaching institutions.

Methods

The collaboration’s projects shift away from the trainee exchange, equipment donation, and clinical service delivery models. Instead, it focuses on three locally identified objectives to improve surgical and perioperative care capacity in Uganda: workforce expansion, research, collaboration.

Results

Recruitment programs from 2007 to 2011 helped increase the number of surgery and anesthesia trainees at Mulago Hospital (Kampala, Uganda) from 20 to 40 and 2 to 19, respectively. All sponsored trainees successfully graduated and remained in the region. Postgraduate academic positions were created and filled to promote workforce retention. A local research agenda was developed, more than 15 collaborative, peer-reviewed papers have been published, and the first competitive research grant for a principal investigator in the Department of Surgery at Mulago was obtained. A local projects coordinator position and an annual conference were created and jointly funded by partnering international efforts to promote collaboration.

Conclusions

Sub-Saharan Africa has profound unmet needs in surgery and perioperative care. This academically based model helped increase recruitment of trainees, expanded local research, and strengthened stakeholder collaboration in Uganda. Further analysis is underway to determine the impact on surgical disease burden and other important outcome measures.

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Acknowledgments

We thank the Mulago Foundation, Grey Family Foundation, Makerere College of Health Sciences, Dean Sewankambo, University of British Columbia, The Laura Case Trust, Amalthea Trust, AAGBI, The Departments of Surgery, Obstetrics, and Anesthesia at UCSF, Ian Metzler, Ikeda Keita, John Okuonzi, Felicia Lester, Robert Wangoda, John Sekabira, GPAS Scholars and Senior Scholars, Sarah Nakitto, Monica Kabagambe, Medical Teams International, Nathan O’Hara, Jane Fualal, Kayvan Roayaie, Rochelle Dicker, Tony Roche, Stephen Kijambu, Sister Margaret Ajiko, Moses Galukande, and Piotr Blachut.

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Authors and Affiliations

  1. Department of Anesthesia and Perioperative Care, University of California, San Francisco, 513 Parnassus Avenue, Room S-436, San Francisco, CA, 94143, USA

    Michael Lipnick & Gerald Dubowitz

  2. Department of Anesthesia, Mulago Hospital and Makerere University, Kampala, Uganda

    Cephas Mijumbi, Arthur Kwizera & Joseph Tindimwebwa

  3. Department of Surgery, Mulago Hospital and Makerere University, Kampala, Uganda

    Samuel Kaggwa & Jacqueline Mabweijano

  4. School of Public Health, University of California at Berkeley, Berkeley, CA, USA

    Laura Goetz

  5. Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA

    Sudha Jayaraman

  6. Department of Pediatric Surgery, Yale University, New Haven, CT, USA

    Doruk Ozgediz

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  1. Michael Lipnick
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Correspondence to Michael Lipnick.

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Lipnick, M., Mijumbi, C., Dubowitz, G. et al. Surgery and Anesthesia Capacity-Building in Resource-Poor Settings: Description of an Ongoing Academic Partnership in Uganda. World J Surg 37, 488–497 (2013). https://doi.org/10.1007/s00268-012-1848-x

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