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Unifying Children’s Surgery and Anesthesia Stakeholders Across Institutions and Clinical Disciplines: Challenges and Solutions from Uganda

  • Phyllis Kisa
  • David F. Grabski
  • Doruk OzgedizEmail author
  • Margaret Ajiko
  • Raffaele Aspide
  • Robert Baird
  • Gillian Barker
  • Doreen Birabwa-Male
  • Geoffrey Blair
  • Brian Cameron
  • Maija Cheung
  • Bruno Cigliano
  • David Cunningham
  • Sergio D’Agostino
  • Damian Duffy
  • Faye Evans
  • Tamara N. Fitzgerald
  • George Galiwango
  • Domenico Gerolmini
  • Marcello Gerolmini
  • Nasser Kakembo
  • Joyce B. Kambugu
  • Kokila Lakhoo
  • Monica Langer
  • Moses Fisha Muhumuza
  • Arlene Muzira
  • Mary T. Nabukenya
  • Bindi Naik-Mathuria
  • Doreen Nakku
  • Jolly Nankunda
  • Martin Ogwang
  • Innocent Okello
  • Norgrove Penny
  • Eleanor Reimer
  • Coleen Sabatini
  • John Sekabira
  • Martin Situma
  • Peter Ssenyonga
  • Janat Tumukunde
  • Gustavo Villalona
Surgical Symposium Contribution
  • 17 Downloads

Abstract

Background

There is a significant unmet need for children’s surgical care in low- and middle-income countries (LMICs). Multidisciplinary collaboration is required to advance the surgical and anesthesia care of children’s surgical conditions such as congenital conditions, cancer and injuries. Nonetheless, there are limited examples of this process from LMICs. We describe the development and 3-year outcomes following a 2015 stakeholders’ meeting in Uganda to catalyze multidisciplinary and multi-institutional collaboration.

Methods

The stakeholders’ meeting was a daylong conference held in Kampala with local, regional and international collaborators in attendance. Multiple clinical specialties including surgical subspecialists, pediatric anesthesia, perioperative nursing, pediatric oncology and neonatology were represented. Key thematic areas including infrastructure, training and workforce retention, service delivery, and research and advocacy were addressed, and short-term objectives were agreed upon. We reported the 3-year outcomes following the meeting by thematic area.

Results

The Pediatric Surgical Foundation was developed following the meeting to formalize coordination between institutions. Through international collaborations, operating room capacity has increased. A pediatric general surgery fellowship has expanded at Mulago and Mbarara hospitals supplemented by an international fellowship in multiple disciplines. Coordinated outreach camps have continued to assist with training and service delivery in rural regional hospitals.

Conclusion

Collaborations between disciplines, both within LMICs and with international partners, are required to advance children’s surgery. The unification of stakeholders across clinical disciplines and institutional partnerships can facilitate increased children’s surgical capacity. Such a process may prove useful in other LMICs with a wide range of children’s surgery stakeholders.

Notes

Acknowledgements

The authors would like to thank all the individuals who participated in the stakeholders’ meeting in 2015. We would also like to thank all the individuals who have assisted on the projects listed in this manuscript and who have endeavored to increase children’s surgery and anesthesia capacity in Uganda over the last 3 years.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Phyllis Kisa
    • 1
  • David F. Grabski
    • 2
  • Doruk Ozgediz
    • 3
    Email author
  • Margaret Ajiko
    • 4
  • Raffaele Aspide
    • 5
  • Robert Baird
    • 6
  • Gillian Barker
    • 7
  • Doreen Birabwa-Male
    • 8
  • Geoffrey Blair
    • 6
  • Brian Cameron
    • 9
  • Maija Cheung
    • 3
  • Bruno Cigliano
    • 5
  • David Cunningham
    • 10
  • Sergio D’Agostino
    • 5
  • Damian Duffy
    • 6
  • Faye Evans
    • 11
  • Tamara N. Fitzgerald
    • 12
  • George Galiwango
    • 13
  • Domenico Gerolmini
    • 5
  • Marcello Gerolmini
    • 5
  • Nasser Kakembo
    • 1
  • Joyce B. Kambugu
    • 14
  • Kokila Lakhoo
    • 15
  • Monica Langer
    • 16
  • Moses Fisha Muhumuza
    • 13
  • Arlene Muzira
    • 1
  • Mary T. Nabukenya
    • 17
  • Bindi Naik-Mathuria
    • 18
  • Doreen Nakku
    • 19
  • Jolly Nankunda
    • 20
  • Martin Ogwang
    • 21
  • Innocent Okello
    • 1
  • Norgrove Penny
    • 22
  • Eleanor Reimer
    • 23
  • Coleen Sabatini
    • 24
  • John Sekabira
    • 1
  • Martin Situma
    • 19
  • Peter Ssenyonga
    • 25
  • Janat Tumukunde
    • 17
  • Gustavo Villalona
    • 26
  1. 1.Department of SurgeryMakerere University School of MedicineKampalaUganda
  2. 2.Department of SurgeryUniversity of Virginia School of MedicineCharlottesvilleUSA
  3. 3.Department of SurgeryYale University School of MedicineNew HavenUSA
  4. 4.Soroti Regional Referral HospitalSorotiUganda
  5. 5.Surgery for ChildrenVicenzaItaly
  6. 6.Department of SurgeryUniversity of British Columbia Faculty of MedicineVancouverCanada
  7. 7.Department of Women’s and Children’s HealthUppsala UniversityUppsalaSweden
  8. 8.Mulago National Referral HospitalUganda Ministry of HealthKampalaUganda
  9. 9.Department of SurgeryMcMaster University Faculty of Health SciencesHamiltonCanada
  10. 10.KidsORAberdeenScotland
  11. 11.Department of AnesthesiologyHarvard Medical SchoolBostonUSA
  12. 12.Department of SurgeryDuke University School of MedicineDurhamUSA
  13. 13.CORSU Rehabilitation HospitalKisubiUganda
  14. 14.Uganda Cancer InstituteKampalaUganda
  15. 15.Department of Paediatric SurgeryOxford UniversityOxfordUK
  16. 16.Department of SurgeryNorthwestern University School of MedicineChicagoUSA
  17. 17.Department of AnesthesiologyMakerere University School of MedicineKampalaUganda
  18. 18.Department of SurgeryBaylor College of MedicineHoustonUSA
  19. 19.Department of SurgeryMbarara University of Science and Technology Faculty of MedicineMbararaUganda
  20. 20.Department of Paediatrics and Child HealthMakerere University School of MedicineKampalaUganda
  21. 21.St. Mary’s Lacor HospitalGuluUganda
  22. 22.Department of OrthopedicsUniversity of British Columbia Faculty of MedicineVancouverCanada
  23. 23.Department of AnesthesiologyUniversity of British Columbia Faculty of MedicineVancouverCanada
  24. 24.Department of Orthopedic SurgeryUniversity of California San FranciscoSan FranciscoUSA
  25. 25.CURE Children’s Hospital of UgandaMbaleUganda
  26. 26.Department of SurgerySaint Louis University School of MedicineSt. LouisUSA

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