Surgery and Anesthesia Capacity-Building in Resource-Poor Settings: Description of an Ongoing Academic Partnership in Uganda
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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.
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.
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.
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.
KeywordsMulago Hospital Academic Collaboration Senior Scholar Academic Partnership Medical Education Partnership Initiative
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.
- 1.Jamison D, Breman J, Measham A (eds) (2006) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New YorkGoogle Scholar
- 2.WHO (2004) The global burden of disease: 2004 update. http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html. Accessed 16 Feb 2011
- 3.WHO (2012) Projections of mortality and burden of disease, 2004–2030. http://www.who.int/healthinfo/global_burden_disease/projections/en/index.html. Accessed 19 July 2012
- 7.Anonymous (2011) Consortium of Universities for global health. http://www.cugh.org/. Accessed 5 Dec 2011
- 11.Anonymous (2012) CNIS—Canadian network for international surgery. http://www.cnis.ca/. Accessed 18 Jan 2012
- 12.Anonymous (2012) IVUmed. http://www.ivumed.org/. Accessed 18 Jan 2012
- 13.Anonymous (2011) SIHS programs—surgeons overseas. http://www.humanitariansurgery.org/. Accessed 4 Dec 2011
- 15.Anonymous (2012) World Bank Data: GNI per capita. http://data.worldbank.org/indicator/NY.GNP.PCAP.CD. Accessed 23 Jan 2012
- 18.Galukande M, Kijjambu S, Luboga S (2006) Improving the recruitment of surgical trainees and training of surgeons in Uganda. East Central Afr J Surg 11:11–24Google Scholar
- 20.Anonymous (2011) NGOs working to reduce poverty. http://www.independent.co.ug/supplement/role-of-ngos-in-poverty-eradication/1581-ngos-working-to-reduce-poverty. Accessed 4 Dec 2011
- 21.Anonymous (2012) Paris declaration and Accra agenda for action. http://www.oecd.org/document/18/0,3746,en_2649_3236398_35401554_1_1_1_1,00.html. Accessed 16 Jan 2012
- 22.Holm JD, Malete L (2010) Nine problems that hinder partnerships in Africa: the chronicle of higher education. http://chronicle.com/article/Nine-Problems-That-Hinder/65892/. Accessed 17 Feb 2011
- 23.Anonymous (2012) Uganda anaesthesia fellowship programme—AAGBI. http://www.aagbi.org/international/overseas-anaesthesia-fund/uganda-anaesthesia-fellowship-programme. Accessed 1 Feb 2012
- 24.Anonymous (2011) GPAS—global partners in anesthesia and surgery. http://www.globalpas.org/projects/capacity-building/scholarships/. Accessed 20 Nov 2012
- 25.Anonymous (2011) Intensive care uganda. http://intensivecareuganda.com/about.html. Accessed 8 Dec 2011
- 32.Fualal J, Moses W, Jayaraman SP et al (2012) Characterizing thyroid disease and identifying barriers to care and treatment in Uganda. World J Endoc Surg 4(2):47–53Google Scholar
- 35.Kimuli T (2011) Blood and body fluid exposures among surgeons in Mulago Hospital. East Central Afr J Surg 16:86–93Google Scholar
- 36.Anonymous (2012) GPAS—Global Partners in Anesthesia and Surgery. http://www.globalpas.org/projects/harmonization/calendar/. Accessed 20 Nov 2012
- 42.Kingham TP, Price R, Casey K, et al (2011) Beyond volunteerism: augmenting surgical care in resource-limited settings. http://www.facs.org/fellows_info/bulletin/2011/jul11bullet.html
- 49.Anonymous (2000) Guidelines for health care equipment donations. http://www.who.int/hac/crises/hti/appeal/medical_supplies/en/. Accessed 5 May 2012
- 50.Petroze R, Mody G, Ntaganda E (2011) International academic collaboration in surgical development: the inaugural meeting of the strengthening Rwanda surgery initiativeGoogle Scholar
- 54.Anonymous (2011) IGOT—Institute for Global Orthopaedics and Traumatology. http://www.globalorthopaedics.org/. Accessed 4 Dec 2011
- 63.Simister N, Smith R (2010) Monitoring and evaluating capacity building: is it really that difficult? Available at: http://www.intrac.org/resources.php?action=resource&id=677. Accessed 5 May 2012