The desire to provide medical care to underserved areas is nothing new to medicine, and represents one of the primary reasons many young women and men continue to choose this vocation. Many physicians in academic and private practices find teaching/training to be one of the most rewarding aspects of their profession. There is a long history of international collaboration in educational efforts and humanitarian activity within otolaryngology-head and neck surgery (Fagan 2012; Isaacson 2014; Pearce et al. 2013). Members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) continue to strive to collaborate with international colleagues in supporting educational efforts in developing countries. However, most physicians in both academic and private practices do not have the flexibility to spend extended times abroad in humanitarian activities due to family and work obligations. This article outlines the experience and ongoing collaborative efforts in East Africa with graduates of the University of Cape Town Karl Storz Head and Neck Surgery (UCTKSHNS) Fellowship Program in Cape Town, South Africa and presents a successful model for humanitarian outreach to developing countries.
Surgery is the only treatment option for head and neck cancer in many African countries that either do not have radiotherapy facilities, or where facilities are inadequate (Abdel-Wahab et al. 2013). The UCTKSHNS Fellowship is the only head and neck fellowship in Sub-Saharan Africa, and is modelled on similar fellowships in the USA. Fellows are either qualified otolaryngologists or general surgeons. The first 10 fellows have emanated from Uganda, Kenya, Nigeria, Senegal, Ghana (2), Tanzania, Rwanda, Malawi, and currently, Zimbabwe (Fig. 1). All have returned to teaching hospitals in their own countries to establish head and neck programs and teach others what they have learned. The next two fellows are from Nigeria and Ethiopia. Previously there were no trained head and neck surgeons in Sub-Saharan Africa and procedures such as parotidectomy, laryngectomy and neck dissection were not performed or taught in public hospitals in many countries (Fagan and Jacobs 2009).
The University of Cape Town does not have the capacity to provide meaningful ongoing academic support to the fellows upon their return to their home countries. This has created a window of opportunity for members of the AAO-HNS to step in and provide ongoing support for these head and neck surgeons to establish and grow their head and neck programs.
From 2009 to 2014, the authors organized 1–2 week educational workshops with graduates of the UCTKSHNS Fellowship Program. These surgery camps have thus far focused on collaboration with physicians in the East African countries of Kenya, Rwanda, Tanzania, and Uganda. Endeavors were designed to build relationships and to continue to support head and neck surgeons as they finish their head and neck surgery training and transition to academic practice in their respective home countries.
The surgery camps have been organized in major academic centers, often in the National Referral Center hospital in the capital city of the respective country. Hosting these workshops at large hospitals at major teaching institutions has allowed maximal participation of local otolaryngologist-head and neck surgeons, general surgeons, oral surgeons, and residents-in-training. Several of the workshops have been organized to coincide with national ENT society meetings so as to maximize the number of participants. Locating many of the workshops in major teaching hospitals has afforded facilities to incorporate didactic lectures and cadaver labs into the surgery camps; although some workshops have been organized in nearby locations due to operating room constraints at the major university hospitals. Surgical cases following the lectures and cadaver labs have allowed opportunities for patient care and hands-on mutual learning experiences. In many cases, local physicians and residents-in-training have travelled hundreds of miles and across borders to attend these workshops.
Relationships established during these workshops have created further opportunities for educational collaboration for the faculty and residents of the East African programs. Many have thereafter attended AAO-HNS annual meetings and other US otolaryngology-head and neck surgery meetings; as well as participated in short-term visits to US Academic programs.