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Is it Possible to Train Surgeons for Rural Africa? A Report of a Successful International Program

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Abstract

Background

The critical shortage of surgeons and access to surgical care in Africa is increasingly being recognized as a global health crisis. Across Africa, there is only one surgeon for every 250,000 people and only one for every 2.5 million of those living in rural areas. Surgical diseases are responsible for approximately 11.2% of the total global burden of disease. Even as the importance of treating surgical disease is being recognized, surgeons in sub-Saharan Africa are leaving rural areas and their countries altogether to practice in more desirable locations.

Methods

The Pan-African Academy of Christian Surgeons (PAACS) was formed in 1997 as a strategic response to this profound need for surgical manpower. It is training surgical residents through a 5-year American competency-based model. Trainees are required to be of African origin and a graduate of a recognized medical school.

Results

To date, PAACS has established six training programs in four countries. During the 2009–2010 academic year, there were 35 residents in training. A total of 18 general surgeons and one pediatric surgeon have been trained. Two more general surgeons are scheduled to finish training in 2011. Four graduates have gone on to subspecialty training, and the remaining graduates are practicing general surgery in rural and underserved urban centers in Angola, Guinea-Conakry, Ghana, Cameroon, Republic of Congo, Kenya, Ethiopia, and Madagascar.

Conclusions

The PAACS has provided rigorous training for 18 African general surgeons, one of whom has also completed pediatric surgery training. To our knowledge, this is the only international rural-based surgical training program in Africa.

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References

  1. Ozgediz D, Riviello R, Rogers SO (2008) The surgical workforce crisis in Africa: a call to action. Bull Am Coll Surg 93:10–16

    PubMed  Google Scholar 

  2. Pereira C, Cumbi A, Malalane R et al (2007) Meeting the need for emergency obstetric care in Mozambique: work performance and histories of medical doctors and assistant medical officers trained for surgery. BJOG 114:1530–1533

    Article  CAS  PubMed  Google Scholar 

  3. World Health Organization (2008) World Health Report 2008: Primary Health Care, Now More than Ever. http://www.who.int/whr/2008/whr08_en.pdf. Accessed 13 August 2010

  4. Kakande I (2005) The challenge of surgery in Africa. http://www.asecma.org/articulos/Ignatius_Kakande.pdf. Accessed 14 July 2010

  5. Ajay OO, Adebamowa CA (1999) Surgery in Nigeria. Arch Surg 134:206–211

    Article  Google Scholar 

  6. World population prospects: the 2008 revision (2008) Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. http://esa.un.org/unpp. Accessed 25 July 2010

  7. Mullan F (2005) The metrics of the physician brain drain. N Engl J Med 353:1810–1818

    Article  CAS  PubMed  Google Scholar 

  8. Schmitz CC (2006) Your intergalactic decoder ring has arrived: “Reliability” and “Validity” defined. http://www.facs.org/education/rap/schmitz0506.html. Accessed 13 July 2010

  9. Debas HT, Gosselin R, McCord C et al (2006) Surgery. In: Jamison DT, Breman JG, Measham AR et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York, pp 1245–1260

    Google Scholar 

  10. McCord C, Chowdhury Q (2003) A cost effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynecol Obstet 81:83–92

    Article  CAS  Google Scholar 

  11. Gosselin RA, Thind A, Bellardinelli A (2006) Cost/DALY averted in a small hospital in Sierra Leone: what is the relative contribution of different services? World J Surg 30:505–511

    Article  PubMed  Google Scholar 

  12. Gosselin RA, Maldonado A, Elder G (2010) Comparative cost-effectiveness analysis of two MSF surgical trauma centers. World J Surg 34:415–419

    Article  PubMed  Google Scholar 

  13. Gosselin RA, Heitto M (2008) Cost-effectiveness of a district trauma hospital in Battambang, Cambodia. World J Surg 32:2450–2453

    Article  PubMed  Google Scholar 

  14. Montagu D, Prata N, Campbell MM et al. (2005) Kenya: reaching the poor throught the private sector—a network model for expanding access to reproductive health services. http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/KenyaMontaguFinal.pdf. Accessed 20 June 2010

  15. WHO-Faith-based Organization Consultation (2007) http://www.chagghana.org/chag/assets/files/FBO%20Meeting%20report%20_2_.pdf. Accessed 14 July 2010

  16. Thomas C (2001) Reviving methodist church hospitals in Africa and Asia. New world outlook. http://gbgm-umc.org/nwo/01ma/reviving.html. Accessed 13 August 2010

  17. Blanchard RJ, Merrell RC, Geelhoed GW et al (2001) Training to serve unmet surgical needs worldwide. J Am Coll Surg 193:417–427

    Article  CAS  PubMed  Google Scholar 

  18. White SM, Thorpe RG, Maine D (1987) Emergency obstetric surgery performed by nurses in Zaire. Lancet 330(8559):612–613

    Article  Google Scholar 

  19. Sani R, Nameoua B, Yahaya A et al (2009) The impact of launching surgery at the district level in Niger. World J Surg 3(10):2063–2068

    Article  Google Scholar 

  20. Sohier N, Frejacques L, Gagnayre R (1999) Design and implementation of a training programme for general practitioners in emergency surgery and obstetrics in precarious situations in Ethiopia. Ann R Coll Surg Engl 81:367–375

    CAS  PubMed  Google Scholar 

  21. De Brouwere V, Dieng T, Diadhiou M et al (2009) Task shifting for emergency obstetric surgery in district hospitals in Senegal. Reprod Health Matters 17:32–44

    Article  PubMed  Google Scholar 

  22. Population under age 15 (percent) (2009) US global health policy. http://www.globalhealthfacts.org/topic.jsp?i=82. Accessed 25 July 2010

  23. Kingham TP, Kamara TB, Cherian MN et al (2009) Quantifying surgical capacity in Sierra Leone: a guide for improving surgical care. Arch Surg 144:122–127

    Article  PubMed  Google Scholar 

  24. Joint WHO-MoH facilitators meeting on integrated management for emergency & essential surgical care: towards strengthening primary health care capacities (2008) Monrovia, Liberia. http://infocooperation.org/hss/documents/s15344e/s15344e.pdf. Accessed 13 August 2010

  25. Bickler SW, Kyambi J, Rode H (2001) Pediatric surgery in sub-Saharan Africa. Pediatr Surg Int 17:442–447

    Article  CAS  PubMed  Google Scholar 

  26. Yeo H, Bucholz E, Sosa A et al (2010) A national study of attrition in general surgery training: which residents leave and where do they go? Ann Surg 252:529–536

    Article  PubMed  Google Scholar 

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Correspondence to Jonathan D. Pollock.

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Pollock, J.D., Love, T.P., Steffes, B.C. et al. Is it Possible to Train Surgeons for Rural Africa? A Report of a Successful International Program. World J Surg 35, 493–499 (2011). https://doi.org/10.1007/s00268-010-0936-z

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