Skip to main content
Erschienen in: World Journal of Surgery 3/2011

01.03.2011

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

verfasst von: Jonathan D. Pollock, Timothy P. Love, Bruce C. Steffes, David C. Thompson, John Mellinger, Carl Haisch

Erschienen in: World Journal of Surgery | Ausgabe 3/2011

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Ozgediz D, Riviello R, Rogers SO (2008) The surgical workforce crisis in Africa: a call to action. Bull Am Coll Surg 93:10–16PubMed Ozgediz D, Riviello R, Rogers SO (2008) The surgical workforce crisis in Africa: a call to action. Bull Am Coll Surg 93:10–16PubMed
2.
Zurück zum Zitat 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 114:1530–1533CrossRefPubMed 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 114:1530–1533CrossRefPubMed
5.
Zurück zum Zitat Ajay OO, Adebamowa CA (1999) Surgery in Nigeria. Arch Surg 134:206–211CrossRef Ajay OO, Adebamowa CA (1999) Surgery in Nigeria. Arch Surg 134:206–211CrossRef
6.
Zurück zum Zitat 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 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.
9.
Zurück zum Zitat 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 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
10.
Zurück zum Zitat McCord C, Chowdhury Q (2003) A cost effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynecol Obstet 81:83–92CrossRef McCord C, Chowdhury Q (2003) A cost effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynecol Obstet 81:83–92CrossRef
11.
Zurück zum Zitat 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 30:505–511CrossRefPubMed 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 30:505–511CrossRefPubMed
12.
Zurück zum Zitat Gosselin RA, Maldonado A, Elder G (2010) Comparative cost-effectiveness analysis of two MSF surgical trauma centers. World J Surg 34:415–419CrossRefPubMed Gosselin RA, Maldonado A, Elder G (2010) Comparative cost-effectiveness analysis of two MSF surgical trauma centers. World J Surg 34:415–419CrossRefPubMed
13.
Zurück zum Zitat Gosselin RA, Heitto M (2008) Cost-effectiveness of a district trauma hospital in Battambang, Cambodia. World J Surg 32:2450–2453CrossRefPubMed Gosselin RA, Heitto M (2008) Cost-effectiveness of a district trauma hospital in Battambang, Cambodia. World J Surg 32:2450–2453CrossRefPubMed
17.
Zurück zum Zitat Blanchard RJ, Merrell RC, Geelhoed GW et al (2001) Training to serve unmet surgical needs worldwide. J Am Coll Surg 193:417–427CrossRefPubMed Blanchard RJ, Merrell RC, Geelhoed GW et al (2001) Training to serve unmet surgical needs worldwide. J Am Coll Surg 193:417–427CrossRefPubMed
18.
Zurück zum Zitat White SM, Thorpe RG, Maine D (1987) Emergency obstetric surgery performed by nurses in Zaire. Lancet 330(8559):612–613CrossRef White SM, Thorpe RG, Maine D (1987) Emergency obstetric surgery performed by nurses in Zaire. Lancet 330(8559):612–613CrossRef
19.
Zurück zum Zitat 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):2063–2068CrossRef 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):2063–2068CrossRef
20.
Zurück zum Zitat 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 81:367–375PubMed 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 81:367–375PubMed
21.
Zurück zum Zitat De Brouwere V, Dieng T, Diadhiou M et al (2009) Task shifting for emergency obstetric surgery in district hospitals in Senegal. Reprod Health Matters 17:32–44CrossRefPubMed De Brouwere V, Dieng T, Diadhiou M et al (2009) Task shifting for emergency obstetric surgery in district hospitals in Senegal. Reprod Health Matters 17:32–44CrossRefPubMed
23.
Zurück zum Zitat Kingham TP, Kamara TB, Cherian MN et al (2009) Quantifying surgical capacity in Sierra Leone: a guide for improving surgical care. Arch Surg 144:122–127CrossRefPubMed Kingham TP, Kamara TB, Cherian MN et al (2009) Quantifying surgical capacity in Sierra Leone: a guide for improving surgical care. Arch Surg 144:122–127CrossRefPubMed
25.
Zurück zum Zitat Bickler SW, Kyambi J, Rode H (2001) Pediatric surgery in sub-Saharan Africa. Pediatr Surg Int 17:442–447CrossRefPubMed Bickler SW, Kyambi J, Rode H (2001) Pediatric surgery in sub-Saharan Africa. Pediatr Surg Int 17:442–447CrossRefPubMed
26.
Zurück zum Zitat 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 252:529–536CrossRefPubMed 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 252:529–536CrossRefPubMed
Metadaten
Titel
Is it Possible to Train Surgeons for Rural Africa? A Report of a Successful International Program
verfasst von
Jonathan D. Pollock
Timothy P. Love
Bruce C. Steffes
David C. Thompson
John Mellinger
Carl Haisch
Publikationsdatum
01.03.2011
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 3/2011
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-010-0936-z

Weitere Artikel der Ausgabe 3/2011

World Journal of Surgery 3/2011 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.