Friday, September 30, 2011

Training of African surgeons on board

Normally I don't copy-paste official articles, but this one is special since I got to be the one who took the photos while Dr Bruce was training a doctor from Kenya on a hernia patient. Originally I was asked only to take some snaps of a female patient, but then Dr Bruce needed pictures during the surgery as well to "use them in medical publications" :) No pressure, tho... So I got to be inside the OR and observe up close and personal.

Here is the article that tells you way better than i would why it is crucial to train African doctors...


"Dr. Bruce Steffes, volunteer CEO of Pan-African Academy of Christian Surgeons (PAACS), says that in some areas of Africa, there is only one surgeon for two and a half million people. This startling and appalling fact has triggered the existence of PAACS, which seeks to respond to the great need for surgeons in the African culture – and, more importantly, to highlight “the importance of spiritual healing as well as medical healing.”

This five-year surgical training program uses rural mission hospitals in several countries to train national physicians in modern surgical procedures, at low cost, with the aim of retaining them to practice within Africa. A nondenominational, volunteer service organization, PAACS serves Africa’s poor by maintaining faith-based health care facilities as it builds capacity within the health care system. Although mission hospitals provide many services, they only make money on surgeries. With so few surgeons, it is difficult to maintain these hospitals.

"Try to focus on the white line, that's the muscle. No, don't cut it. Yes, I know, hard to focus, there is too much red there. Just stitch around it..." Dr Bruce talking to me and to the surgeon simultaneously. :)
This plastic will serve as the new wall in the muscles so the organs cannot come out and form a bulge again.
Operating under the umbrella of the Christian Medical and Dental Association, candidates must be African graduates from recognized medical schools, be less than 40 years of age, have a valid medical license in their home and training countries, and be fluent in English. Training is given at a well-established evangelical mission hospital in Africa, under the supervision of board-certified surgeons. PAACS is affiliated with the Loma Linda University in Loma Linda, California.

Dr. Steffes, who is completing his eighth mission with Mercy Ships, has spent the past three months training three well-qualified trainees in general surgery, anesthesia and maxillofacial surgery. This is the second time the Africa Mercy has been a training site for PAACS residents.


Dr. Agneta Odera is a fourth-year PAACS general surgery resident from Tenwek Hospital in Kenya. She will graduate next year and plans to begin a three-year pediatric surgery training program before returning to Tenwek Hospital to begin a practice as a missionary surgeon. “Everywhere in Africa there is a need for good health care,” she said. “We have capable people, but after they are trained, they go to the west where there is more financial reward.” She is dedicating her life to being part of the solution for medical needs in Africa.

Dr. Bruce Steffes, volunteer CEO of PAACS, trains resident  Dr. Agneta Odera in a surgery in the OR of the Africa Mercy. Dr. Arega Fekadu Leta (see picture) is from Gimbie, Ethiopia, and is also a fourth-year PAACS general surgery resident from Tenwek Hospital. After graduation, he plans to return as the only surgeon at the Gimbie Adventist Hospital. “This program is the best way of building capacity for the neediest in Africa, since we need equipment and financial support. This is also a good way to address and expand the good news of the Gospel. Most countries (in Africa) are 75% Muslim, so there’s a huge need,” he said. “We witness to patients and crew and won’t discharge patients unless they have been told the Gospel.”

Dr. Philadelphie Dembele, from Mali, is a rising fourth-year general surgery resident from Bongolo Hospital in Lebamba, Gabon. He will graduate in 2013 and return to the Christian and Missionary Alliance Women’s and Children’s Hospital in Koutiala, Mali, where he will be the only general surgeon. “The (Mercy Ships) OR is so well-organized with many things we don’t have,” he said. “Organization is important to change things, and there’s a big difference between what I have here and what I have when I go home.”

“It makes me angry when people say that with so many differences in background that people can’t work together. Here at Mercy Ships, we are doing it, and we are doing it  efficiently,” said Dr. Agneta Odera.

At the end you need to stitch everything back together layer after layer after layer...
The training program does not feature the usual lecture approach, nor does it require the customary thesis of most master’s degree programs. That material is included in the reading, patient care, rounds, operating room, conference schedule, and the constant preparation of reports and presentations. Clinical and academic study, spiritual and ethical training, research projects, written reports, a study of current surgical texts, log-book keeping, post-operative care, hands-on training in the operating room under supervision of board-certified surgeons, and in-service examinations are all included in the training program. By 2020, it is hoped the program will graduate 20 to 25 surgeons a year.

“We are trying to make our residents the best surgeons in Africa. But, literally, the most important thing is not the 50 to70 more years we can give by physical healing. It is the spiritual healing that gives them eternal life,” said Dr. Steffes.
" (by Elaine Winn)

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