In December 2018, Dr. Vanessa Fawcett attended the annual meeting of the College of Surgeons of East, Central, & Southern Africa (COSECSA) in Kigali, Rwanda. As Chair of the Canadian Association of General Surgeons (CAGS) Global Surgery Committee, Dr. Fawcett is collaborating with COSECSA to further surgical education in the region. Dr. Fawcett then taught at the Coast Provincial General Hospital Mombasa, Kenya, accompanying a surgeon from University of British Columbia for his first visit to that hospital under a partnership between COSECSA and CAGS. Dr. Fawcett is a key team member of the Office of Global Surgery (OGS), which has established a teaching partnership with the Mombasa hospital.
Dr. Abdullah Saleh, the director of the OGS, also attended the COSECSA meeting in Kigali and presented the results of a systematic review and establishing a framework on the ethics of global surgery alongside Tessa Elliott, a researcher from McMaster University. This presentation was the kick-off ahead of the Bethune Round Table conference June 6-9th 2019, being hosted for the first time at the University of Alberta and hosted by the OGS. The office will also be hosting two webinars in the next few months with global participation to build on the framework and flesh it out ahead of the Bethune Round Table.>
Volunteer surgeons from the divisions of otolaryngology and plastic surgery have also joined the OGS - an umbrella group that coordinates surgeons who volunteer to help under-serviced countries. Under the OGS umbrella, both divisions carried out missions in Kenya last year. The Academic Model for Providing Access to Healthcare (AMPATH) - a network of top North American universities that engage in overseas surgery development - asked the Division of Otolaryngology to do surgical camps in Moi Teaching Referral Hospital in Eldoret - a region in Western Kenya.
Dr. Andre Isaac, a former University of Alberta otolaryngology resident now working in the U.S., who was on the OGS team that visited Kenya says "The goal is sustainability."
Eldoret has a small otolaryngology department whose main challenges are in head and neck cancer surgery and ear surgery. The only centre equipped to perform radiation and big head and neck cancer operations is more than 300 kilometers away in Nairobi. Many patients can't afford even transport let alone the cost of treatment and end up dying. "We're trying to establish a comprehensive hearing health program - a viable and sustainable way to get hearing aids to patients, along with capacities to surgically treatchronic ear disease. One step towards sustainability is identifying the specific surgical procedures we're going to train them to do," Dr. Issac says.
The Division of Plastic Surgery's burns team, including Drs Josh Wong and Regan Guilfoyle, visited the hospital - Kenya's second National Referral Hospital, which provides specialized care to clients in Western Kenya. They spent an operating day there and gave presentations. Dr. Guilfoyle says, "We found a couple of things we can help with that would dramatically improve the situation, such as the rehabilitation team. At our centre, certain burn patients would have skin graft and potentially treated and out the door in three weeks. These same patients in Moi are there for three to five months because they're waiting for OR. If you make it more efficient it will translate into shorter wait times for those kids - most of them were under 12.
To help fix this, OGS organized a visit in November of Drs Clifford Mwita and Ruth Negesa, General Surgery Residents in Kenya, to the University of Alberta. Building capacity in under-serviced countries to create sustainability is an OGS goal. Dr. Negesa says, "It's been a great experience. Getting exposure to a different way of doing things, including the structure of rotations and how to work as a team, will be beneficial back home." She said her experience in the burn unit was of particular interest.