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Scaling Sustainable Surgical Training in Ethiopia

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A groundbreaking ReSurge and Stanford University study found that one surgeon in a low-income country can treat 10,000 patients in their career. If they become a full-time surgeon-trainer, they can transform over 400,000 lives in their lifetime by their succeeding trainees. Scaling surgical training can create a substantial multiplier effect across generations!

In Ethiopia, we’re training a new generation of African surgeons. By incorporating Proximie’s Innovation Hub, we are scaling and improving access to surgical care within Ethiopia and across Africa. Overall Ethiopia is becoming a center for Pan-African learning, collaboration, and innovation in global surgery.

Emerging Frontiers: Innovation in Surgical Care

ReSurge International and Proximie recently piloted an exciting initiative establishing a Proximie Plastic Surgery Innovation Hub at ALERT Hospital in Addis Ababa, Ethiopia. Founded by Plastic and Reconstructive Surgeon, Dr. Nadine Hachach-Haram, Proximie is a digital surgical connectivity software. It enables multiple fields of view of the operating room with collaboration tools that facilitate remote training, mentorship, and upskilling.

ReSurge International Partners with Proximie

We’re excited to integrate Proximie’s digital software into ReSurge’s world-class training programs. Ninety percent of ReSurge surgeries are done by local physicians trained in 17 countries across Africa, Asia, and Latin America. ReSurge was one of the first organizations to move away from the surgical fly-in model in the 1990s and invest in the training of local surgical teams. With Proximie, surgical teams can collaborate remotely —sharing expertise, peer-to-peer support, and mentorship improving training within and across borders.

Surgical teams at ALERT Hospital can leverage the technology to address various training objectives and challenges, for example, surgical trainees’ limited visual access to cases in the operating theater. Teams can collaborate across Africa, improving and scaling the quality of surgical care. Residents can call in, learn, and collaborate across borders in places like Burundi, where no residency program exists. Ultimately, this integration will address barriers to accessing surgical training opportunities within Africa.

This couldn’t have been possible without ALERT Hospital. It has one of the most robust plastic and reconstructive training programs across the College of Surgeons of Eastern, Central, and Southern Africa (COSECSA).

“We are so grateful for the help. It is a perfect match with the dream of the department in regards to uplifting the teaching process. I would like to thank Resurge International and Proximie on behalf of all the beneficiaries. I am proud of ALERT’s administration, quality team, IT procurement, unit maintenance, and operation theater staff.”

– Dr. Abraham Gebreegziabher

Ethiopia: An Emerging Hub for Global Surgery

This is the latest in a series of investments toward in-country capacity building in Ethiopia in conjunction with key industry milestones that the Ethiopian surgical community has been at the forefront of. Last year, 17 new certified reconstructive surgeons graduated from Sub-Saharan Africa through COSECSA. Moreover, a total of 171 surgical trainees from countries including Ethiopia, Kenya, Zambia, and Zimbabwe took their exams. This cohort represented the largest in COSECSA history.

While ReSurge was in Ethiopia for the COSECSA graduation, we pioneered a microsurgery workshop with Stanford Plastic Surgery. We used a Stanford microsurgery curriculum to test whether smartphones can provide the magnification necessary to train surgeons in microsurgery. Microsurgery is a crucial component of surgical care — with success rates as high as 97%-99% in high-income countries. However, it remains largely nonexistent in Sub-Saharan Africa. Therefore, finding a feasible way for surgeons to perform microsurgery in Africa is critical to bridging the global surgical disparities. As a result of this partnership, African surgical trainees continued to grow their skills in microsurgery techniques.

“ALERT is one of the pioneers in plastic and reconstructive surgery and is now trying to establish a microsurgery service and training program. We were looking for a collaboration to make our dream a reality. This collaboration with Resurge will serve as a springboard to advance microsurgery in Ethiopia.”

– Abraham Gebreegziabher

Training in Action

This new integration with Proximie will help advance and scale our training in Ethiopia. On this recent trip, we held another one-week microsurgery workshop at ALERT Hospital. As a result, visiting surgeons and residents collaborated with local surgical teams on various cases, including addressing traumatic and ballistic injuries.

These initiatives have fostered interregional collaboration, enthusiasm, and synergy among African surgical trainees, residents, and partners. We recently connected with Dr. Bizoza Yves from Burundi who will be training to become the first plastic and reconstructive surgeon in Burundi. Additionally, we met with a dynamic cohort of African junior residents and trainees eager to learn and collaborate. They underwent training sessions and lectures on microsurgery, anesthesiology, and general reconstruction. Ultimately, this is the interregional and bidirectional learning we are excited about!

What’s Next?

In Africa, many countries don’t have a plastic and reconstructive surgery training program. Therefore, young African surgeons go abroad for academic and professional opportunities in global surgery. ALERT is on track to become the first training center in microsurgery within Africa, while further enabling the training of plastic and reconstructive surgeons throughout the continent. We plan to support its continued growth as a center of excellence within the region. 

“The dream is coming true. Young Ethiopian surgeons can now train in microsurgery in their home country, and the hope is that each young visiting African surgeon who learns at this center will bring that knowledge back to their home countries and build out their own plastic and reconstructive surgery training programs.”

 – Natalie K Meyers, MPH, Chief Program Officer at ReSurge International

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