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Online Pre-Conference Discussion: Innovation and Collaboration for Surgical & Anaesthetic Care in Uganda

By Michael Lipnick | 02 Sep, 2015

- How can high-level reports translate to local relevance and action in LMICs?
- What is the role of international NGOs & academic collaborations in surgical & anesthetic capacity building?
- What are potential strategies for increasing the role of allied health professionals to increase access to surgical services?

Since 2010, Global Partners in Anesthesia & Surgery (GPAS) and partners have hosted three conferences to help promote harmonization among global surgery and anesthesia efforts in Uganda. The upcoming Fourth Conference on Innovation & Collaboration for Surgical Disease in Uganda will bring together key stakeholders to strategize how to increase access to high-quality surgical and perioperative services in Uganda. The conference will take place September 25-26 in Entebbe, Uganda with pre and post conference workshops and sub group meetings.

Ahead of the conference we hope to initiate this online pre-conference forum to facilitate discussion among conference participants, interested parties who cannot attend, and the public health community.

There are three sub-themes that will be discussed at the 2015 conference (Listed above). Please add questions, commentary or resources to help generate productive discussion in these areas. These comments will be used to guide further dialogue at the conference. Thank you for your participation.

Attached resources:

Replies

 

Cathy kilyewala Replied at 11:33 AM, 5 Sep 2015

In the quest to increase access to high quality surgical, peri and post operative care in Uganda, what do we think surgical camps score?

How sustainable are they?

What is their impact on training?

And how can they be made more effective?

What would be the best alternative to surgical camps?

Obieze Nwanna - Nzewunwa Replied at 12:49 PM, 5 Sep 2015

I think surgical camps play their role. Although public sector healthcare
in Uganda is free, there are challenges with quality in the public sector
especially in areas with very low surgeon: patient ratio. Despite the free
care access to care is poor because the primary level facilities are not
performing the basic surgeries within their purview (lumpectomy,
appendectomies etc) for that reason, the secondary level facilities are
overloaded with basic surgical cases which then crowd out the cases that
should be seen at the regional referral level.
I see surgical camps as a means of debulking the massive surgical burden
which the regional referral hospitals see.
Also, the surgical camps offer certain skills or surgeries which may be
unavailable in particular are eg. VVF repair. There is a VVF camp which is
conducted in different parts of Uganda and I think it is helpful in places
that lack the skill to handle this.
Finally, Surgical camps can strengthen the referral system, they can
identify cases that medical officers or clinical officers may be unable to
identify due to their level of training or skills.
Surgical camps, if designed properly, can be used as an opportunity to
teach the local clinical officers or medical officers surgical skills.
About sustainability, this depends on the government and policymakers. If
it is prioritized and included in the budget then sustainability is not
going to be an issue. I think the VVF camp which I witnessed in Soroti ,
Uganda was supported by the MoH of Uganda. Such initiatives should be
encouraged.

Surgical camps do their part in LMIC settings. In a fully functional heath
system with equal access, they would be less important.

John Wright Replied at 6:50 AM, 9 Sep 2015

Do mobile operating theatres have a role to play in providing greater access to surgery for rural communities in Uganda and elsewhere?

They require reasonable roads, obviously, but they have been used successfully in the Australian outback, for example, to deliver general surgery to rural Aboriginal populations who live hundreds of miles from the nearest hospital; extensively in the UK and Europe; and even on the Caribbean island of Bonaire (where a mobile served as the main operating theatre for months while the main hospital theatre was being refurbished).

The mobiles have integral anaesthetic rooms, OR and two-patient recovery areas and have a back-up generator and can move around a country to where the need is greatest. They are used extensively for general surgery, cataract, orthopaedic and maternity services - could they be the answer to creating greater access to surgery for rural and remote populations?

Catherine Apio Replied at 4:23 PM, 10 Sep 2015

From a Ugandan point of view and having participated in some camps, i can surely say that they serve a life saving purpose. Much as they still have some gaps to fill like post operative care, they still acomplish much that i would myself be more than happy to help whenever asked in any medical camp and in any part of the country! I do wish that it would be better for the specialists or one of them to stay abit longer with the local health facility monitoring and guiding on how to carefully manage the patients because out of experience i noticed on several occasions the eam is so exhausted and tired, they rush out of the place leaving vulnerable patients under the care of not fully trained workers in that field. Also preoperative care needs to be rehearsed in details as a group of participants with EVERY BODY i mean even the cleaners also!
To sustain this needs enoemous government and international support which needs active not theoretical action.

This Community is Archived.

This community is no longer active as of December 2018. Thanks to those who posted here and made this information available to others visiting the site.