World Orthopaedic Concern UK

WOC NEWSLETTER 100  May 2007, PAGE 3

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ETHIOPIA

Sally Tennant, who specialises in feet and children’s orthopaedics, has recently undertaken an extensive Instructional Course in the Ponseti and other techniques for the treatment of Club Foot, at the Black Lion Hospital in Addis Ababa. She reports on the continued enthusiasm among the young doctors in training, and describes the difficulties under which teaching continues. This was one of the earliest teaching hospitals in East Africa and it has a long history of regular visits from orthopaedic surgeons from the US and UK. At this, her most recent teaching visit, Sally reports on the moral (although not financial) support from the charity CURE, who gave their encouragement, and flags. Sally remains anxious about the trainees and pleads that western visitors are sorely needed to maintain the level of instruction, while at the same time realising that visitors cannot, and should not, simply supply sporadic service.

The current Bulletin of the Royal College of Surgeons of England (May 2007) contains a substantial report following visits to Ethiopia by the President, Mr. Bernard Ribeiro, and by Mr. Gordon Williams, a urologist at the Hammersmith Hospital from where he is to retire to live in Ethiopia. He made the comment that “It is an unfortunate fact that many doctors trained in Africa leave in search of better opportunities in developed countries.” He goes on to comment on the part to be played in the rural areas by trained but medically unqualified care workers.

The article in the Bulletin goes on to draw the comparison with the work in Malawi, describing Chris Lavy’s ten year period. Chris had only planned a short visit 12 years ago, but the scenes of desperate need caused him to stay. “We saw children with legs so bowed that their buttocks touched their ankles, and spines so twisted that their chest and pelvis faced in different directions.” Basic maintenance lead, eventually, to the development of a new hospital and the training of OCOs (Orthopaedic Clinical Officers) to provide basic safe care of fractures, for which they have become the “backbone” of the country’s trauma service. Linkage with neighbouring countries lead to the formation of the College of Surgeons of East Africa.

The President of the R.C.S. Mr Bernard Ribeiro, has recently met with Lord Crisp, author of the report “Global Health Partnerships” to discuss the role of the College in encouraging health education and training in Africa. They plan to establish a register of surgeons prepared to work and teach in developing countries. Professor Lavy expresses his appreciation of the Presidential visits and acknowledges the support, both physical and financial, of the College and the major charity, Beit CURE, in the development in Blantyre. He hopes that the College “will encourage UK surgeons to make teaching and service visits… to appraise and accredit time spent overseas and support research. While we have made great progress in Malawi, there are still only four orthopaedic surgeons  for 12 million people.” Mr. Williams echoes these emotions, adding “Working in Africa is an incredibly rewarding experience. There must be hundreds of surgeons who are retired or have holiday to take. They could come out and teach on a regular or irregular basis and take a look at this stunningly beautiful continent.” Chris adds “I recommend that all UK doctors spend some time in the developing world so that they can ground themselves in the realities of what is happening on our planet.”  {“e” bulletin@rcseng.ac.uk}