Establishment of an Orthopedic Training Program
A longstanding goal of my mission to northwest Tanzania has been to establish a recognized program for training physicians to become orthopaedic surgeons. This goal was reached two years ago with the establishment of resident training in nearby Mwanza, the second largest city in Tanzania. The training program is at the Bugondo Medical Centre (BMC), an eleven story hospital built more than 50 years ago.
I first served as a volunteer at the BMC in 1993 and had returned there for a month a year from 1993 through 2005. I ran a program through Health Volunteers Overseas (HVO) for American orthopaedic surgeons to volunteer for a month at a time at the BMC. Our mission was to train general surgeons to provide high quality orthopaedic care to the people of that region. In addition, we provided instructions to physician assistants training at BMC. The program for HVO was highly successful, but BMC closed the program unexpectedly in 2005. We used the remaining money in our Tanzanian bank account to support Dr. Isidor Ngayomeyla in orthopaedic residency training in Kampala, Uganda. The returns from this investment have been tremendous as you will see in what follows.
I spent my annual month of volunteer time during the next three years after 2005 volunteering at various hospitals in neighboring Kenya but did not find a suitable facility to enable me to continue teaching orthopaedic surgery. Two of my orthopaedic volunteers from my program at BMC, Tom Setter and Joe Pilon, had done additional volunteer work in nearby Bukoba, Tanzania and following their lead I went there in 2009. I initially volunteered at the Kagera Regional Hospital there, but I found much better support for my work at the St. Joseph Hospital in Kagondo. Since that time, I have directed my efforts to develop St. Joseph Hospital as a center of orthopaedic care and for reconstructive surgery for victims of trauma. These efforts have been documented in past newsletters.
Simultaneously Dr. Ngayomeyla finished his training in orthopaedic surgery in Kampala and returned to BMC as their first fully trained orthopaedic surgeon. Through my urging he established a training program in orthopaedic surgery. Today the program has five fully trained staff orthopaedic surgeons and five residents training in orthopaedic surgery in their program.
The BMC is a very large hospital with dozens of surgeons but only five operating rooms available during the day. The residents receive valuable experiences in treating the many cases of trauma seen after regular office hours but lack experience in elective and reconstructive surgery. The hospital has some good equipment but at times suture material, orthopaedic implants and instruments are in short supply.
Dr. Ngayomeyla was invited to serve at Kagondo St. Joseph Hospital a few years ago. We offered unlimited time in our theatres, a full supply of implants and good power equipment to perform orthopaedic procedures. One of the fully trained orthopaedic surgeons from BMC now serves at KSJH for a week each month.
In November of 2017 I brought Dr. Albert Katembo, a second-year resident at BMC, to train in elective orthopaedic surgery under my supervision. For me this was the culmination of a 25-year effort to establish orthopaedic training in Northern Tanzania. Dr. Katembo proved to be a very receptive pupil and placed great value on his time with me.
Kagondo St. Joseph Hospital Foundation is now funding second year residents at BMC to accompany the fully trained orthopaedic surgeons from BMC when they spend a week at St. Joseph Hospital. We are paying for transportation costs and St. Joseph Hospital is providing room and board at the hospital during their stay.
Dr. Ngayomeyla, chief of Orthopaedics at BMC, has hailed this as an important step in training their residents. They are gaining experience in a wide spectrum of elective and reconstructive procedures and performing operations under the supervision of certified orthopaedic surgeons. These surgical teams have unlimited access to theatre time while at St. Joseph Hospital. We have come a long way since 1993!
What I have learned. As volunteers, we can advise and financially assist the development of an orthopaedic training program but the program can only be established by the residents of that country. The doctors in the developing nations are as bright and enterprising as anyone in the developed world. With a little help and advice they are accomplishing so much in the field of orthopaedics and at a rapid pace.
During my stay in November of 2017 the water collection system was completed and the season of the short rains started. In two weeks the tanks were already half full. The project was officially opened with officials from the Church and various branches of government attending.
One of thirteen collection tanks
Another advantage of rain water collection is that it does not depend on the underground aquaphor. Just like any other area of the world, too many wells drawing on the aquaphor will drop the water table and result in the need to drill deeper and deeper wells.
Bishop Rwoma, myself and Regional Governor at dedication
A new company is being formed as a result of this new form of construction and the newly trained workers will now have employment. Two large projects involving several buildings are in the planning stages for the area.
Voltage surge protection
In the past two years we have experienced damage to the electrical system in four different areas of the hospital. Through the donations of special donors we have ordered equipment that will prevent voltage surges from further damaging our electrical system. Generally all our donations go directly to patient care but these special donors to this project have given permission to direct their funds to this very necessary project.
You will recall from our last news letter the case of Ines, a 9 year old girl with a disabling burn scar to her left wrist and hand and disfiguring scars to her head. In November I performed the fourth skin graft to her hand. She is now undergoing dynamic splinting and exercises in physical therapy and making great progress. Ines has been skin grafted four times and she never once has complained. We have supplied her with a wig which brought out her beautiful smile. We are also going to fund her further education to a private school where she will be able to catch up with her peers. More information on this case is available in a powerpoint THE DANGERS OF COOKING FIRES.
Ines, smiling,with her mother
During the rest of the year we will complete the installation of the voltage surge protector. We will install air conditioning to the main operating theatre. The heat in the afternoon’s there can be very intense. We must eliminate sweating of the surgeons dripping into the wounds. This will require sealing off one entrance and installing two-way doors in the main entrance and sealing the outside windows. These special projects are supported by very special donors who give permission to fund these projects rather than to direct patient care.
Unless designated in this way your donations will be used for direct patient care. Donations large and small are greatly appreciated. These people are among the most impoverished on the planet and have little or no money for health care. Please continue to support us financially. See our “support us” page for donation and mailing instructions.
Wend Schaefer, M. D.
President, Kagondo St. Joseph Hospital Foundation