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Strengthening Rwandan Surgery: Surgical Residents’ Perspective

Guest bloggers Gita Mody, Robin Petroze & Edmond Ntaganda discuss efforts to strengthen surgical care in Rwanda.

In March 2011, the Rwanda Surgical Society hosted a workshop in Kigali on the theme “Strengthening Rwanda Surgery.” Rwanda has been extremely successful in combating morbidity and mortality due to communicable diseases and is now actively tackling treatment of non-communicable diseases, many of which require surgery.  However, there are very few surgeons in Rwanda, and over the past several years, there has been growing interest amongst local, regional and international partners to promote Emergency and Essential Surgical Care as well as specialty surgical care in Rwanda.  Therefore, the purpose of the workshop was for stakeholders in Rwandan surgery to meet one another, form the basis of lasting partnerships, and strategize on cooperatively expanding surgical services.  The attendees were forty-five surgeons, anesthesiologists, industry representatives, residents, students, and others from five countries.  There were some long-term and some brand new participants in Rwanda surgery, but all were eager to form a collaborative with a shared vision of a Rwandan-owned, sustainable surgical training and delivery program.

Attendees to the March, 2011 Strengthening Rwanda Surgery workshop in Kigali, Rwanda.

The hope in holding the meeting was that we could establish a framework for ongoing communication, decrease duplication, and ensure that international partners were working within a fully Rwandan agenda in order to improve surgical outreach projects in Rwanda.  The result of the workshop was a set of recommendations to the Republic of Rwanda Ministry of Health (MOH) on necessary steps to growing surgical capacity and the formation of an ad-hoc team – the Strengthening Rwanda Surgery (SRS) advising group. Developing and maintaining multi-disciplinary partnerships was felt by the workshop participants to be central to achieving our goals.

The first of the SRS meeting recommendations stated strengthening in-country surgical and anesthesia postgraduate training is a priority.  Therefore, the international steering committee of the SRS advising group has been meeting via regular conference calls with a focus on discussing goals, strategy, and coordination of curricula and resources.  Training the next generation of surgeons will provide not only more caregivers but also the leaders who will shape the future of surgical care delivery in Rwanda.  Our focus on training surgical and anesthesia specialists was in line with the existing Rwanda MOH Human Resources for Health (HRH) Strategic Plan and overall health sector strategic plan. The foresight of the Rwanda Surgical Society in holding the initial SRS meeting to enhance communication and coordination toward this common goal was lauded by the Rwanda MOH.

On February 13, 2012 a 2nd annual SRS meeting was held in Kigali.  There, surgeons and anesthesiologists discussed ways in which the SRS group could synergize with the soon to be implemented cross-disciplinary HRH scale-up plan.  The group felt energized by this and other innovations in Rwanda healthcare training and delivery, which will provide the context and resources to make the SRS mission successful.

As surgical residents from different institutions and countries, we found the exercise of planning the SRS workshops both educational and inspiring.  In the process, we were given the opportunity to think deeply about where surgery falls within Rwanda’s healthcare priorities and how to begin building a concrete action plan for expanding services.  From our mentors, we learned the value of engaging in partnership and complementary activities amongst those with diverse backgrounds but a common goal: to strengthen surgery in Rwanda.  The results have kept us a rapt audience to the evolution of surgical education and care delivery in Rwanda.

Gita Mody is a general surgery resident at the Brigham and Women’s Hospital, Robin Petroze is a general surgery resident at the University of Virginia School of Medicine, and both are Fogarty International Research Clinical Fellows.  Edmond Ntaganda is a surgery postgraduate at the National University of Rwanda. Contact:

  1. What Gita, Robin, Edmond, Albert and all those in this picture are doing in Rwanda is inspiring. I am a medical student who was part of the same Fogarty International Clinical Research training program cohort (2010 – 2011) and I remember a particularly telling discussion that I had with Robin and Albert during our training about the number of surgeons in Rwanda. They mentioned that there are 30 surgeons in all of Rwanda (see here), a country with a population of 10.5 million. That works out to approximately 350,000 people per surgeon. When compared to the United States—7200 people per surgeon (see here)—the number is quite stark; there are more people per surgeon in Rwanda by a factor of about 50.

    When I work out the numbers, the work described above and the collaboration which is now in its 2nd year takes on all the more importance. Thanks for the great work you are all doing.

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