It’s Sunday night in Zimbabwe and we just finished two weeks of teaching Trauma and Basic Laparoscopy as part of the educational collaborative we have with the Department of Surgery at the College of Health Sciences at the University of Zimbabwe. The first week we taught spent principles of advanced trauma care to their general and specialty surgical residents and ER doctors (casualty officers as they call them here). We also did trauma case presentations for resident discussion, plain XRAY interpretation, and hands on skills teaching cricothyroidotomy, DPL, and chest tubes. We made ward teaching rounds saw some very interesting and complex patients. In addition we learned some new local styles for case presentations, for example instead of saying the patient is a non smoker or drinker the phrase is “she is women of sober living habits”. We have been learning a lot about their health care. They kept on speaking about patients with “Medical Aid” which, to me, sounded a lot like Medcaid. I thought it was their safety net program for poor people. Instead it actually means the private insurance that people with means can purchase. There is no real safety net so manypeople stay in the hospital trying to raise funds to pay for tests or surgery.
The second week was a great success. We focused first on didatic lectures with videos of laparoscopic operations that could be done with the resources currently at hand. We focused on diagnostic laparoscopy, appendectpmy, cholecystectomy, and treatment of perforated ulcer. We then did inanimate stations of a porcine gallbladder model and then spent 2.5 days in their vetrinary school doing live lap porcine surgery. It was a lot of teaching for the two of us and a bit exhausting but the residents were so interested and engaged so it was very rewarding. We also got the opportunity to learn from their pediatric surgeon who does a lot of laparoscopic surgery how to hand tie an endoloop, certainely cheap and easy and something I can now do back in the US to save money in the OR. I am very pleased with our joint program between the two institutions and we are planning more activities over the next year.
We had some interesting down time at the weekend. We had a lovely dinner at the home of the chairman and then the next day went to a local game reserve. It was amazing to see the plains game, elephants, rhino, cape buffalo, giraffe (including a >6ft tall baby) all walking around in the beautiful country side. Overall a very satisfying trip and well worth the incredible amount of time we spent in the plane to get there.