Johannes J Fagan1, Jeffrey Otiti2, Joyce Aswani3, Anna Konney4, Evelyne S Diom5, Kenneth Baidoo6, Paul A Onakoya7, Rajab M Mugabo8, Patrick Noah9, Victor Mashamba10, Innocent Kundiona11, Mainasara Garba12, Melesse G Biadgelign13, Chege Macharia14, Mesele Bogale15, Wayne M Koch16. 1. Division of Otolaryngology, University of Cape Town, Cape Town, South Africa. 2. Uganda Cancer Institute, Kampala, Uganda. 3. Department of Otolaryngology, University of Nairobi, Nairobi, Kenya. 4. Department of Otolaryngology, Komfo Anokye Teaching Hospital, Kumasi, Ghana. 5. Department of Otolaryngology, Université Assane Seck, Ziguinchor, Senegal. 6. Department of Otolaryngology, Korle Bu Teaching Hospital, Accra, Ghana. 7. University College Hospital, University of Ibadan, Ibadan, Nigeria. 8. Department of Otolaryngology, King Faisal Hospital, Kigali, Rwanda. 9. College of Medicine, University of Malawi, Blantyre, Malawi. 10. Department of Otorhinolaryngology, Muhimbili National Hospital, Dar Es Salaam, Tanzania. 11. Department of Surgery, Parirenyatwa Group of Hospitals, Harare, Zimbabwe. 12. National Ear Care Centre, Kaduna State University, Kaduna, Nigeria. 13. Department of Surgery, Bahir Dar University, Bahir Dar, Ethiopia. 14. AIC Kijabe Hospital, Kijabe, Kenya. 15. ORL-HNS, Adama Hospital Medical College, Addis Ababa, Ethiopia. 16. Department of Otolaryngology, Johns Hopkins University, Baltimore.
Abstract
BACKGROUND: There is an extreme shortage of head and neck surgeons in Africa. Fourteen head and neck surgeons have completed fellowships in Cape Town and Cameroon. This study determines whether such Africa-based fellowships are a good model for developing countries by making a sustainable impact on head and neck cancer care. METHODS: An observational study was conducted by emailing questionnaires to past fellows. RESULTS: All fellows had returned to teaching hospitals in their counties. Seven established new multidisciplinary cancer teams. Head and neck operations had increased by >335%, as had complexity of the surgery. There was effective transfer of surgical skills to trainees. All considered head and neck fellowships to be the best model to grow head and neck care. CONCLUSION: Head and neck fellowships in developing countries are effective models for establishing training programs and for increasing provision of specialized surgical services in a sustainable fashion.
BACKGROUND: There is an extreme shortage of head and neck surgeons in Africa. Fourteen head and neck surgeons have completed fellowships in Cape Town and Cameroon. This study determines whether such Africa-based fellowships are a good model for developing countries by making a sustainable impact on head and neck cancer care. METHODS: An observational study was conducted by emailing questionnaires to past fellows. RESULTS: All fellows had returned to teaching hospitals in their counties. Seven established new multidisciplinary cancer teams. Head and neck operations had increased by >335%, as had complexity of the surgery. There was effective transfer of surgical skills to trainees. All considered head and neck fellowships to be the best model to grow head and neck care. CONCLUSION: Head and neck fellowships in developing countries are effective models for establishing training programs and for increasing provision of specialized surgical services in a sustainable fashion.