mylesclough at shaw
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Jan 15, 2009, 12:35 PM
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[ORT-L] Visit to Africa
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I invited myself to spend two weeks in Mulago, Uganda and two weeks
in Eldoret, Kenya setting up a trauma recording system in each of
these institutions and giving workshops on the use of Information
Technology in Orthopaedics. If you would like a copy of my complete
report please send a message to me privately at mylesclough@shaw.ca
(not the list).
I don't know if you have visited the program at Eldoret but (IMO)
they are doing a great job with the limited resources they have. The
program only just started - none of the trainees have completed their
exams yet. They have a busy practice drawing from the North Rift
Valley region, close supervision by the staff with daily xray/trauma
rounds and a go-ahead attitude. Eldoret was the first place in Kenya
to adopt the SIGN nail.
That said, it is undoubtedly true that better equipped and funded
hospitals in the "North" (South Africa, Australia, Europe and North
America) do offer broader and deeper training which can often be
adapted to the needs of less developed medical systems. I was
particularly struck by the need for expertise in Ilizarov methods in
the places I visited because of the volume of neglected and
malaligned trauma cases. If you and your colleagues return to Kenya
with these sorts of skills I would hope that the 'excuses' would be
over in short order and the region would be looking to local
orthopaedic institutions for leadership and training. Because on the
other hand I was also struck by the feeling that the problems of
supplying orthopaedic care to huge populations with few surgeons and
fewer resources would be not be solved by "Northern" thinking but
(perhaps) by a combination of knowledge of "best practice",
appreciation of the strengths and resources they do have and a
roadmap of how to get from there to here. Hence my focus on
information resources. It is not impossible to lead the world from
poorly resourced medical systems. We have seen how Russian
orthopaedics took a leadership position in deformity correction with
very little in the way of resources. It is my belief that there are
similar salutary shocks to world orthopaedics in the future and they
may come from anywhere.
I retired from active orthopaedic practice to undertake educational
activity like this and would be delighted to consider invitations
from anywhere ('North' or 'South').
On 15-Jan-09, at 10:28 AM, DR ASSAD MUGHAL wrote:
> Hi Myles, just read your reply and was curious. What were u doing
> in Kenya lols. im from kenya but doing my ortho fellowship in cape
> town cos their programme ( like all others) are waaaayyy better
> than the excuse of an orhto programme we have in Kenya.
>
>
Myles Clough MD FRCSC
Orthopaedic Surgeon, Retired
Kamloops, BC
mylesclough@shaw.ca
Clinical Instructor, University of British Columbia
Associate Editor, Orthogate www.orthogate.org
Editor, Orthopaedic Web Links (OWL) www.orthopaedicweblinks.com
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