10 January 2019

Rwanda: New Centre to Address Acute Shortage of Plastic Surgeons

Rwanda has been selected to host a regional training centre for plastic surgeons. It has been set up at Rwanda Military Hospital (RMH).

This, officials say, will among other benefits, increase the number of plastic surgeons in the country and, consequently, accelerate healthcare provision in this specialty.

Plastic surgery is a procedure to repair and reconstruct missing or damaged tissue and skin on a human body.

The main aim of plastic surgery is to restore the function of tissues and skin to as close to normal as possible, while improving the appearance of body parts is an important, but secondary aim.

Currently, Rwanda has two such surgeons.

The military hospital was selected as a training centre in plastic surgery for the College of Surgeons of East, Central and Southern Africa (COSECSA).

COSECSA is a non-profit professional body that fosters postgraduate education in surgery and facilitates surgical training throughout the East, Central and Southern Africa region.

The body delivers common surgical training programme with a common examination and an internationally recognised surgical qualification.

Subsequently, RMH will be able to train Rwandan specialists in plastic surgery.

"We only have two plastic surgeons in the country and it is very important that we look for ways to get more to serve people better and even take over from us when we retire," said Colonel Dr Charles Furaha, a plastic surgeon at the military hospital.

Furaha, who is one of the two plastic surgeons in the country, is part of the team of teachers who will train the students in this medical field.

He said that the only other surgeon in the field is deployed at the University Teaching Hospital of Kigali (CHUK).

Four years on waiting list

According to Furaha, the demand for their services is overwhelming currently.

"Some patients end up waiting for three years or four to get treated," he told journalists during the tour of the facility where regional surgeons will be trained under COSECSA.

Currently, he said, he has more than 400 people on the waiting list, and yet some are urgent cases that cannot wait for the three or four years.

"It means pushing back those who are already on the list, which can even be more frustrating for the patient."

"And that is not a good thing; we cannot talk about accessibility to health services when people are waiting for more than three years to be operated on. So, introducing the training of plastic surgeons is the more sustainable way to increase surgeons that will be able to provide those services," he observed.

The new initiative got a grant of $0.6 million from Operation Smile to help start the activity and sustain it for three years; but, after that period, the Government will take over.

Colonel Dr Charles Furaha, a plastic surgeon at the military hospital speaks to the media after a tour of the facility. Nadege Imbabazi.

Importance of plastic surgery

Underscoring the importance of this therapy, Furaha gave an example of a situation where body parts or tissues are damaged because a person developed a cancer, ultimately causing the removal of such parts.

"For instance, a person may suffer from nose cancer, and as a treatment, the entire or part of the nose is cut off. That person with a decapitated nose will certainly get uncomfortable to be in public and that is how plastic surgery comes in to reconstruct the nose," he said.

The treatment is also required for survivors of bad accidents, which he said form the majority of their patients.

The training programme

The training programme under COSECSA will start with three Rwandan trainee surgeons.

He said that limiting the number of trainees has been dictated by the rationing of teachers against the number of students.

According to him, supervising these students and having time to give them enough attention is critical to quality.

In addition, he said, each trainee has to perform or serve as an assistant in 200 plastic surgery cases per year, which brings it to 600 cases per year with three trainees.

It was planned that the training would take up five years, but, Furaha said, those who will be trained in the initial phase will have done general surgery for two years, so that they undergo a three year-course in plastic surgery.

In the long run, the initiative envisages working with University of Rwanda, whereby it will be receiving two students per year to be able to scale up its impact.

Furaha said that, under the initiative, they have partnerships with globally acclaimed surgeons who will be offering visiting tutorship.

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