Establishment of a Pediatric Surgical Unit at a University Hospital in Eastern Africa

Abstract

Introduction: Ethiopia is a rapidly developing country in Eastern Africa. In total, 43.2% of the population are younger than 15. In contrast, until a few years ago, pediatric surgery was only available in Addis Ababa. Now, Ethiopia is making great efforts to improve the care of children who require surgery. JimmaChild was established to set up a pediatric surgery in Jimma.

Material and methods: JimmaChild developed from a scientific collaboration between Jimma University (JU) and Ludwig-Maximilians-University. The project was developed and realized by Ethiopian and German colleagues. A curriculum was written for this purpose. The pediatric surgical training of the fellows was carried out on-site by German pediatric surgeons.

Results: A new pediatric surgery was established at JU with its own operating room, ward, and staff. After two and a half years, two fellows completed their final examinations as pediatric surgeons. Among others, 850 elective surgeries were performed, 82% assisted by the German colleagues. The German colleagues rated the preparation for the trip, the on-site support, and the professional progress of the fellows mostly as good to very good. Reported problems in the program flow were also recognized and solved in part.

Conclusions: The best possible integration of the project into existing structures was achieved by close cooperation of Ethiopian and German colleagues during the project development. Problems were identified and addressed early on by external monitoring. As the project responsibility was mainly with the Ethiopian colleagues, a department was created that now exists independently of external funding and trains its own fellows.

Keywords: Ethiopia; development cooperation; pediatric surgery; specialized care.

Figure 1

A bird’s eye view of Jimma University Teaching Hospital. The building was ready to be opened in 2016.

Figure 2

Graphical illustration of the development of individual aspects over time.

Figure 3

View into the operating room during an operation. In the foreground is the surgical equipment required to perform these operations.

Figure 4

One of the hospital beds in the pediatric surgery ward. The children usually lie in bed together with their mothers, who then also take over the essential part of the care during the inpatient stay.

Figure 5

One of the heated beds at the Neonatal Intensive Care Unit (NICU). Due to lack of space, the beds are usually occupied by up to four neonates. From a surgical point of view, a major problem at the NICU is that parenteral nutrition is not available for the children.