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West Africa: training the pediatric surgeons of tomorrow
In West Africa, less than half of all hospitals have more than two pediatric surgeons. Yet the need is growing. Faced with this situation, La Chaîne de l'Espoir is contributing to the training given as part of the Diplôme d'Études Spécialisées en chirurgie pédiatrique (DES-CP). Here's a look back at this ten-year-old program.
“In the healthcare sector, in sub-Saharan Africa more than anywhere else, the crucial issue is human resources. Whether in terms of availability or training”, explains Mikaël Pozzoni, geographic manager for Africa at La Chaîne de l’Espoir.
With this in mind, in 2014 our association launched a program to support the teaching of pediatric surgery. As part of this, it organizes and finances joint seminars for DES-CPs in Côte d’Ivoire, Togo, Benin, Senegal, Guinea Conakry, Mali and Burkina Faso*. ” This program is perfectly in line with our missions, since one of the pillars of our action is training”, points out Camille Nicolas, Africa Multi-Country Programs Coordinator.
The need for specialization
In practical terms, week-long seminars are organized in turn in each of the seven countries. Aimed at DES-CP students in West Africa, they are led by volunteer European professors and surgeons. Their content is tailored to the needs of local managers, in liaison with the program’s medical referent at La Chaîne de l’Espoir. The aim is to develop paediatric surgical specialization more widely in the sub-region. West Africa has a very young population. Given the very strong demographic growth, the need for pediatric surgery will only increase in the coming years, and will have to be dealt with in ever greater numbers in specialized care centers. ” In my country, pediatric surgery is sometimes entrusted to adult surgeons whose approach is generally too invasive”, explains Indra Ngo Bayemi, a Cameroonian-born doctor who is following a specialization course in Côte d’Ivoire.
“I come from the Democratic Republic of Congo. Many children arrive at the hospital and we can’t treat them because we lack the necessary expertise. says Hilaire Muhindo Mutuka. That’s what really motivated me to become a surgeon and specialize in pediatrics. To do this, I went to study in Benin. That’s where I was able to take the DES-CP course.
Combining theory and practice
For Laurence Boutin, deputy medical director of La Chaîne de l’Espoir: “In all cases, the idea is to offer content that is difficult to teach in these countries, due to a lack of local skills, training, equipment, etc., while taking into account the context of their technical facilities, and above all always seeking to combine theory and practice”. As a result, these training courses are systematically combined with live operations broadcast in the amphitheatre. Whenever possible, travelling missions are organized in parallel to enable students to operate on a large number of children.
“These real-life situations are conducive to rich exchanges with the students. We’re there to answer all their questions,” explains Agnès Liard. A pediatric surgeon at Rouen University Hospital and volunteer for La Chaîne de l’Espoir, she is the program’s medical referent. “The aim is to provide them with a very high level of teaching, as demanding as that given to our students in France, while giving them the opportunity to see as many specific cases as possible.”
A regional network
Another major challenge is to create synergies. “These seminars bring together dozens of students from all over West Africa. This makes them ideal for exchanging and sharing experiences, skills and knowledge… These relationships can be useful throughout their professional careers,” explains Camille Nicolas. Dr Cheick Seye, representative of the DES-CP coordinator for Senegal, confirms: “This dynamic contributes to structuring local training networks, which encourage paediatric surgeons to set up practice in their own country. This is essential for the development of our healthcare systems. All the more so as the students trained may well be tomorrow’s professors. “I myself took the DES-CP when I was a student. Today, it’s my turn to support pediatric surgeons in the making. The thread of transmission extends to sub-Saharan Africa…
* The universities of Abidjan (Côte d’Ivoire), Lomé (Togo), Cotonou (Benin), Dakar (Senegal), Conakry (Guinea), Bamako (Mali) and Ouagadougou (Burkina Faso) offer a Diplôme d’Études Spécialisées en chirurgie pédiatrique (DES-CP) recognized by the Conseil Africain et Malgache pour l’Enseignement Supérieur (CAMES) and harmonized by the West African Health Organization (WAHO).
2 questions to
Nathalie Kapessa Dinganga, 5th year DES-CP student, Lomé (Togo)
What did you learn from the two seminars organized by La Chaîne de l’Espoir that you attended in 2023 and 2024?
I enjoyed meeting professors in pediatric surgery, like Agnès Liard, who came to share their knowledge and experience. You learn a lot. Especially as these seminars are coupled with practical sessions where children are selected for surgery. This gives us the opportunity to attend lectures in an amphitheater where a professor is available to answer all our questions live. It’s very concrete and interactive. In parallel, I also took part in a traveling mission to Togo in the spring of 2023. We operated on 127 children in five days. This greatly enriches our know-how.
How do you see the next stage of your career?
I’m coming to the end of my training. After that, I’d like to return home to the Democratic Republic of Congo to practice as a pediatric surgeon and finish my thesis. My aim is to become a professor and pass on my expertise. In my country, there is as yet no DES-CP. French doctors (from Hôpital Necker-Enfants malades in Paris, CHU Besançon…) frequently come to teach. But this is not enough to cover the needs of nearly 100 million inhabitants. We need to train our own pediatric surgeons.
