haglund – building surgical capacity through twinning, training
TRANSCRIPT
Michael M. Haglund, M.D., Ph.D., FAANS, FCS (ECSA) Distinguished Professor of Neurosurgery, Neurobiology, and Global Health Program Director, Duke Neurosurgery Training Program Co-Director Ugandan East African Neurosurgery Training Program Surgical Director, Duke Epilepsy Center
Building Surgical Capacity through
Twinning, Training, and Technology
Countries in East Africa
Total Population
No. of Neurosurgeons
Ration Neurosurgeons to population
Neuro-surgical Centers
Neurosurgery Training Program(s)
Northern Africa and South Africa: 486 of 563 Neurosurgeons ( ex. Morocco) Uganda United States
32 million 33 million 320 million
171 5
3.500
1:187,000
1:6.6 million
1:90,000
15 2
31 in NC
6 0
95 Nationally
Neurosurgery in Africa 2007
Technology: Equipment and Train Biomedical Engineers Duke Global Health PLUS program Dedicated Biomedical Technician for Neurosurgery Bioengineer training critical to maintain equipment (Duke and
Makerere Biomedical Engineering) Twinning and Training: Develop a Neuroscience Center of Excellence
Improving Neurosurgical services within Mulago Hospital Develop Neurosurgery Training Program Development of dedicated Neurosurgical Operating Theater Developing Neurosurgical Unit into a Neuroscience Institute Center of Excellence for Traumatic Brain Injury for Adult and
Pediatrics, Epilepsy, and Skull Base Surgery August 2013 start weekly Neurosurgery Conference
Top-Down Approach: Potential to impact all of Uganda: 2020 have 19 Neurosurgeons all over Uganda with modern
equipment Ratio would be 1 neurosurgeon for less than 1.6 million people
Building Capacity in Uganda: Twinning, Training, & Technology
Duke Technology Transfer: – Total 2007-2013:
• 2007: $1,250, 000/ 9 tons equipment/supplies & $90,000 donations • 2008: $1,875,000/ 8 tons equipment/supplies & $150,000 donations • 2009: $ 750,000 / 4 tons equipment/supplies & $140,000 donations • 2010: $ 1,3750,000/ 7 tons equipment/supplies & 135,000 donations • 2012(2): $ 850,000/ 8 tons equipment/supplies & 175,000 donations • 2013(1st /2nd): $ 200,000/ 4 tons equipment/supplies & 225,000 donations • Total: $5,250,000 and 40 tons of equipment & $915,000 donations • Total: 14,175,000,000,000 UgSh and 2,470,500,000 UgSh in donations
– Benefactors: – Duke University Health System: Chancellor Victor Dzau MD – Duke University: President Richard Brodhead PhD – Duke Global Health Institute: Director Michael Merson MD – Division of Neurosurgery: Allan Friedman MD – Duke Global Surgery: Michael Haglund MD, PhD – Duke Global Health PLUS: Duke Global Health Institute and DUHS – Corporate Support: Synthes Spine, Integra Neuroscience, Biomet,K2M
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Cas
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Elective OR + Duke NSU CampNSU Elective OR
Neurosurgical Cases per Qtr
73,000
83,000
93,000
103,000
113,000
123,000
133,000
143,000
153,000
163,000
FY06 FY07 FY08 FY09
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Mulago gets Shs540m brain theatre
Dr. Michael Haglund shows Health Minister Christine Ondoa the new equipment at the theatre.
January 12, 2013
Uganda East African Neurosurgery Training Program: Co-Directors: Dr. Michael Muhumuza and Professor Michael Haglund Duke Neurosurgery Curriculum and East African NSTP Curriculum Start first two Ugandan residents Aug 2009: Dr. Obigga and Dr. Muhindo, Dr. Tamera starting September 2011, two more residents in Summer 2013
MMed Neurosurgery at Makerere University, Winter 2014 Registered with COSECSA (Dr. Haglund) Executive Director Mulago provides housing Five year program, then bonded for 4-5 years to other major cities MOH provides Senior Registrar and Consultant Posts at Other Hospitals
Uganda East African Neurosurgery Training Program: Twinning Uganda residents spend one month at Duke observing in year 4 Duke Neurosurgery Residents spend one month Uganda PGY-5/6
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VISION
2020
2018