Clinic for Ophthalmology Herzog Carl Theodor, München, Germany.
Can J Ophthalmol. 2013 Aug;48(4):324-30. doi: 10.1016/j.jcjo.2013.04.007.
We aim to demonstrate that vitreoretinal surgery can be established in Nairobi, Kenya, by intermittent short visits of experienced surgeons combined with clinical/surgical observerships over a longer period of cooperation. This strategy might be a model for other developing countries.
Time series over 11 years.
685 operations were performed over 11 years.
After the 1998 al-Qaeda bomb assault on the U.S. embassy in Nairobi, Kenya, the Ludwig-Maximilians-University München (Germany) provided materials for surgery of 42 victims with eye injuries. From the year 2000 onward, this equipment has been used to establish a training unit at the Kenyatta Hospital in Nairobi. In 1 annual "project week," 1 author (C-L.S.) performed vitreoretinal surgery at the University of Nairobi in cooperation with the Kenyatta National Hospital and supervised resident eye surgeons. After 7 years of training in Nairobi, clinical/surgical observerships of vitreoretinal surgeons and operating theatre staff were commenced in Munich by 4- to 12-week visits. The project week in Nairobi was carried on. Number, indications, operating surgeons, kind, difficulty, duration of operations, and preparation were recorded and evaluated.
The percentage of operations by resident surgeons increased from 29% (in 2000) via 80% (in 2009) to 73% (in 2010) with a partial failure of the laser device. The learning curve of local surgeons is also reflected by an increase of the operations' difficulty with only a moderate increase in operation time and marked decrease of preparation time.
A vitreoretinal unit has been established in Nairobi using our training model. This unit has the potential to train colleagues from other sub-Saharan countries. This strategy has advantages over long-term aid deployment of foreign physicians such as avoiding financial burden for the surgeons to be trained and improving the home facility, but it requires commitment for long-term cooperation.
通过经验丰富的外科医生间歇性短期访问与长期合作的临床/手术观摩相结合，我们旨在证明在肯尼亚内罗毕可以开展玻璃体视网膜手术。这种策略可能成为其他发展中国家的模式。
11 年的时间序列。
11 年内进行了 685 例手术。
1998 年肯尼亚美国大使馆爆炸袭击事件后，慕尼黑路德维希-马克西米利安大学（德国）为 42 名眼部受伤的受害者提供了手术材料。从 2000 年开始，该设备被用于在内罗毕肯雅塔医院建立一个培训单位。在每年一次的“项目周”中，1 位作者（C-L.S.）与肯雅塔国家医院合作在肯尼亚内罗毕大学进行玻璃体视网膜手术，并指导住院眼科医生。在 7 年内在内罗毕培训后，4 至 12 周的玻璃体视网膜外科医生和手术室工作人员临床/手术观摩开始在慕尼黑进行。内罗毕的项目周继续进行。记录并评估了手术的数量、适应证、手术医生、类型、难度、手术持续时间和准备情况。
住院外科医生手术的比例从 2000 年的 29%（2000 年）增加到 2009 年的 80%，再增加到 2010 年的 73%（2010 年），同时激光设备出现部分故障。本地外科医生的学习曲线也反映在手术难度的增加，而手术时间仅略有增加，准备时间明显减少。
在内罗毕使用我们的培训模式已经建立了一个玻璃体视网膜单位。该单位有潜力培训来自撒哈拉以南非洲其他国家的同事。与外国医生的长期援助部署相比，这种策略具有优势，例如避免受训外科医生的财务负担，改善国内设施，但需要长期合作的承诺。
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