Sheth Neil P, Hardaker W Mack, Zakielarz Kevin S, Rudolph Michele, Massawe Honest, Levin L Scott, Premkumar Ajay
Department of Orthopaedic Surgery, Pennsylvania Hospital, Philadelphia, PA.
Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
J Orthop Trauma. 2018 Oct;32 Suppl 7:S25-S28. doi: 10.1097/BOT.0000000000001296.
There is a devastating lack of access to surgical care, including orthopaedic surgery, in low- and middle-income countries. Similar to other low- and middle-income countries, Tanzania has a severe shortage of trained orthopaedic surgeons. The surgeons available are inundated with acute trauma care and musculoskeletal infections; elective procedures are infrequently performed and the burden of neglected care continues to rise annually. Over the past several years, our interdisciplinary team of both American and Tanzanian members has worked to understand the current local cultural and economic barriers to increasing surgical capacity, ensuring surgical safety, delivering affordable care, providing adequate patient follow-up, and improving surgical education. We propose a new paradigm for the delivery of musculoskeletal care and creation of sustained surgical capacity in this setting by building an Orthopaedic Center of Excellence in Moshi, Tanzania, augmented by international partner institutions year-round. This initiative is a public-private partnership led by the University of Pennsylvania in conjunction with Kilimanjaro Christian Medical Center. A growing number of contributors, including the Tanzanian Health Ministry, several universities, and industry partners, including general electric (GE) Health Care Africa, are currently helping to advance this concept into reality. Through our model, we aim to increase surgical capacity and quality, as well as enhance local surgical education, with the ultimate objective of training the next generation of African surgeons in the latest surgical techniques and equipment.
在低收入和中等收入国家，包括骨科手术在内的外科护理严重缺乏。与其他低收入和中等收入国家类似，坦桑尼亚严重缺乏训练有素的骨科外科医生。现有的外科医生忙于急性创伤护理和肌肉骨骼感染；择期手术很少进行，被忽视护理的负担每年都在持续增加。在过去几年里，我们由美国和坦桑尼亚成员组成的跨学科团队致力于了解当前当地在提高手术能力、确保手术安全、提供可负担护理、提供充分的患者随访以及改善外科教育方面的文化和经济障碍。我们提出了一种新的模式，通过在坦桑尼亚莫希建立一个卓越骨科中心，并由国际合作伙伴机构常年提供支持，来提供肌肉骨骼护理并建立持续的手术能力。该倡议是由宾夕法尼亚大学与乞力马扎罗基督教医疗中心联合牵头的公私合营项目。越来越多的贡献者，包括坦桑尼亚卫生部、几所大学以及行业合作伙伴，包括通用电气（GE）非洲医疗保健公司，目前正在帮助将这一概念变为现实。通过我们的模式，我们旨在提高手术能力和质量，以及加强当地的外科教育，最终目标是用最新的手术技术和设备培训下一代非洲外科医生。
