ENT Global Surgery Outreach in Mwanza, Tanzania

by Lia Jacobson, MD

Facilitated by Mending Kids, a pediatric humanitarian surgery nonprofit organization, I developed an ongoing academic partnership with a new ENT residency program at Bugando Medical Centre in Mwanza, Tanzania.  Bugando is one of the largest hospitals in Tanzania; it serves a catchment area of 16 million people and faces severe shortages in surgical infrastructure and capacity.  A principle goal of this partnership is to promote sustainable improvements in Otolaryngology surgical care and resident training through knowledge sharing and support from academic, nonprofit and governmental sectors.

In response to a request by Bugando’s ENT director for a surgical teaching mission with Mending Kids, I conducted a site visit and needs assessment with the organization in November 2016. I returned in November 2017 to coordinate a pediatric ENT training mission with Pediatric Otolaryngologist Dr. Ayal Willner, and Anesthesiologist Dr. Sia Fooladian, both of whom have led Mending Kids missions to Guatemala previously. During our weeklong visit, we performed 12 surgeries with residents and faculty from Mwanza. The procedures we performed included laryngoscopy and bronchoscopy, congenital neck mass excision, and tracheotomy. In addition, we developed a daily lecture series on pediatric airway management and otology, two topics identified by local and visiting teams as areas in need of academic development.

Onsite at Mending Kids Pediatric ENT Training Mission Nov 2017

I’ve also applied for and received grant funding by USC’s Dhablania and Kim Family Global Health Fellowship. I returned to Tanzania in Winter 2018 to build on this service-learning program through implementation of electronic and remote teaching resources, partnerships with local and global organizations to improve audiologic and otologic services, and coordination of a second surgical training mission. Dr. Lindsay Reder, a Laryngologist in the USC Caruso Department of Otolaryngology – Head and Neck Surgery, also plans to travel and participate in this training mission with me.  Future directions for this project include developing research and service opportunities for USC residents at Bugando hospital, and facilitating reciprocal opportunities at USC for visiting residents and faculty from Tanzania.

My global health experiences are a cornerstone of my professional aspirations as a surgeon.  I am humbled and grateful to have gained perspective on the realities of surgical and medical disparity in developing countries, and I am inspired by the patients and health care professionals who persevere in the face of such challenges.  I intend to continue to build humanitarian partnerships and contribute to training and capacity-building in Otolaryngology-Head and Neck Surgery globally in the future.

Implementing Smart Phone Adapters for Direct Laryngoscopy
Operative Training at Bugando Medical Centre
In the Operating Theatre with ENT Faculty and Residents in Mwanza, Tanzania