2023 International Medical Volunteer Experience

Dr. Chizoba Efobi was the recipient of the 2023 International Medical Volunteer Scholarship. He is based in Nigeria, and joined Every Heartbeat Matters awardee Dr. Pranava Sinha on a surgical outreach trip to Uganda. Here is his story.

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I arrived in Kampala, Uganda on the 12th of November 2023 not sure what to expect but with a firm belief that it will be different and exciting - and it was!

Preparing for the Experience

In the 3 weeks preceding my trip to Uganda, I had volunteered in another facility in a rural location of my country where I participated in a 3-week long cardiac surgery mission covering both pediatric and adult cardiac surgeries. Coordinated by a U.S. based charity organization, it received several dozen Americans as volunteers who worked with the local team over the 3-week period. They included adult and pediatric cardiac surgeons, cardiologists, anesthetists, intensivists, perfusionists, nurses, respiratory therapists, [residents] and others; in the end completing dozens of cases. It formed an exciting preparatory experience with a lot of lessons to learn and I intend to continue to join this group whenever they come. This was their 4th mission at this location and I have participated in all of them.

Uganda Heart Institute

The Uganda Heart Institute [in] Kampala, Uganda is located within the Mulago National Referral Hospital, the largest hospital in Uganda, which serves as the teaching hospital of Makerere University College of Health Sciences. During my week-long stay I saw a country with similar challenges like ours: widespread poverty, reduced access to education, inadequate healthcare funding; political, security and infrastructural challenges.

Visiting Team Philosophy

The visiting team within which I was embedded came from the U.S. and they have been coming on a yearly basis (except for Covid) for more than a decade, for the sole purpose of mentoring the local team across the various disciplines in heart care.

Their mission model is focused on teaching, training, and skills transfer rather than outright volume of cases performed. This is a significant departure from the usual mission routine where it is almost always about the number of cases performed within the short period of time. In this case, skills and knowledge transfer were given the highest priority and guided other activities.

This has made a tremendous impact as the local teams are imbued with capacity and can perform heart surgeries on their own during the extended period of time the mission team is not around. One major and very interesting discussion was how the local team can become more efficient and proficient in the utilization of available tools and equipment in order to increase the yearly total number of heart surgeries performed to 250.

A Remarkable Adventure

I observed a different model of upscaling skills and training not limited to surgery, but across the entire field of heart care from cardiology, intensive care, anesthesia, nursing and even clinical administration on a face-to-face basis.

The results of the sustained local capacity building were very evident.

Others like inter-center/regional cooperation and collaboration, rheumatic heart disease registry, literary contributions in articulating the burden, need and capacity of managing heart diseases in these parts were also very impressive.

Inspiring Teachers and Teamwork

I encountered some of the greatest physicians I have ever met. My direct mentor, Dr. Pranava Sinha, is an extremely skillful cardiac surgeon and an exceptionally good teacher who bestows incredible confidence upon his mentees. The resourcefulness of Dr. Craig Sable, a cardiologist, is simply limitless and the team cohesion is exemplary. These are some of the virtues that build up a nascent program.

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Bringing the Lessons Home

My participation in the TSF International Medical Volunteer Scholarship has started yielding results with the successful recommencement of our open-heart surgery program only a fortnight ago. All patients who received open-heart surgery went through an uneventful perioperative period, were discharged within a week of surgery, and have continued to do well.

This clearly demonstrates the benefits this scholarship has afforded our program. The opportunity will continue to provide the impetus that will assist our program to continue to grow, become sustainable and achieve viability. We shall continue to seek collaborations, partnerships, connections and associations to enable us in the course of achieving this ultimate goal.

Prior to achieving the clinical milestone mentioned above, we organized and hosted the 6th Annual Meeting and Scientific Conference of the Association of Cardiovascular and Thoracic Surgeons of Nigeria. The conference theme was: “Advancing Cardiovascular Care in Nigeria: Challenges and Solutions” and the subthemes were: “Cardiac Surgery Training and Capacity Building” and “Global Collaboration for Cardiac Surgery Excellence”. It was well attended by cardiothoracic surgeons in Nigeria as well as cardiothoracic surgery residents.

Several exciting abstracts were presented during the conference and we received presentations from international faculty from the U.S., U.K. and Uganda. I also ensured that my mentor and host in my previous TSF International Medical Volunteer Scholarship made presentations at the conference so that conference participants can learn from their wealth of experiences on medical missions and hear their views on the means and mechanisms for a sustainable cardiovascular surgery development.

I remain grateful to TSF for granting me this excellent training opportunity, of receiving the International Medical Volunteer Scholarship. I have obtained tremendous knowledge and experience through this program and the impact to our local program is becoming obvious.