Bush - Plastic Surgery - Uganda?
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  • 1. Plastic Surgery – Uganda? Dr. Kevin Bush UBC
  • 2. UBC Division of Plastic Surgery participation
    • 12 active division members
    • 5 of 12 members doing overseas work
    • 8 residents set to go
    • 6 of 8 residents completed missions
    • 2 did not complete missions because of political issues i.e. 9/11
  • 3. BC participation
    • 2 plastic surgeons from Campbell river doing work in Guatemala
    • 1 plastic surgeon in Kelowna
    • Dr.Rai running operation rainbow out RCH
    • 1 surgeon from Victoria
  • 4.  
  • 5. Why Uganda?
    • Other groups going
    • Loose agreement with UBC
    • Possible new residency program
    • Chance to build capacity
    • Chance for full division participation
    • Regular resident participation
  • 6.  
  • 7. Uganda-Political issues
    • Limited resources
    • “Stable government”
    • 32 year war
    • Public/private medical system
      • 500 dollars a month
  • 8. Mulago Hospital
    • Group rounds
    • Weekly opd clinic
    • Weekly rounds
    • 2 plastic OR days a week
    • 3 Burn days a week
  • 9. My Week
    • Monday - 8:00am Weekly Meeting at Dept. of Surgery followed by patient rounds
    • Tuesday - 9:00 am Plastic OR day at Mulago Hospital
    • Wednesday - In-patient rounds (9:00am start)
    •                    - meeting with Ministry of Health
    •                    -meeting with Dept. of Dentistry
    • Thursday - 7:00 am - Private Clinic day with Dr. Khingi
    • Friday - available in case Wednesday meetings have to be rescheduled
  • 10.  
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  • 17.  
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  • 20.  
  • 21. Medical Resources
    • Mulago hospital
      • – 32 million referral hospital. Four surgeons – none plastic surgery certified.
      • Approximately 1000 burn admissions a year
    • CBM – mission hospital doing more elective surgery. One British trained plastic surgery. One local trained plastic surgeon.
  • 22. Plastic surgery equipment resources at Mulago
    • Microscope – uncertain ability to focus
    • C-arm – not working
      • Donated c-arm waiting at Cambie
    • Dingman – occasionally
    • Plates and screws – not available
    • Sutures limited
  • 23. Anaesthesia
    • Problematic
  • 24. Nursing
    • Present
    • Visiting nurse in past was a poor experience making nursing assistance EXTREMELY difficult
    • Dedicated burn unit
    • Plastic floor
  • 25. Current Medical relationships
    • Netherlands burn connection
    • Smile train
    • Summerland from UK
    • Occasional visiting surgeons
    • CBM?
  • 26. Who does what?
    • Hand surgery – nobody and everybody
    • Soft tissue coverage – plastics occasionally but relationships with orthopedics and other specialties limited
    • Clefts – CBM plastic surgeons
      • Mulago plastic surgeons
      • Lips and palates only
    • Burns – Mulago plastic surgeons
    • Elective plastics?
  • 27. Residency Program
    • Approved
    • Not yet in place
    • Residents unfunded
    • Curriculum unclear and minimally developed
    • Certification - COSECA
  • 28. What they want
    • Collaborative relationship
      • Possible rotations in Vancouver
    • Curriculum development for COSECA certification
    • Development of current skill set
  • 29. Problems
    • Equipment issues
    • Anaesthesia issues
    • Nursing issues
    • Work ethic
  • 30. What could we set up?
    • Collaboration with other groups from UBC during their visits
    • Program development
    • Curriculum development and particularly filling in areas of expertise not largely available there
    • Resident /staff education
  • 31. Model week
    • Arrive weekend
    • Monday clinic
    • Plastics main OR toes and Friday
    • Burns OR Weds, Thurs, Friday
    • CBM OR day
    • Teaching
  • 32. Costs
    • 1000 dollars per trip for accommodation, licensing etc
    • Airfare 2300 dollars
    • Miscellaneous equipment costs
    • Roughly 4000 dollars per person per trip