Training Medical Professionals
HEAL Africa's medical center in Goma is well-recognized as a teaching hospital venue, providing ongoing training for healthcare professionals. It is the hospital of choice for good care in the region and acts as a referral center for the most difficult cases.
HEAL Africa’s initial vision was the training of doctors for rural areas. This has expanded based on the reputation for quality experience that HEAL Africa has built over time. Graduates with specialist skills and a vision for whole person medicine will serve many areas of Congo. The hospital offers training with specialists in Family Medicine, Gynecology and Obstetrics, General Surgery, Orthopedic Surgery, Radiology, Internal Medicine and Pediatrics. In response to the need for appropriate training for the wide range of skills needed by doctors serving in rural areas, HEAL Africa has also developed a Family Medicine residency program. At any given time, there are 120-160 women waiting for fistula surgery.
To ensure oversight of the public health services of the town of Goma in a time of political turmoil, HEAL Africa has hired and made available a physician as District Medical Superintendent for the past three years. This is a national and regional government position. He is responsible for oversight of the three-tiered structure (220 bed Referral Hospital, 12 Health Centers and 10 outlying dispensaries) and all services of preventive medicine (vaccinations, ante-natal clinics, water and sanitation).
HEAL Africa's hospital in Goma is the UNFPA-designated training center for fistula repair in Congo. Physicians and nurses come there to learn from other hospitals in Congo. The urban hospital in Goma is linked with a rural hospital in Shyira, Rwanda. Residents rotate to both hospitals and thus benefit from a varied learning experience.
What difference has it made?
Many children and adults come for orthopedic repair for conditions such as clubfoot, cleft palate, spina bifida, polio and rickets, as well as land mines, gunshot and grenades. HEAL Africa provides a medical service to the poor as well as to the wealthy through the Mercy Fund, which subsidizes care. No one is refused medical care at the hospital for lack of ability to pay.
The first three Family Medicine residents to come through the program in Goma were recently ranked first, second and third in nationwide exams of fourth-year residents in Congo. Medical excellence and effective learning for doctors and medical professionals are a long-term commitment of HEAL Africa staff.
In addition to medical care, HEAL Africa works closely with community activists in HIV/AIDS education and care, and identification, referral and healing both medical and psycho-social of victims of sexual violence in Goma and North Kivu,. The Nehemiah Initiative, begun in 2004 to work with war-ravaged communities and to help returning widows, orphans and victims of sexual violence to return in safety and rebuild their lives, provides ongoing assistance to ensure long-term care in a local setting.
The agricultural program Mawe Hai plants vegetables and demonstration plots at the hospital to introduce new vegetables to the patients, provide occupation and new concepts such as intensive growing and container gardens.
Family Medicine Residency Program
In response to the need for appropriate training for the wide range of skills needed by doctors serving in rural areas, HEAL Africa developed a Family Medicine residency program. The first graduate of this four-year residency accredited by MEDUNSA (Medical University of Southern Africa) graduated in 2003. In the academic year 2005-6, the program is training 11 doctors at the site in Goma and with pediatric rotation in Shyira, Rwanda. This partnership between an urban hospital in Goma and a rural hospital in Shyira provides an opportunity for residents to experience a variety of cases in different settings.
What difference has it made?
HEAL Africa is pioneering the first nationally certified Masters level Family Medicine program which began in October 2005, in the University of Goma. Because of HEAL Africa, Family Medicine is now recognized as a medical sub-specialty in the Democratic Republic of the Congo.
Partnerships are now established with Family Medicine departments in the University of Pretoria, the Flemish Universities of Belgium (specifically for Goma, the University of Ghent). We seek to develop our program of visiting faculty instructors and other residents on rotation. We seek assistance in developing an innovative curriculum appropriate for rural doctors in resource poor countries.
Medical and Surgical Outreach
Outreach trips have proved very profitable for continuing medical education in rural areas. In partnership with CBM and Northwest Medical teams, HEAL AFRICA has been able to perform surgery with local providers at Nyamilima, Mweso and Butembo and five referral hospitals in Maniema province. Doctors serving in isolated rural hospitals receive clinical competency training alongside experienced specialists: they discuss cases before surgery and then assist in all surgery. Funding for these trips comes from Christoffel Blindenmission, UNICEF and the German Development Bank. Since 2001, orthopedic surgeons have performed an average of 60 surgeries in two weeks, and four trips a year. In the next three years, there will be one trip every six weeks, both medical and surgical training, in Maniema province, funded by KfW (German Development Bank).
To ensure oversight of the public health services in Goma in a time of political turmoil, HEAL Africa has hired and made available a physician as District Medical Superintendent for the past three years. This is a national and regional government position. He is responsible for oversight of the three tier structure (220 bed Referral Hospital, 12 Health Centers and 10 outlying dispensaries) and all services of preventive medicine (vaccinations, ante-natal clinics, water and sanitation.
What difference has it made?
As an example of the success of Goma's public health programs despite chaotic public services, in 2004, 97% of children received BCG vaccines and nearly three quarters completed the recommended first year series of vaccines. The public health program interventions are funded by USAID through the SANRU program. HEAL Africa's close tie with this position allows the opportunity to assess the effectiveness of many of HEAL Africa's community interventions. HEAL Africa will continue to fund the staff position until the state is able to take over its own responsibility.
Safe Motherhood and Family Planning (Maternite a Moindre Risque)
A program delivering contraception through health centers was introduced in five Public Health Districts surrounding Goma, thanks to a grant from the Scott Evans Foundation. HEAL Africa provided training of health center staff and supplies of IUD, pills, condoms and Norplant. The local culture has historically encouraged large family size and introducing family planning has been a great challenge. The program is now fully implanted in Goma, Rutshuru, Kirotshe, Masisi, Mweso and Birambizo and no longer needs funding from HEAL Africa.
Training for nurses and traditional birth attendants (TBAs) continues to reduce the risk of pregnancy for women in North Kivu. A new development in this program is savings groups for at-risk pregnant women. Women in groups meet regularly and save to prepare for the cost of Caesarian delivery ahead of time; the family is aware of the risk and committed to get her to medical care in time. 32 nurses and 72 TBAs have been trained; 128 groups to be formed by the end of 2006.
Medical Research and Study
HEAL Africa was founded on the principle that all interventions should be closely monitored for their outcomes and effectiveness. Each of the residents in the family medicine program does several research theses over the course of their training, and many of the faculty are also involved in research of their own.
The Great Lakes Medical Journal was established by HEAL Africa and is edited by Prof Dr Ahuka. It is a peer reviewed medical journal, the only one of its kind in Kivu Province; the 2nd edition is in process with 11 original articles in review.
Current Topics of Study:
- Causes of meningitis and sepsis in children. (Seeking funding, HEAL AFRICA with Dr Ruel, UCSF)
- Resilience - a factor in the health of populations in prolonged crisis. (A WHO multi-country study - Dr Lutala)
- Causes of Infertility in couples seeking treatment at HEAL AFRICA. (Dr Kalume for PhD)
- Teaching comprehensive care of traumatized women in DRC. (Dr Lutala for PhD)
- The impact of prolonged hospitalization on the family economies of orthopedic patients at HEAL AFRICA. (Dr Malemo for MA.FamilyMedecine)
- Knowledge and attitude towards abortion among school girls in Goma. (Dr Paluku for MA.Family Medicine)