In 2013, the Royal College of Surgeons of Ireland (RCSI) in partnership with COSECSA established the Essential Surgical Training (EST) Programme. EST is aimed at equipping General Medical Officers (GMOs – i.e. general practioners, nurses and anaesthetic technicians) in rural hospitals with basic surgical and referral techniques.
EST is critical because surgery in district and provincial hospitals across the COSECSA region is frequently practiced by GMOs who have no structured training apart from peer training and support systems. EST trainings are conducted by experienced, senior level COSECSA surgeons. The trainings focus on trauma, general surgery problems and also addresses management of actual emergencies. Each year there are 4-6 sessions in each EST Country.
Priority is given to the most remote hospitals as most city district hospitals benefit from greater learning opportunities. The EST Programme commenced with a one year pilot programme in Zimbabwe and expanded to Rwanda and Zambia in late 2014. It is anticipated that the EST Programme will extend to other COSECSA Member Countries in the coming years with support from Health Ministries and international partners. Each EST Programmes has a dedicated Programme Coordinator. For more information see the EST country profiles.
COSECSA, in collaboration with the Royal College of Surgeons in Ireland, iheed, the World Health Organisation Emergency and Essential Surgical Care programme (WHO EESC) and a number of other partners, has produced an open access e-learning tool for non-specialist medics who perform basic surgery and anaesthesia in resource poor settings. This tool is based on the WHO EESC Emergency Trauma Care course.
WHO Emergency Trauma Care e-learning programme is available through the link below:
The Rwanda EST Programme was established in November 2014 by COSECSA, the Rwanda Surgical Society (RSS) and the Royal College of Surgeons of Ireland (RCSI). The 2015 REST Programme takes place in rural hospitals, bringing together GPs (General Practioners), anaesthetic assistants and theatre nurses. There are currently 45 district hospitals and 4 referral hospitals in Rwanda.
REST trainings have been completed by over 20 non-surgeons/General Practioners from 15 district hospitals. Each training takes place over 3 days per session: Day 1 focuses on theory, patient screening and theatre preparation and pre-workshop evaluation; Days 2 and 3 are dedicated theatre days.
Curriculums are not uniform and vary from training to training. A sample REST curriculum is available below.
REST Programme Coordinator
Mercy Kamukama
Mercy Kamukama completed her Bachelor’s Degree in Arts with Education at the Kigali College of Education, ICT training at the Kigali Institute of Science and Technology, and COSECSA training in Tanzania. She previously worked at Wagtech International and at the Rwanda Organization for Community Health Development. She is currently serves as the Coordinator for Rwanda Essential Surgery Training (REST) for the Rwanda Surgical Society and COSECSA.
If you are interested in learning more about or participating in the REST trainings you can contact Mercy at rest@cosecsa.org
The primary objective of the ZEST programme is to train medical doctors and theatre staff stationed at district and other high-volume facilities, in an integrated curriculum covering key concepts in the management of surgical emergencies in various specialties which include: a. Trauma; b. General Surgery; c. Pediatric Surgery; d. Cardiothoracic Surgery; e. Neurosurgery; f. Urology; g. Orthopedics; and h. Obstetrics & Gynecology.
In 2014 and 2015, training workshops were conducted at hospitals in Matabeleland South, Mashonaland East, Manicaland and Masvingo which catered for medical officers from 4 provinces. A total of 48 doctors have been trained to August 2015. Zimbabwe successfully undertake the EST pilot programme and the Ministry of Health has given its support for the programme to continue. A number of Specialists Surgeons and doctors have taken time off from their busy schedule and travelled around the country conducting the EST Programme. At one training a total of 12 Surgeons attended.
ZEST Programme Coordinator
Neriser Sibanda
Mrs Neriser Sibanda is the Project Coordinator responsible for management of the ZEST programme. She liaises with hospital management and staff to ensure that all logistics associated with hosting the trainings are prepared for the trainings. She graduated in Business Administration and has worked in various organisationi currently she is an Events Consultant since 2010. She anages corporate events and is deeply involved with coordinating medical events across the country. She has a background in Quality Assurance Management Systems including Internal Quality Audits since 2000.
The first ZamEST training was successfully conducted from 17 – 19 July 2015, at Monze Mission Hospital in the Southern Province. The faculty team utilised the WHO recommended essential surgical skills training materials.
The ZamEST training is undertaken in two phases. The first phase is lecture based with practicals using mannequins/models. A second follow up training is scheduled to be held two months later. The trainees will then conduct surgery under the supervision of the faculty on booked patients.
A sample ZamEST Curriculum (based on WHO Manual “Surgical Care at the District Hospital”) is available here.
ZamEST Programme Coordinator
Issac Kasaro
Isaac PB Kasaro studied Social Work at the University of Zambia. He later studied Hospital Management (Nuffield Institute Of Health) at Leeds University. He has been working for the Ministry of Health in Zambia since 1990. He previously held the following positions; Hospital Social Worker, Hospital Administrator, Executive Director and now Chief Hospital Administrator for the largest referral hospital in Zambia. He also serves as Coordinator for EST for the Surgical Society of Zambia.