A partnership between Stanford University surgeons, the global surgery nonprofit ReSurge International, and the College of Surgeons of East, Central, and Southern Africa is helping Sub-Saharan Africa meet its great need for reconstructive plastic surgery.
By Jamie Hansen, Communications Manager
When a child is badly burned, reconstructive plastic surgery can be essential to their recovery. Without it, for instance, a child’s injured arm can contract and lose its mobility, preventing them from attending school and requiring the parents to miss work.
Yet in sub-Saharan Africa, where burns and other injuries requiring reconstructive surgery are common, demand far outpaces capacity. This region sees an estimated one million burns each year, with just a handful of trained plastic surgeons to treat them.
To address this problem, a partnership between Stanford University surgeons, the global surgery nonprofit ReSurge International, and the College of Surgeons of East, Central and Southern Africa (COSECSA) is training a new generation of reconstructive surgeons and empowering them to train others in turn.
“I think we’re at a historical point in the development of plastic surgery in Africa,” said Dr. James Chang, Johnson & Johnson Distinguished Professor and Chief of the Division of Plastic and Reconstructive Surgery at Stanford and Consulting Medical Officer at ReSurge. “You’ve heard the saying about teaching a man to fish. We’re trying to start fishing academies; we’re trying to enhance regional training centers that can continue doing this.”
Since standard reconstructive surgery is not very expensive in terms of resources, equipment, and supplies, teaching surgeons the principles of reconstructive plastic surgery is the most important component of building a system’s capacity for plastic surgery, Chang said.
ReSurge’s connection with COSECSA developed in 2014, when Dr. Sherry Wren, director of global surgery at the Stanford Center for Innovation in Global Health, connected Chang to Zimbabwean Professor of Surgery Dr. Godfrey Muguti.
Chang had recently become Consulting Medical Officer at ReSurge International, which has its roots at Stanford and focuses much of its efforts on training, funding, and capacity-building in partner countries.
Muguti later became president of COSECSA. Under his leadership, COSECSA sought to grow its capacity for plastic surgery. Until recently, only about a dozen plastic surgeons were working across all 14 countries comprising the network. They asked ReSurge for support in formalizing and expanding their plastic surgery examinations and online educational resources.
In December 2022, ReSurge helped COSECSA administer the board certification exams to 14 trainees at the organization’s annual conference in Namibia, with funding and support from Stanford Surgery’s Global Engagement Office. Chang, Stanford Professor of Plastic Surgery Dr. Gordon Lee, and Professor of Surgery Emeritus Dr. Vincent Hentz joined surgeons from around the world to help administer the exams alongside African examiners.
All the trainees passed, nearly doubling COSECSA’s plastic surgery capacity.
“These young surgeons were amazing,” Chang said. “They knew details for operations they’d never seen before; they were so well-read and prepared. The future is extremely bright with people like this.”
The partners hosted a two-day Train the Trainers conference, in which the pioneering reconstructive surgeons in Sub-Saharan Africa learned how to train others using an extensive online curriculum developed by ReSurge International. In addition, US surgeons and African surgeons worked together to develop shared interests and collaborations.
“We hope there will be a multiplier effect,” Chang said. “When one plastic surgeon trains three or four others, each trainee may go on to treat 300-400 cases per year. We hope they all will go on to train others in turn.”