Situation analysis completed! We collected evidence documenting surgical care in district facilities in Malawi, Zambia and Tanzania

SURG-Africa researchers, Chiara Pittalis and Gerald Mwapasa, during field data collection at Nkhotakota district hospital, Malawi

​Since July 2017 the SURG-Africa team has been travelling extensively around Zambia, Malawi and the Northern Zone in Tanzania to conduct a situation analysis of surgical capacity at district hospitals.​

The assessment kicked off with a field trip to Zambia in July 2017, followed by missions to Malawi in September and Tanzania in October. To-date a total of 85 district health facilities have been surveyed.

The trips brought us to some of the most remote areas of rural Africa, across the dirt roads of Zambia, the lake shores of Malawi and the nature reserves of Tanzania. We have learned first-hand from local surgical providers, anaesthetists and theatre nurses what are the key obstacles to surgical care delivery in their facilities.

​Shortages of infrastructure, equipment and supplies are frequent everywhere, but all surveyed hospitals have the minimum capacity to do essential emergency and elective surgery (the Bellwether procedures and more). The challenge is surgical productivity. Some procedures reported as not possible by some hospitals (i.e. elective hysterectomy, BPH, amputations, club foot repair) are successfully done in others. One obvious reason for this is the uneven skills level. In every surveyed hospital a good number of clinicians is able to do C/S, but very few can handle other surgeries. This results in low numbers of general surgical cases performed and inappropriate referrals.

Ol Doinyo Lengai or "Mountain of God" in Tanzania Arusha region, on the way to Wasso Hospital

​​We hope that our capacity building programme, to be launched in 2018, will make a significant contribution to narrowing the skills gap in these hospitals and bring about positive change for the rural populations served by these facilities.