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country of origin throughout their professional career. This `brain
drain' has had severe and unintentional consequences, weakening
the human resource capacity in these regions and, more damagingly,
creating a negative perception of African-led training and educational
institutions. COSECSA, as a young and dynamic organisation, is best
placed to reverse that perception." How significant an impact could
surgical services have in alleviating health problems in Africa? "A
lack of access to surgical services, particularly at rural facilities in
Africa, results in excess morbidity and mortality from a broad range
of treatable surgical conditions including injuries, complications
of pregnancy, sequellae of infectious diseases, acute abdominal
conditions and congenital anomalies."
According to the WHO, 11 per cent of the global disease burden
can be addressed through surgery and in particular 80 per cent of
deaths related to non-communicable disease (NCD) could be averted
through surgery. Africa has witnessed the world's most rapid and
uncontrollable rise in NCDs. "There has also been an uncontrollable
increase in road traffic-related mortality and injury across Africa
and, in particular, within COSECSA countries such as Kenya which
witnessed, in 2013, over 3,000 deaths related to road traffic accidents.
Many of these deaths would have been avoidable if there was timely
access to surgical intervention."
Without the RCSI's commitment, COSECSA would not be what it is
today, Mr Kaikumba states. "The RCSI collaboration has been pivotal
in establishing COSECSA's common examination and developing
its institutional capacity across the countries that it operates in.
One cannot overestimate the valuable role that RCSI plays. I hope
to see this relationship evolving into a mutually beneficial strategic
partnership that will strengthen both organisations' capacity
in delivering excellent surgical training. The strengthening of
COSECSA's core functions through this collaboration will position it
more effectively to demonstrate leadership in global health delivery
and, in working side by side, both organisations can amplify their
voices in international health policy circles to champion agreed and
desired outcomes."
He added: "Lastly, through international collaborations like this,
COSECSA has the ability to offer global solutions at a local level."
Mr Kaikumba believes that for surgeons who want to make a
difference, Africa is the right location. "Choosing to work here,
you are working where there is immense need and making the
greatest impact in the lives of many. The one thing I know about
surgeons is that many enter this field not for the status or money
but because they see surgery as a vocation and many are driven by
humanitarian, religious and humanist instincts to make a positive
difference in people's lives. Africa gives you the greatest opportunity
to achieve this in our time." He has observed a growing appreciation
of the excellent work/life balance that many who have worked in
Africa have experienced. "As a result of financial pressures and the
commercialisation of professional working cultures, many feel that
jobs in the West have become more focused on meeting narrowly
defined targets, business objectives and outputs, as opposed to
delivering the kind of holistic, integrated care that is evident in many
health institutions in Africa. I urge surgeons to come and work here
and experience the benefits that can be gained from a working culture
that is fundamentally more focused on meeting the needs of patients
as people, not as service users.
"Also, having had another glorious day in the sunshine in Tanzania, I
have to admit that the most persuasive reason for a surgeon to work
over here is the heavenly weather and the jaw-droppingly epic scenery
that surrounds you!"
As CEO of COSECSA, Mr Kaikumba's key objectives are:
to establish and diversify COSECSA's income streams to
enable the organisation to be more sustainable and self-
to strengthen COSECSA's corporate identity, making it
more visible within and beyond Africa;
to improve COSECSA's service offer;
to strengthen COSECSA's infrastructure both physical and
to build a headquarters for COSECSA while reviewing
and developing the organisation's internal systems,
policies and practices to ensure that the organisation is
effective, efficient and enabled to deliver on a broader
programme of work;
to build on the strong foundations already in place in
relation to examinations, training and education activities;
to enable COCECSA to be recognised as a leader within
the profession and within the further education sector as
a whole.
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