What if we could save lives by training a new generation of surgeons in low-resource settings?
WE CAN
Two thirds of the world’s population lack access to safe, affordable and timely surgical care.
Surgery that is common in developed nations is often unavailable, because of a severe lack of trained and qualified providers. Many childhood conditions are treatable through simple surgical intervention. Without this intervention, however, the probability of complications, lifelong disability and even death is high.
This holds very true in Malawi, where there are few pediatric surgeons practicing in the country – our Texas Children’s pediatric surgeon Dr. Bip Nandi and one other in the capital, Lilongwe, and only three in Blantyre, the largest city. In a country of nearly 20 million, this imbalance is catastrophic for many.
Texas Children’s collaborates with hospitals and universities to share training and provide direct care and treatment in many countries, including Malawi, Uganda, Botswana and Guatemala.
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Our Mission
The Texas Children’s Global Surgery & Anesthesiology program aims to address training disparities and increase access to quality surgical services for children in resource-limited settings.
THE CHALLENGE
Access and availability of surgery for children
At a minimum one pediatric general surgeon is needed for every 200,000 children. Currently there is a deficit of 46 pediatric surgeons in Malawi alone.
Lack of capacity and training programs
Surgeons, anesthetists and nurses at central hospitals and clinical officers at the district level lack access to training and capacity building programs.
Our Approach
It is a myth that surgery is an expensive luxury. We have come to learn that surgery can be as cost effective as many medical interventions such as drugs for heart disease and HIV, and even public health programs such as some vaccinations and bed nets for malaria. Our approach is to create sustainable, high-impact interventions to increase access to skilled pediatric surgical care and training.
CARE
We provide pediatric-trained surgeons to help address surgical back-logs and employ telemedicine to consult on complex cases and mentor surgeons and anesthetists in other countries.
Dr. Bip Nandi and his team in Malawi perform over 500 pediatric surgeries annually and conduct 2,500 outpatient visits and inpatient consultations at Kamuzu Central Hospital.
TRAINING
We offer shoulder-to-shoulder training and classroom instruction to doctors, nurses and surgical clinical officers and develop pediatric surgery and anesthesia curricula trainings.
Pediatric surgical training in sub-Saharan Africa is supervised by the College of Surgeons of East, Central and South Africa (COSECSA). Our accredited training site in Malawi serves as a regional training hub.
RESEARCH
We review outcomes to continuously improve quality control and trial new techniques to improve those outcomes.
global surgery fellowship
We provide opportunities for surgeons with an interest in making a lasting impact on pediatric surgical outcomes in low-resource settings.
Where we work
MALAWI
Malawi’s GDP per capita ranks in the lowest 10 of all countries globally, and roughly half of its population is under the age of 18. In response, Texas Children’s has established a comprehensive pediatric surgery program in Lilongwe at Kamuzu Central Hospital (KCH). Under the guidance of Malawi-based Baylor College of Medicine pediatric surgeon Dr. Bip Nandi , the program offers much needed clinical care to infants and children with surgical problems along with health sciences research and a training program accredited by College of Surgeons of East, Central and Southern Africa (COSECSA).
Dr. Nandi is one of only five pediatric surgeons in Malawi—and the only pediatric surgeon serving central and northern Malawi. As such, the program also focuses on outreach in surrounding communities to train practitioners how to safely care for certain pediatric ailments locally and when to refer more complex cases to Dr. Nandi’s team at KCH.
UGANDA
One of the fastest growing nations in Africa, Uganda boasts a substantial youth population—66% of its citizens are below the age of 24 and 50% are below the age of 18. A group of six pediatric surgeons, led by Dr. John Sekabira and based in Kampala, aim to provide surgical care for these 20 million children. In addition to Dr. Sekabira’s in country team, pediatric surgeons travel from around the world to assist in complex shoulder to shoulder operations. The team has also developed close collaborations with Kids OR and with Global HOPE to improve the outcomes of children requiring surgical care.
Texas Children’s Hospital and Baylor College of Medicine are actively fundraising in support of an expanded fellowship program in Uganda. Plans are also being developed to build out a pediatric ward to complement dedicated pediatric ORs at Mulago National Hospital.
Team
Surgeon-in-Chief, Texas Children’s Hospital
Professor of Plastic Surgery, Orthopedic Surgery and Pediatrics and Chair of Plastic Surgery, Baylor College of Medicine
Director, Texas Children’s Global Surgery Program
Professor and Chief, Global Surgery, Baylor College of Medicine
Bip Nandi, MBBCh, FCS (COSECSA), FRCS (UK)
Pediatric Surgeon, Texas Children’s Global Surgery Program
Assistant Professor of Surgery, Baylor College of Medicine
Anesthesiologist-in-Chief, Texas Children’s Hospital
Professor of Anesthesiology and Pediatrics, Baylor College of Medicine
Division Chief, General Anesthesiology and Associate Anesthesiologist-in-Chief for Academic Affairs, Texas Children’s Hospital
Professor of Anesthesiology, Pediatrics and Obstetrics & Gynecology, Baylor College of Medicine
Pediatric Anesthesiologist, Texas Children’s Hospital
Assistant Professor of Anesthesiology, Baylor College of Medicine
Dr. Bip Nandi, pediatric surgeon for Texas Children’s Global Surgery Program in Malawi, shares about the pediatric surgical services offered in Central and Northern Malawi.