Surgical Training Collaborative Updates

Hawassa, Ethiopia

Building Regional Leadership in Trauma Care: ATLS Progress in Hawassa, Ethiopia

As part of the ACS Health Outreach Program for Equity in Global Surgery (ACS H.O.P.E.^®) Surgical Training Collaborative, the partnership with Hawassa University Comprehensive Specialized Hospital (HUCSH) in Ethiopia continues to demonstrate the value of sustained collaboration in strengthening surgical systems and expanding access to high-quality trauma care. Through a shared commitment to education, capacity building, and local leadership development, HUCSH has emerged as a regional leader in trauma training, advancing clinical excellence and long-term program sustainability.

Since promulgating Advanced Trauma Life Support (ATLS) in February 2023, HUCSH has built steady momentum, hosting three ATLS Provider Courses and one Instructor Course, with participants from Ethiopia, Zambia, Somaliland, and South Sudan. This growing regional reach reflects the strength of the training and the increasing demand for standardized trauma education across East Africa. The program prioritizes sustainability through the development of local faculty and the implementation of a business plan to support long-term independence. Revenue generated from courses is reinvested to expand training capacity, maintain essential equipment, and reinforce local ownership.

The impact is evident across the region, with providers from trauma centers throughout Ethiopia gaining critical skills that directly improve patient care. At HUCSH, ATLS training is integrated into broader trauma system strengthening efforts, including enhancements in prehospital care and in-hospital trauma response. To support these clinical advancements, HUCSH has partnered with MedAid to deliver certificate-level training for 12 biomedical technologists. Training these biomedical technologists is a key component of building a sustainable trauma system where workforce development, equipment readiness, and clinical training all advance together.

Lusaka, Zambia

Advancing Surgical Nutrition and Pediatric Surgical Capacity in Zambia:
University of Michigan ACS H.O.P.E. Site Visit

Vanessa S. Niba, MD, MS, Robin T. Petroze, MD, MPH, FACS

In January 2026, a team from the University of Michigan in Ann Arbor, supported through the ACS H.O.P.E., partnered with colleagues in Zambia to advance surgical care delivery through collaborative education, quality improvement, and research initiatives.

The visit was led  by Robin T. Petroze, MD, MPH, FACS, director of the Michigan Center for Global Surgery at the University of Michigan in Ann Arbor, and Vanessa S. Niba, MD, MS, a resident at the University of Michigan and one of the 2025 ACS H.O.P.E. Resident Research Award recipients. Dr. Niba’s research focuses on developing sustainable strategies to improve surgical preparedness, with an emphasis on pediatric nutrition and cancer care disparities. This work includes creating and validating a culturally appropriate nutritional assessment tool for outreach programs in rural Zambia. Together with multidisciplinary stakeholders at the University Teaching Hospital (UTH) in Lusaka, and Kabwe Central Hospital, the team focused on strengthening perioperative systems and expanding pediatric surgical capacity.

During the first week at UTH, engagement with pediatric surgeons, anesthesiologists, nurses, and nutritionists identified critical gaps in preoperative nutritional assessment. Discussions revealed inconsistent documentation of patient weights, limited screening protocols, and infrastructure constraints affecting the identification and management of malnutrition.

Across disciplines, there was strong consensus on the need for a standardized approach. In response, the team collaborated with surgical registrars to develop and introduce a preoperative checklist for all elective surgical patients—an important step toward improving perioperative risk assessment and patient outcomes.

The second week focused on pediatric surgical outreach at Kabwe Central Hospital, where a multidisciplinary team conducted an intensive 2.5-day program. A total of 70 pediatric patients were evaluated in clinic, presenting with a wide range of congenital and acquired conditions. Forty-one surgical procedures were performed. US and Zambian providers worked side by side with local surgical interns, emphasizing hands-on training in clinical evaluation, operative techniques, and postoperative care.

In parallel, research planning sessions advanced Dr. Niba’s collaborative study examining the impact of perioperative nutritional status on surgical outcomes. Site coordinators were oriented, and study objectives were shared broadly to foster multidisciplinary engagement.

Next steps include finalizing the study protocol, securing local ethical approvals, and initiating pilot data collection. Efforts will focus on standardizing perioperative nutritional assessments, training local teams in data collection procedures, and establishing systems to support data quality and continuity. Ongoing mentorship and regular check-ins will help ensure alignment and support sustained engagement in the study.

This visit underscores the value of sustained, bidirectional partnerships in addressing context-specific surgical challenges. By integrating clinical care, education, research, and quality improvement, the collaboration continues to build a strong foundation for long-term improvements in surgical systems and patient outcomes in Zambia.

ACS H.O.P.E. Expands Global Impact Through UTH Seed Grant Program

This year, ACS H.O.P.E. launched the UTH Seed Grant Award, providing up to four $2,500 grants to senior registrars and junior faculty at UTH in Lusaka, Zambia. The review committee received 11 proposals and selected four for funding. Each project reflects a shared commitment to strengthening surgical care delivery, improving patient outcomes, and building sustainable local capacity. Read more about the funded projects below.

Body Image, Quality of Life, and Perceptions of Reconstructive Surgery in Postmastectomy Breast Cancer Patients in Zambia
Principal Investigator: Kim T. Mbewe

This project examines the psychosocial impact of mastectomy among women with breast cancer, with a focus on body image, emotional well-being, and perceptions of reconstructive surgery. Although breast reconstruction can play a critical role in recovery and quality of life, access remains limited in Zambia. By centering patient experiences and expanding the focus from survival to survivorship, this research aims to inform counseling practices, guide clinical care, and support policy discussions—advancing a more holistic and patient-centered approach to breast cancer management.

Adaptation of the Enhanced Recovery After Surgery (ERAS) Protocol to the Local Context of the University Teaching Hospital
Principal Investigator: Patricia Chipalabwe

This project focuses on adapting the ERAS protocol to Zambia’s resource-limited healthcare setting. ERAS has been shown to reduce postoperative complications and length of hospital stay. However, implementation in low- and middle-income countries remains limited. By identifying local barriers and developing a context-appropriate ERAS pathway, this study aims to strengthen perioperative care, promote efficient resource utilization, and support sustainable improvements in surgical systems.

Impact of Operating Elective Theatre Turnover Time on Surgical Efficiency at the University Teaching Hospital
Principal Investigator: Sylvia Mulenga

This prospective study evaluates elective operating theatre turnover time and its impact on surgical efficiency at UTH. Delays between cases can reduce theatre utilization and slow patient care. By identifying system-level challenges and opportunities for improvement, the project seeks to inform evidence-based strategies that optimize operating room workflow, strengthen surgical capacity, and enhance timely access to care.

Building Sustainable Surgical Capacity in Gastroschisis Management in Zambia
Principal Investigator: Thomson L. Lukisa

Gastroschisis remains associated with high neonatal mortality at UTH. This initiative introduces a standardized management protocol adapted from Muhimbili National Hospital in Tanzania, where similar efforts have improved survival. With an emphasis on training, knowledge transfer, and long-term sustainability, the project aims to strengthen institutional capacity and improve outcomes for newborns requiring complex surgical care.

Together, these projects demonstrate ACS H.O.P.E.’s commitment to collaborative research and sustainable progress in surgical care. By supporting investigator-led initiatives at UTH, the Seed Grant Program advances long-term efforts to strengthen surgical systems and expand equitable access to safe, high-quality care.

Kigali, Rwanda

Advancing Craniofacial Care in Rwanda: A Collaborative Visiting Professorship Model

Greta Davis, MD, Amanda Gosman, MD, FACS, Catharine Garland, MD

In January 2026, under the leadership of Faustin Ntirenganya, MD, MMed, PhD, FCS(ECSA), FACS, the Department of Plastic Surgery at the University of Rwanda in Kigali, hosted a Craniofacial Visiting Professorship grounded in collaborative, learner-driven education. The program was developed through several months of virtual engagement with senior residents who identified priority topics and selected operative cases to guide focused, intraoperative teaching. This deliberate preparation ensured that course materials, hands-on workshops, and operative objectives were aligned with locally defined training needs and long-term program growth.

The week included three high-impact operative days addressing craniosynostosis, encephalocele, and nasal reconstruction. A central goal was to strengthen local capacity to safely perform increasingly complex craniofacial procedures while advancing practical, sustainable solutions. This included the fabrication and use of cranial springs for spring-assisted cranioplasty using locally sourced materials. This approach paired technical skill development with resource-conscious innovation to support durable surgical care delivery.

Operative experience was reinforced through daily case discussions, participation in grand rounds, and bedside teaching focused on perioperative optimization, flap monitoring, and longitudinal follow-up. Hands-on skills laboratories in fracture plating, soft tissue coverage, and spring-mediated cranioplasty further strengthened core management principles and technical confidence.

Educational sessions were led by Amanda Gosman, MD, FACS (University of California San Diego), Catharine Garland, MD (University of Wisconsin-Madison), and Yves Nezerwa, MD (University of Rwanda; former SickKids craniofacial fellow). Greta Davis, MD (University of California San Francisco plastic surgery resident), who is supported by an ACS International Visiting Professor/Trainee Scholarship, developed a low-cost soft tissue facial flap simulator for sustainable local use and provided onsite workshop support. Nada Botros, a medical student from the Medical College of Wisconsin in Milwaukee, contributed high-fidelity, 3D-printed skull models to enhance operative planning and simulation.

Evaluation data demonstrated meaningful impact. Resident participants reported increased confidence in craniofacial planning and management, supported by measurable improvement in pre- and post-course knowledge assessments. The visit further strengthened a growing longitudinal partnership focused on sustainable craniofacial capacity building, continuous mentorship, and improved access to safe, high-quality surgical care in Rwanda.