Surgical Collaborative Training Updates

Development of Cardiothoracic Fellowship in Rwanda

In 2020, when ACS H.O.P.E. established a partnership with King Faisal Hospital (KFH) in Kigali, Rwanda, to support the development of several surgical specialties, including cardiothoracic (CT) surgery, there was only one fully trained CT surgeon in the country. Cardiac surgical care was delivered sporadically through mission trips by expatriate volunteer cardiac teams. There was no systematic approach to general thoracic surgical care. Recruitment of additional CT surgeons and the creation of a CT surgical fellowship were considered pivotal to developing sustainable CT surgical care.

Following the recruitment of three additional surgeons from outside Rwanda to provide adult and pediatric cardiac surgical care, attention turned to developing a CT surgical fellowship. Fellows of the American College of Surgeons (FACS) working with ACS H.O.P.E. collaborated with KFH surgeons and CT leadership in the College of Surgeons of East, Central and Southern Africa (COSECSA) to create a training curriculum and index case requirements consistent with COSECSA board certification parameters and supplemented by select training requirements of the American Board of Thoracic Surgery.

A document outlining the rationale for a 3-year fellowship and a detailed didactic and operative training plan was jointly developed by ACS Fellows, local CT surgeons, and KFH administrative staff responsible for surgical education. Following review and approval by the University of Rwanda and the Ministry of Health, the fellowship program was approved and began enrolling fellows in 2024.

Currently, the training program includes one first-year and two second-year CT surgical fellows. The program represents a significant achievement in surgical capacity building in Rwanda and a milestone in the country's collaboration with ACS H.O.P.E.

Hawassa Seed Grant Proposals

This year, the Hawassa research workgroup launched a seed grant opportunity to encourage resident-led research and support the advancement of surgical care at Hawassa University Comprehensive Specialized Hospital in Ethiopia. Through this initiative, residents were invited to submit research proposals addressing important clinical challenges and opportunities to improve patient care.

The initiative reflects ACS H.O.P.E.'s ongoing commitment to fostering research, strengthening local surgical capacity, and supporting the next generation of surgeon-scientists. The selected proposals highlight innovative approaches to improving surgical outcomes and addressing critical healthcare needs within the institution. The selected projects are described below.

Success Rates and Predictive Factors of Hydrostatic Reduction for Pediatric Intussusception at Hawassa University Comprehensive Specialized Hospital: A 2-Year Retrospective Study

Author: Iyuel Abayneh, MD – General Surgery Resident

This study evaluates the success rate and predictors of hydrostatic reduction for pediatric intussusception at Hawassa University Comprehensive Specialized Hospital (HUCSH) in Ethiopia. Using a retrospective review of pediatric patient records, the research will identify factors associated with successful and unsuccessful nonoperative treatment. Variables include age, sex, symptom duration, clinical presentation, bowel vascularity, operator experience, number of reduction attempts, and procedure duration.

The study aims to improve clinical decision-making, reduce treatment delays, identify procedure-related complications, and support the development of a standardized institutional management protocol. Findings will help optimize patient selection, improve outcomes, and provide baseline data for future research.

Time to Imaging Modalities Among Trauma Patients Presenting to Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia: A Cross-Sectional Study

Author: Binyam Tesfaye, MD – General Surgery Resident

This study assesses the time to diagnostic imaging and factors associated with imaging delays among trauma patients presenting to HUCSH in Ethiopia. Using a cross-sectional design, the research will evaluate the interval between emergency department arrival and completion of initial imaging studies, including x-rays, focused assessment with sonography for trauma (FAST), and CT scans.

The study aims to identify patient-, hospital-, and system-related factors contributing to delayed imaging and assess compliance with recommended imaging timelines. Findings will provide evidence to improve trauma care processes, optimize resource utilization, support standardized imaging protocols, enhance collaboration between departments, and ultimately improve patient outcomes through earlier diagnosis and treatment.

Pain Management Practices and Adequacy of Analgesia Among Trauma Patients Presenting to Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia: A Cross-Sectional Study

Author: Leul Zerihun, MD, MPH – General Surgery Resident

This study assesses pain experiences, pain management practices, and the adequacy of analgesia among trauma patients presenting to HUCSH in Ethiopia. Using a cross-sectional design, the research will evaluate the prevalence and severity of pain, the timeliness and appropriateness of analgesic administration, and the use of standardized pain assessment tools in trauma care.

The study also aims to identify patient-, provider-, and health system-related factors associated with inadequate pain management. Findings will help identify gaps in current practice, support the development of evidence-based pain management protocols, improve patient-centered trauma care, strengthen multidisciplinary collaboration, and enhance the overall quality of emergency and surgical services.

2026 Resident Research Winners

Each year, ACS H.O.P.E. invites surgical residents from the Hawassa and Lusaka consortia to submit research proposals that advance surgical education, strengthen local capacity, and improve patient care. This initiative reflects our ongoing commitment to fostering academic collaboration and supporting the next generation of surgeons.

This year, six proposals were submitted, highlighting innovative approaches to addressing surgical challenges in resource-limited settings. The two selected awardees (one from each hub) presented research projects that have the potential to make a meaningful and lasting impact on surgical care.

Lusaka Hub

Awardee: Katherine Palmer Loveluck, MD

Institution: University of Massachusetts Chan Medical School

Research Proposal: Building Provincial Trauma Capacity in Zambia through Sustainable Primary Trauma Care Curriculum Implementation

Katherine Palmer Loveluck, MD, is a general surgery resident at UMass Chan Medical School. She earned her medical degree from Wayne State University School of Medicine in Detroit, Michigan, where her clinical training sparked an interest in general and trauma surgery and the role of social determinants of health in surgical recovery beyond the operating room.

Dr. Palmer Loveluck has pursued this interest during her dedicated research years, focusing on adult and pediatric trauma outcomes and injury prevention and culminating in a Master of Public Health degree. This additional training has strengthened her ambition to apply a thoughtful, preventive approach to traumatic injury and surgical care.

Dr. Palmer Loveluck plans to complete a fellowship in trauma and surgical critical care, with the goal of serving patients inside and outside the hospital through clinical excellence, research, and advocacy.

Her research proposal for the ACS H.O.P.E. Resident Research Scholarship will bring a standardized trauma care training course to healthcare providers in parts of Zambia where specialized care for patients with traumatic injuries is scarce. She looks forward to continuing her surgical training and advancing her professional goals.

Hawassa Hub

Awardee: Kaleem Ahmed, MD

Institution: University of Wisconsin-Madison

Research Proposal: A Systemic Gap Analysis and Needs Assessment of Cancer Capacity at Hawassa University Comprehensive Specialized Hospital

Kaleem Ahmed, MD, is a general surgery resident at the University of Wisconsin–Madison interested in pursuing a career as a global surgeon and surgeon–informatician. His research focuses on applying advanced data science methods in low- and middle-income countries (LMICs) to improve surgical outcomes, decision-making, and health equity.

His work leverages large-scale electronic health record (EHR) and health system datasets to develop predictive models for postoperative complications, survival, and resource utilization, particularly among patients undergoing surgical procedures for gastrointestinal diseases.

Dr. Ahmed's training uniquely positions him at the intersection of global surgery, informatics, and outcomes research. He is among a small group of global health and surgical outcomes researchers with surgical training and a graduate degree in artificial intelligence, and he is on track to become a double-board-certified surgeon–informaticist.

Before residency, through the Wisconsin Surgical Outcomes Research program within the Zafar Lab, he developed formal expertise in clinical study design, statistical analysis, supervised and unsupervised machine learning, and EHR-based data commons development.

During his academic training and residency, he has expanded this work to include machine learning models for postoperative morbidity and survival, registry development, and health system capacity assessment research in both high- and low-resource settings. He has led and contributed to international projects in Ethiopia and Pakistan evaluating surgical care capacity and global oncology efforts.

2025-2026 Hawassa Resident Researcher

As the 2025 ACS H.O.P.E. Resident Research Scholarship awardee, Kyle J. Alexander, MD, MS, a PGY-3 general surgery resident at Virginia Commonwealth University Health System, had the opportunity to work alongside surgical colleagues in Hawassa, Ethiopia, contributing to initiatives aimed at strengthening surgical education, trauma care, and health systems. In this reflection, Dr. Alexander shares how his experience fostered meaningful collaborations, deepened his understanding of global surgery, and reinforced his commitment to advancing sustainable surgical care.

My experience as an ACS H.O.P.E. Global Surgery Fellow in Hawassa has been one of the most meaningful and career-shaping experiences of my surgical training. I am especially grateful for the privilege of being welcomed by our colleagues in Hawassa, building relationships with residents and faculty from both Hawassa and across the ACS, and working together to strengthen surgical and trauma care.

I especially appreciate the longitudinal nature of the ACS H.O.P.E. partnership. Building on prior trauma and surgical system assessments conducted in 2019 and 2024, we had the opportunity to help identify persistent gaps in care and witness firsthand the challenges involved in building and sustaining surgical and trauma systems.

I also had the opportunity to contribute to the many ways the ACS-Hawassa partnership strengthens surgical care, from improvements to the resident learning space and expanding laparoscopic surgery, to supporting the surgical registry and trauma team response. I am particularly proud of our trauma team alert system, developed in close collaboration with emergency medicine, surgery, and nursing colleagues in Hawassa, which has grown from an idea into a functioning system.

I am deeply thankful to ACS H.O.P.E. and to our colleagues in Hawassa for allowing me to be part of this work. The experience will continue to shape how I approach my work as a surgeon, and I hope to remain involved in global surgery and surgical systems development throughout my career.

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