ASSET Course Advances Trauma Care in Sub-Saharan Africa

The ACS Advanced Surgical Skills for Exposure in Trauma (ASSET^®) course, held for the first time in sub-Saharan Africa in July 2025, was a pivotal first step toward sustainable trauma care and local surgeon educator development. This was more than a training session—it was the start of a long-term strategy to strengthen trauma care capacity and create a sustainable pipeline of surgical educators in that area of the world.

Why ASSET Matters in Africa

Trauma is a leading cause of death globally, and the burden is particularly heavy in East Africa. According to the World Health Organization, traumatic injuries are consistently a top 10 cause of death and disability-adjusted life years in the region. Surgeons have limited access to resources and few opportunities for structured trauma operative training; yet, they must care for patients with complex injuries. The ASSET course addresses this educational gap by teaching critical exposure techniques for managing vascular and visceral injuries—skills that can mean the difference between life and death.

The Nairobi Surgical Skills Centre (NSSC) hosted the ASSET course, led by Rich Davis, MD, FACS, in partnership with Vanderbilt Surgery’s Global Health Program and AIC Kijabe Hospital in Kenya. Supporting faculty members included Lydia Lam, MD, FACS, Peep Talving, MD, FACS, Christopher Dodgion, MD, MSPH, MBA, FACS, and Stephen P. Gondek, MD, MPH, FACS.

The NSSC is a premier facility for surgical education in East Africa that provides an ideal venue for cadaver-based training. Participants included senior surgical residents and junior faculty from across Kenya and neighboring countries, creating a dynamic, multidisciplinary learning environment.

2-Day Course with Purpose

The course was structured over 2 days: Day 1 delivered the standard ASSET curriculum to a cohort of senior residents and early career faculty, while Day 2 transitioned selected participants into instructor candidates, giving them hands-on teaching experience under faculty supervision. A total of 16 surgeons and surgeons in training were able to complete the course, and two new instructors were trained.

This approach reflects a guiding principle: sustainability through local ownership. Rather than a one-off event, the course was designed as the first step in a multiyear plan to establish a self-sustaining ASSET program in East Africa.

The ultimate goal is ambitious yet achievable: by spring 2026, a follow-up course will return to the region to elevate these instructor candidates to course directors, enabling the program to run entirely with local leadership. This model—train, mentor, transition—ensures that ASSET becomes embedded in the region’s surgical education ecosystem rather than dependent on external faculty.

Lessons Learned and Early Impact

Feedback from participants was overwhelmingly positive. Many cited the cadaver-based format as a rare and invaluable opportunity to practice complex exposures in a controlled environment. Faculty noted the enthusiasm and technical aptitude of learners, reinforcing the belief that local surgeons are ready to lead this effort.

“The ASSET course transformed the way I approach trauma surgery by bridging the gap between theory and real-world application,” shared participant Leahcaren Oundoh, MD. “It strengthened my confidence in vascular exposure and organ-specific approaches, and I now feel comfortable operating in the abdominal, thoracic, pelvic, and neck compartments since the training—skills I’ve already applied successfully in several trauma cases.”

Key takeaways for future iterations of this structured course include early engagement with institutional partners to streamline logistics and cadaver procurement; clear pathways for instructor development, including mentorship and remote support between courses; and integration with national surgical societies to align ASSET with broader workforce development goals.

While international course production did present unique challenges, an experienced group of faculty, engaged students, and a robust curriculum made for an effective delivery of the content.

This initiative reflects the commitment of the ACS and its Committee on Trauma to global healthcare equity and surgical education. ASSET is more than a course—it’s a commitment to equity in surgical education. By investing in local capacity, the ACS and its collaborators are helping to close the gap in trauma care outcomes between high-resource and resource-limited settings throughout the world. The ripple effect is profound: every surgeon trained in ASSET becomes a multiplier, training other surgeons in their area and improving care for countless patients across the region.

Looking Ahead

The next locally led ASSET course is planned for this year, with specific instructor candidates advancing as course directors. Until then, faculty and candidates will remain connected through virtual mentorship and shared resources, ensuring momentum continues.

“Trauma is truly an undertreated disease in this part of the world,” said Dr. Davis. “ASSET training is only one part of the puzzle. We also need improvement in prehospital care, systems, and the capacity of the hospitals themselves. The spark to make these improvements will come from these young African surgeons themselves. It’s a joy to help them develop their interest in the field of trauma surgery.”

Disclaimer

The thoughts and opinions expressed in this article are solely those of the authors and do not necessarily reflect those of the ACS.

Dr. Stephen Gondek is an associate professor of surgery and program director of the acute care surgery fellowship at the Vanderbilt University Medical Center in Nashville, TN.