International Surgery - Projects

CAGS surgeon visitors to Guyana

before 2005: Dr. R. Taylor

2005:    Dr. B. Cameron, Dr. J. Barnhill

2006:    Dr. B. Cameron, Dr. S. Chia, Dr. W. Harris, Dr. R. Lett, Dr. J. Barnhill

2007:    Dr. B. Ostrow, Dr. B. Cameron, Dr. A. Abraham, Dr. R. Fairfull-Smith, Dr. Y. Ying

2008:    Dr. P. Willard, Dr. R. Taylor, Dr. R. Fairfull-Smith, Dr. W. Yakimets, Dr. J. Just,

              Dr. W. Harris, Dr. G. Hwang, Dr. B. Cameron

2009:    Dr. B. Ostrow, Dr. O. Henao (with Dr. A. Okrainec by teleconference), Dr. B. Cameron, Dr. F. Huang, Dr. R. Fairfull-Smith, Dr. R. Mimeault, Dr. R. Lett, Dr. Y. Ying, Dr. P. Willard

CAGS GUYANA PROJECT UPDATE

December 4, 2009

         The second Guyana Medical Scientific Conference was held November 22^nd followed by a banquet honoring the 4 new Postgraduate Diploma in Surgery graduates.   Surgical textbooks were presented on behalf of the CAGS surgeons. Three government Ministers attended the entire conference, and the Canadian CIDA representative also attended the dinner. Conference organizer Dr. Madan Rambaran continues to provide extraordinary leadership to the Program and the Hospital.



Here’s an outline of some of the activities underway.

1. The tutorial modules will continue, and CAGS visitors are needed to assist with the tutorial.  CAGS visitors are also needed as mentors in the regional hospitals. Let me know if you can visit in 2010.

2. The next final examination for 3 residents will be in April 2010. We must thank Dr. Robin Fairfull-Smith for compiling the exam and for being the external examiner for the last 2 years. One CAGS visitor will still be needed each year as an external examiner.

3. The Endoscopy service is improving.  During the last 2 CAGS visits Dr. Allan Tinnie was able to do about 20 procedures (gastroscopy and colonoscopy) using the existing scopes at GPHC. He has taken the leadership to prepare the patients, set up and clean the scopes, and involve the nurses. His skills are developing, and he is looking forward to a 3 month fellowship with Dr. Bill Harris in Thunder Bay to focus on endoscopy. If you can contribute to the endoscopy program, contact Bill.

4. The Plastic Surgery service is developing with visits by Dr. Tim Sproule and Dr. Nanda Nandagopal from Scarborough, and Dr. Yvonne Ying is organizing a fellowship for Dr. Shilo Rajkumar.

5. Dr. Allan Okrainec from Toronto, with his Fellow Dr. Oscar Henao, taught the SAGES Fundamentals of Laparoscopic Surgery course to the Guyanese residents and faculty via Skype earlier this year.  One of the graduates will need to take this on to develop the basic laparoscopic program.

6. Dr. Ron Lett taught the CNIS Trauma Team Training Instructors course in Georgetown in July, and all the residents are now Instructors. Dr. Chris Prashad directed the 5^th Guyana TTT Provider’s course in November.

7. Dr. Brian Ostrow has put an incredible amount of work into the development of the Diabetic Foot Centre at GPHC, which is under the direction of Dr. Carlos Martin in collaboration with Dr. Gary Sibbald of Toronto (an international wound care expert). With CIDA funding for a foot screening , education and debridement program over the past 18 months, they have decreased the amputation rate by almost 50% at GPHC. Several papers and posters have been presented internationally. We are awaiting news from CIDA on a request for a 3-year program funding – CAGS would be the Canadian partner.

8. Four papers from Guyana were presented at the 2009 Bethune Round Table on International Surgery by Dr. Rajendra Sukhraj, Dr. Chris Prashad, and Dr. Brian Ostrow. Dr. Madan Rambaran was invited by the Royal College to attend the International Conference on Residency Education.   A paper on the CAGS-Guyana Project will appear in the February 2010 issue of the Canadian Journal of Surgery.

9. Monthly web-conferences with Guyana continue. Let me know if you would like to be the featured commentator. It would be great to pair up each resident presentation with a CAGS surgeon.

10. However the Guyana Minister of Health and the CAGS President have signed a MOU indicating that CAGS would continue to recruit 5 surgeon visitors annually and the Ministry would supply local accommodation and travel. We would pay our own airfares and receive a tax receipt through CNIS since this is a Member’s Project.

Thanks to all who have contributed to the success of the CAGS-Guyana Project.

Brian Cameron

Co-ordinater, CAGS-Guyana Project

cameronb@mcmaster.ca

-----------------------------------------------------------------------------------------------------------------------------------------January 2009

First Surgical Residents Graduate in Guyana

            CAGS is a proud partner in the University of Guyana’s Diploma in Surgery training project now completing its 3rd year. This first local postgraduate program is a source of immense pride for Guyana. CAGS has sent 14 surgeons on 20 teaching visits totaling 45 weeks over the past 3 years.

            A graduation ceremony for the first cohort of 5 surgeons took place on November 2^nd in Georgetown, with the Minister of Health and other local dignitaries including the Canadian High Commissioner in attendance.   This co-incided with the country’s first Medical Scientific Conference where 11 young Guyanese doctors presented their research. Dr. Robert Taylor’s keynote topic was ‘Surgical Care – a Timeless Mandate’. Surgical texts were presented to the graduates on behalf of CAGS.

            CAGS-Guyana visitors 2006-2008 were: Drs. Abe Abraham, John Barnhill, Brian Cameron, Shea Chia, Robin Fairfull-Smith, Bill Harris, Ghee Hwang, Jon Just, Ron Lett, Brian Ostrow, Robert Taylor, Peter Willard, Wally Yakimets, and Yvonne Ying.



photos:

“Dr. Robert Taylor of Vancouver delivers keynote address”



“Awards Banquet (standing L-R: Mrs. Janice Sukhraj (Administrative Manager), Dr. Shilindra Rajkumar (grad), Dr. Carlos Martin (grad), Dr. Brian Cameron (CAGS), Dr. Navindranauth Rambaran (grad), Dr. Robert Taylor (CAGS), Dr. Allan Tinnie (grad), Dr. Shawn Legall (grad), Professor Ivor Crandon (Jamaica).

Sitting L-R: Dr. Madan Rambaran (Program Director), Dr. Deen Sharma (Guyana), Dr. Leslie Ramsammy (Minister of Health), Dr. W.I. (Bud) Lee (Guyana)”

Background

CAGS-Guyana Project

based at the Georgetown Public Hospital Corporation (GPHC)
in Georgetown, Guyana

The CAGS-Guyana collaboration is focused on assisting with surgical training. Guyana and its population of 860,000 is nestled between Venezuela, Surinam, and Brazil on the Caribbean coast of South America. Over the past two decades, political instability and a weak economy have triggered emigration of health professionals. There are currently only a handful of Guyanese surgeons working in the public hospitals; much of the surgical care is provided by expatriates from China, Cuba and India on short-term contracts. In 1992 the University of Guyana graduated its first medical doctors, and by 2005 had produced 141 doctors, but only about 60 remain in the country. Most who have done postgraduate training overseas have not returned.

A small group of Guyanese surgical leaders were frustrated about the loss of so many of their graduates, and identified locally-based surgical training as one way to provide a career path for their house officers and improve surgical care. Recognizing the need to collaborate with overseas partners, this idea was further explored in 2000 when Dr. Bob Taylor of CAGS met with Mr. Deen Sharma, a Guyanese urologist and surgical leader. After completing a Needs Assessment, a 2 year surgical curriculum was developed and approved by the University of Guyana, funding was obtained through CIDA’s Canadian-Caribbean Cooperation Fund (CCF), and the first five residents were enrolled in the training program in May 2006. They passed their exams in April 2008 and are expected to graduate with a Diploma in Surgery from the University of Guyana in November 2008. Seven more surgical residents are currently in training.

The Program Director is Dr. Madan Rambaran, a general surgeon and Director of Medical and Professional Services at GPHC. Canadian surgeons visit quarterly for 2-3 weeks to teach tutorial modules. Between October 2005 and August 2008, 13 Canadian surgeons have made a total of 18 training visits to Guyana.

Guyanese surgical residents with examiners, April 2008.

(left to right) Dr. Carlos Martin, Dr. Shawn Legall, Dr. Robert Taylor (CAGS), Dr. Robin Fairfull-Smith (CAGS), Dr. Shilindra Rajkumar, Dr. Navindranauth Rambaran, Dr. Madan Rambaran (Guyana), Dr. Allan Tinnie, Dr. Deen Sharma (Guyana), Dr. Ivor Crandon (University of the West Indies).

Additional collaborative projects are being developed including a recently initiated Diabetic Foot Project led by Dr. Brian Ostrow. The CAGS-Guyana Project co-ordinator is Dr. Brian Cameron