Mass. Eye and Ear's OGSH launches new collaboration to care for people ENT diseases

Rates of death and disability stemming from ear, nose and throat conditions continue to rise in developing countries like Uganda, but despite the need, fewer than 15 operating ear, nose and throat (ENT) surgeons serve Uganda's 33.4 million and growing population. Only two ENT residency programs exist in this country, but many trainees do not remain in the country after graduation. Mass. Eye and Ear's Office of Global Surgery and Health (OGSH) is launching a new collaboration with Mbarara University Science and Technology School of Medicine and Mbarara Regional Referral Hospital to help address the need for more trained physicians to care for the ENT diseases and conditions of this population and to help encourage those who are ENT trained to stay in the country to care for those who need them.

Beginning on Nov. 10, two-person teams comprised of Mass. Eye and Ear/Harvard Medical School faculty and fellows began an onsite clinical component, rotating every two months, providing subspecialty surgical instruction, didactic lectures, clinical assessments and mentorships. The onsite component will be supplemented and supported through telemedicine, teleradiology and remote educational resources from Mass. Eye and Ear with the cooperation of faculty and staff from ENT, radiology and anesthesia.

"Each subspecialty module will last two weeks and be integrated into the local curriculum, dove-tailing into the local education infrastructure to provide maximum benefit and local relevance to the Mbarara ENT residents," said Mack L. Cheney, M.D., a long-time Mass. Eye and Ear physician and Harvard Medical School Professor of Otology and Laryngology, incumbent of the Steven C. and Carmella R. Kletjian Endowed Chair in Global Surgery, and director of the OGSH. "The program begins with laryngology with Ramon Franco, M.D., Mass. Eye and Ear director of Laryngology, and Paul Paddle, M.D., laryngology fellow, as the first rotation."

In addition, through a grant from Mass. Eye and Ear's Curing Kids Fund, the OGSH is sponsoring the training of ENT resident Dr. Esther Nakasagga for the duration of a three-year program in Mbarara. "In Uganda, medical residents are not salaried and must pay tuition. This has served as an obstacle to increasing surgical capacity as careers in infectious disease are much more likely to be supported due to considerable investment by international aid." Dr. Cheney said. "Mbarara University Science and Technology School of Medicine (MUST) learned about all of the qualified candidates who applied for the Curing Kids Fund grant and sponsored a second candidate, Dr. Jamilah Nabukenya. These two first-year residents will be part of the surgical training collaboration that the OGSH is starting this month.

The OGSH was made possible through the generosity of Carmella Kletjian, who established the Steven C. and Carmella R. Kletjian Endowed Chair in Global Surgery.