The Impact of Colonialism on Surgical Training Structures In Africa Part 1: Contextualizing the Past, Present And Future

Authors

Nqobile Thango, Department of Neurosurgery, University of Cape Town, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
Andrea L. Klein, School of Medicine and Health Sciences, The George Washington University, Washington, DC; Milken Institute School of Public Health, The George Washington University, Washington, DC.
Beverly Cheserem, Department of Neurosurgery, Aga Khan University Hospital, Nairobi, Kenya.
Muhammad Raji Mahmud, Department of Neurosurgery, Ahmadu Bello University, Zaria, Kaduna, Nigeria.
Abebe Bekele, Department of Surgery, University of Global Health Equity, Kigali, Rwanda.
Efosa Ohonba, Department of Neurosurgery, University of Cape Town, Cape Town, South Africa.
Gloria Shani Kabare, Department of Neurosurgery, Aga Khan University Hospital, Nairobi, Kenya.
Saidu Abdulkarim Umar, Department of Neurosurgery, Ahmadu Bello University, Zaria, Kaduna, Nigeria.
Jules Iradukunda, Department of Surgery, University of Global Health Equity, Kigali, Rwanda.
Gail L. Rosseau, Department of Neurosurgery, The George Washington University, Washington, DC; Barrow Neurological Institute, Phoenix, AZ. Electronic address: gailrosseaumd@gmail.com.

Document Type

Journal Article

Publication Date

2-23-2024

Journal

World neurosurgery

DOI

10.1016/j.wneu.2023.11.147

Keywords

Africa; colonialism; global neurosurgery; global surgery

Abstract

Since the first African country attained independence from colonial rule, surgical training on the continent has evolved along three principal models. The first is a colonial, local master-apprentice model, the second is a purely local training model, and the third is a collegiate inter-country model. The three models exist currently and there are varied perceptions of their relative merits in training competent neurosurgeons. We reviewed the historical development of training and in an accompanying study, seek to describe the complex array of surgical training pathways and explore the neocolonial underpinnings of how these various models of training impact today the development of surgical capacity in Africa. In addition, we sought to better understand how some training systems may contribute to the widely recognized "brain drain" of surgeons from the African continent to high income countries (HIC) in Europe and North America. To date, there are no published studies evaluating the impact of surgical training systems on skilled workforce emigration out of Africa. This review aims to discover potentially addressable sources of improving healthcare and training equity in this region.

APA Citation

Thango, Nqobile; Klein, Andrea L.; Cheserem, Beverly; Mahmud, Muhammad Raji; Bekele, Abebe; Ohonba, Efosa; Kabare, Gloria Shani; Umar, Saidu Abdulkarim; Iradukunda, Jules; and Rosseau, Gail L., "The Impact of Colonialism on Surgical Training Structures In Africa Part 1: Contextualizing the Past, Present And Future" (2024). GW Authored Works. Paper 4315.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4315

Department

Neurological Surgery