UVA Global Surgery Initiative
CGH Scholar Summer Projects/Rwanda
The UVA Global Surgery Initiative has committed to mentoring 3 summer CGH interns to participate in our Rwandan projects. On the following pages please find below a listing of current projects.
1) Burden of Surgical Disease (Kigali, Rwanda)
a. Background: Access to surgical care and the burden of surgical disease have historically been neglected by the global health community. Yet, with over 230 million surgical procedures performed worldwide each year, there is growing evidence that providing surgical services should be considered a global health priority. Surgical disease contributes to at least 11% of the total global burden of disease and greater than 25 million disability-adjusted life years (DALYs). While metrics for the evaluation of surgical disease have been proposed, scientific evaluation of the burden of surgical disease is really in its infancy, and these metrics have yet to be tested in a controlled, scientific fashion. Previous work by the UVA Department of Surgery in Rwanda has included conducting hospital-level capacity surveys and a nationwide household study to assess the burden of surgical need.
b. CGH Scholar Position: The student will primarily work with previous research results to estimate surgical DALYs and surgically-avertable DALYs. This position is predominantly research based, and the student will be expected to prepare a manuscript at the end of the project.
c. Faculty Mentors: Dr. Forrest Calland will serve as the primary UVA mentor. There will be interaction with groups at the World Health Organization who work on understanding the burden of surgical disease worldwide.
2) Injury Epidemiology and Care Processes (Kigali University Teaching Hospital, Butare University Teaching Hospital)
a. Background: Road traffic accidents are one of the most rapidly rising causes of death in developing countries. The availabilities of emergency services, prompt resuscitation and surgical management greatly influence the outcome in potentially survivable injuries. The Injury Registry at the two University Teaching Hospitals in Rwanda (CHUK and CHUB, located in Kigali and Butare, respectively) was started as a collaborative project between the University of Virginia and the National University of Rwanda in 2011. The objective of this registry is to provide a longitudinal study of the prevalence and outcome of trauma at the main trauma referral centers in Rwanda, to discern the sources of success and failure in acute resuscitation, and to provide a framework for measurement of trauma incidence and outcomes at the district hospital and referral level.
b. CGH Scholar Position: The student will work with the Rwanda Injury Registry team at CHUK/CHUB to measures trauma process variables and outcomes.
c. Faculty Mentors: Dr. Forrest Calland, a UVA trauma surgeon with significant experience in Rwanda and in trauma system development, will serve as the primary UVA mentor. Dr. Jean Claude Byiringiro, a Rwandan surgeon and the head of the Department of Accident and Emergency at Kigali University Teaching Hospital, will serve as the primary Rwandan mentor.
3) Health Perceptions in the Community (Kigali, Rwanda with some outreach to rural communities)
a. Background: A key challenge to improving health in resource-limited settings is understanding health perceptions in the community and identifying barriers to care. Last summer, two of the CGH students began projects looking at health perceptions. The first was a survey of healthcare professionals to assess their perceptions of intimate partner violence (IPV) (which is known from community surveys to be prevalent in the population) on healthcare outcomes, practices, and attitudes and to characterize social and cultural beliefs towards IPV, attitudes towards IPV in medicine, and their practices in relation to IPV in healthcare. Another project looked at perceptions of illness in the rural community, and the intersection of traditional medicine and allopathic medicine as seen by traditional healers and community leaders.
b. CGH Scholar Position: The student will follow-up on these previous healthcare worker surveys and community interviews through close interaction with the NUR School of Public Health. The student will work to develop further collaborations amongst organizations working in Rwanda and the University of Virginia to develop interventions and education based upon the results.
c. Faculty Mentors: Dr. Forrest Calland will serve as the primary UVA mentor with a goal of involving other schools or centers at UVA (in anthropology or through the Women’s Center, for example). Dr. Joseph Ntaginara at the National University of Rwanda School of Public Health will serve as the primary Rwandan mentor.
4) Art With A Mission – Kigali (Ivuka Art Studio, Kigali, Rwanda)
a. Background: Art with a Mission is a charity-based project aimed at bringing children ages 6-17, many of whom are orphaned, together in a creative environment. Based in Kigali, Art with a Mission was founded by Emmanuel Nkurunga, a self-taught Rwandan mixed-media visual artist. The program seeks to empower these children through instruction in the arts, to include painting, drawing, sculpture and computer graphics. These skills can serve to heal empower, and promote life skills and self-awareness.
b. CGH Scholar Position: Work as a community development intern with Ivuka Art Studio to help establish sustainable community outreach projects and prepare some of the background for the establishment of a local art center. Responsibilities may include: report writing, focus groups, outreach to international partners, website design, among others. The Scholar will work with Emmanuel Nkuranga and Innocent Nkurunziza.
c. Faculty Mentors: In addition to Dr. Forrest Calland, UVA Department of Surgery, the student will work with a faculty mentor at UVA with experience in art/community development (TBD) and artists at McGuffey Art Center in Charlottesville (who host Art With a Mission-Charlottesville).