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Lung Health Care Capacity in Ethiopia Improved With Two Newly Trained Pulmonologists

Note: World Lung Foundation united with The Union North America. From January 2016, the combined organization is known as “Vital Strategies.”

(Addis Ababa, Ethiopia and New York, USA) – World Lung Foundation (WLF) today hailed the graduation of the first two Fellows to complete fellowship training in pulmonary medicine under the auspices of the East African Training Initiative, a major new program run by World Lung Foundation in partnership with Addis Ababa University and Tikur Anbessa (Black Lion) Hospital, with the support of the Ministry of Health of Ethiopia. The training program was launched two years ago to help create a new generation of lung health specialists by providing specialist training in-country at Addis Ababa University and the Black Lion Hospital for graduates of accredited medical schools in Ethiopia.

The two new Fellows – Dr Fahmi Oumer and Dr Tola Bayesa – were recognised in a graduation ceremony held today at Addis Ababa University. The Chief Executive Director of the College of Health Sciences of Addis Ababa University, the Chairman of the Department of Medicine and the State Minister of Health all attended the event. Immediately afterwards, a Symposium was held to inaugurate the Ethiopian Thoracic Society which will help to further build capacity and improve health. Speakers at the Symposium included WLF’s Chief Scientific Officer and leader of the Training Initiative, Dr Neil Schluger, and Dr Jeremiah Chakaya, a leading thoracic specialist, public health expert in Africa and Head of the TB control programme in Kenya.

For the past two years, Dr Oumer and Dr Bayesa have been instructed, mentored and supervised by a visiting faculty of lung health experts drawn primarily from the USA and Switzerland. In addition to their training in Ethiopia, Dr Oumer and Dr Bayesa presented original research about the nature and extent of lung cancer and other common and chronic lung diseases in Ethiopia at the Union World Conference on Lung Health in Barcelona, in October 2014. This research will be invaluable in helping public health specialists in Ethiopia to develop preventative approaches to lung disease. Near the end of their two-year training program, the doctors undertook a five-week rotation in the USA at Brown University in Rhode Island and Columbia University Medical Center in New York. After graduating, Dr Oumer will remain at the Black Lion Hospital, the largest public hospital in Addis Ababa and Dr Bayesa will return to his home institution of St Paul’s Hospital, also in Addis Ababa.

The graduation of these Fellows will have an immediate impact and help to deliver sustainable capacity over the longer term. First, it increases the number of specialist pulmonologists available to diagnose and manage lung disease at an individual patient level in the public sector. Second, it increases the availability of lung health specialists to assess public health and medical services at village, city, regional and country-wide levels, and to develop the surveillance and assessment tools that are critical to informing public policy and health delivery strategies. Third, these pulmonologists will act as role models and help to train the next generation of health professionals – building sustainable capacity within Ethiopia’s public health system.

Dr Neil Schluger, Chief Scientific Officer, World Lung Foundation, said: “We have been impressed with the commitment and professionalism shown by Dr Oumer and Dr Bayesa and it has been an honor to work alongside them. This achievement would not have been possible without the contribution of Dr Charles Sherman of Brown University, who has played a key role in developing the curriculum and monitoring the Fellows. Dr Jane Carter, also of Brown University, has been invaluable in co-leading the program and in overseeing the doctors during their rotation in the USA. We are grateful to the visiting Faculty, drawn from the USA and Switzerland, who have volunteered their time and expertise to come to Ethiopia to teach, supervise and mentor the students on the training program and we thank Swiss Lung Foundation for its invaluable financial support.

“We thank our colleagues at Addis Ababa University and the Black Lion Hospital, who shared our vision of developing and delivering the Initiative. Over the next few years, a further six doctors will join Dr Oumer and Dr Bayesa in becoming qualified pulmonary specialists. This is a life-saving achievement; the initiative shows that it is possible to develop medical specialists in their own country in a way that makes a real difference to the public, to the medical practitioners and facilities involved and to public health in the countries willing to commit to building capacity.”

Dr. Ahmed Reja, Executive Director of the College of Health Sciences, Addis Ababa University, said: “In Ethiopia, one of the biggest problems we encounter in combating lung disease is the lack of qualified pulmonologists. From an academic perspective, we were frustrated that we could not help to develop a new cohort of qualified pulmonologists because there was no existing cohort to teach them. That is why this initiative is so important. Our doctors don’t need to leave Ethiopia to develop this expertise; for most of the two years of the training program, the visiting Faculty comes to them. Dr Oumer and Dr Bayesa – and the other doctors now following them through the Program – are being trained to the highest international standards in the context of providing medical care in Ethiopian hospitals and addressing the specific lung health needs of Ethiopians. We can now build that cohort of Ethiopian specialists who can help to train the next generation, delivering not just new but sustainable capacity.

“We extend our thanks to World Lung Foundation for partnering with us in this initiative and to the host of other partners and visiting Faculty who have helped to make it possible. We can assure our colleagues that the public of Ethiopia will benefit from our collective investment in these outstanding young doctors.”

About The Initiative

WLF and Addis Ababa University jointly designed the comprehensive two-year training program, with the content specifically tailored to the needs of the local hospitals and population. The fellowship training program is based on the United States Accreditation Council on Graduate Medical Education (ACGME) Competencies of Patient Care, Medical Knowledge, Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal and Communication Skills. The program incorporates the on-site presence of a qualified pulmonary physician and regular visits by visiting professors from leading academic medical centers such as Columbia University and Brown University. Fellows spend 24 months pursuing inpatient clinical rotations supervised by the faculty and participate in weekly outpatient continuity clinics for at least 18 months. In addition, they are expected to develop research projects and other scholarly activities that contribute to the field of pulmonary medicine and attend relevant conferences and lectures. The two newly-graduated Fellows both presented their research at the recent Union World Conference on Lung Health in Barcelona. Upon graduation, the Fellows achieve the status of qualified pulmonary physicians. The program and the salaries of the physicians undertaking the program are funded by World Lung Foundation, the Swiss Lung Foundation and the Ministry of Health of Ethiopia.

The Director of the Program is Dr. Neil Schluger, Chief Scientific Officer of World Lung Foundation and Chief of the Division of Pulmonary, Allergy and Critical Care Medicine at the Columbia University Medical Center and Professor of Medicine, Epidemiology and Environmental Health Science at the Columbia University College of Physicians and Surgeons and Columbia’s Mailman School of Public Health. Co-director of the program is Dr. Jane Carter, Associate Professor of Medicine at the Warren Alpert School of Medicine of Brown University and Director of the Brown Kenya Program.

About lung health in Ethiopia

Ethiopia is the second largest country in Africa, with a population of 94.1 million people, and ranks in the world’s bottom 10 countries in terms of gross domestic product (GDP) per capita according to the World Bank. Diseases such as tuberculosis, acute respiratory infections, chronic obstructive lung disease, lung cancer, and asthma are major public health problems in Ethiopia. The rate of TB is 261/100,000, placing Ethiopia among the 22 high-burden countries in the world (third highest in Africa and eighth highest in the world). Rates of acute respiratory infections are among the highest in the world and rates of asthma, COPD and lung cancer are rising. The burden of chronic lung disease (especially in women) due to exposure to indoor air pollution and outdoor air pollution is substantial. A 2009 report from the World Bank (“Ethiopia: Improving Health Service Delivery”) notes that in efforts to improve health care delivery and outcomes “the key constraint was the lack of specialized doctors” to provide basic services at the primary and secondary care level. Prior to the graduation of the Fellows, there had been only one public sector lung health specialist in Ethiopia and this lack of specialist physicians is a significant obstacle to reducing morbidity and mortality from these diseases.