The initiative to establish urological services at Hawassa Referral Hospital (HRH) in Ethiopia is a project led by the charity subcommittee UROLINK of the British Association of Urological Surgeons. https://www.baus.org.uk/professionals/urolink/urolink_home.aspx
Notably, the organization UroLAP is not involved in this endeavour. However, within the framework of UROLINK, one of our board members (ZA) participated in three workshops focused on Lower Urinary Tract Endoscopy.
Background on Urological Services in Ethiopia and HRH
Ethiopia faces significant limitations in urological healthcare, with only 15 qualified urologists serving a population of nearly 120 million people until 2019. HRH, established in 2005, serves as the primary tertiary care hospital for nearly 20 million individuals in Southern Ethiopia. UROLINK’s collaboration with HRH commenced in 2010, following a request from the host General Surgeon, Dr. Aberra Gobezie. Mr Shekar Biyani from Leeds spearheaded the project, aiming to establish a comprehensive urology unit at HRH. Before UROLINK started it’s campaign, many patients needed referral to capital Addis Ababa for endo-Urological procedures and complex Urological conditions.
As a member of the UROLINK faculty, our board member (ZA) actively participated in three workshops as part of these efforts.
1st Workshop 22-26th June 2015
2nd Workshop 3rd-11th December 2015
Faculty : Graham Watson and Zeeshan Aslam
During the timeframe of these workshops, the primary aims of UROLINK were to establish services for Lower Urinary Tract (LUT) Endoscopy. In the initial two workshops held in 2015, Dr. Abera was the sole faculty member offering Urological services for a population of 20 million. Dr. Getaneh Teferi, in the later stages of his Urological training in Addis Ababa, regularly participated in these workshops. Throughout both events, a variety of procedures including Transurethral Resections of the Prostate (TURPs), Bladder Neck Incisions, and Optical Urethrotomies were conducted, leading to evident skill enhancement. Additionally, educational sessions were conducted for medical students, and plans for auditing operative procedures were outlined.
In 2015, endoscopic resections were performed using dextrose and were typically applied for prostates ranging up to 50-60 grams in size. Thanks to prior efforts made during UROLINK workshops, stringent adherence to protocols such as those from the World Health Organization (WHO) and TURP checklists was observed. Anesthesia services were efficiently provided by trained nurses.
Numerous challenges were faced during this initial phase, including brief periods of electricity shutdowns and equipment malfunctions. Nonetheless, the team persisted in overcoming these obstacles, adapting to such circumstances, and remained resolute in their endeavor to establish successful Urological services.
3rd Workshop 16-20th October 2017
C Badrakumar, Zeeshan Aslam, Lewis Taylor
Following the disappointment of a last-minute workshop cancellation in 2016, attributed to a brief period of political instability in Ethiopia, UROLINK organized a subsequent workshop in 2017. Since the previous workshop, two significant developments have catalyzed a surge in the campaign: the introduction of a bipolar resection kit and Dr. Teferi’s completion of his urological training, leading to his joining HRH as faculty. This workshop once again centered on bladder outlet obstruction procedures. Subsequent to this event, the UROLINK committee deemed the host team sufficiently skilled to progress from LUT endoscopic workshops to other specialist areas such as stone disease and genito-urethral reconstruction.
Throughout its ongoing collaboration with UROLINK, HRH has seen significant growth in its faculty and has recently received accreditation from the College of Surgeons of East, Central, and Southern Africa (COSECSA) as a training center in Urology. The department has developed expertise in Urethroplasty and is poised to commence training in EndoUrology in the near future.
