Building surgical capacity in Malawi: Investing in training and education

In Malawi, there is a drastic shortage of trained surgical providers to adequately meet the needs of the more than 16 million residents.  While in the US there are approximately 44.6 surgeons per 100,000 population, it is estimated there are as few as 0.1 surgeon per 100,000 population in Malawi, equating to one surgeon for every million residents.  A multi-pronged and integrated effort is necessary to overcome this deficit.  Since 2011, Physicians for Peace (PFP) has partnered with Queen Elizabeth Central Hospital (QECH) and the College of Medicine of Malawi to provide general surgery training to interns, registrars (equivalent to residents in the US), and clinical officers.  This has primarily been executed by international surgical volunteers serving as trainers for three month periods, on a year-round basis.  This collaborative approach with the surgical department at QECH has increased manpower within the nation’s busiest hospital to both perform surgeries and provide focused training for multiple levels of practitioners.  PFP has also enhanced QECH’s surgical procedure and training capacity through the provision of equipment and resources for an additional operating room.  The program now also includes a direct investment in a regional surgery education program for two registrars which provides an internationally-recognized qualification, enhancing the standard of surgical care in the country and region for years to come. Given the resource limitations of Malawi’s medical system, these collaborative efforts have been effective methods of strengthening surgical training, serving as a small but important part of building the surgical capacity in the country.