Editorial Message: Greetings From Kenya

  I bring you greetings from Kenya, East Africa (on the other side of the continent from the Ebola epidemic). Because of the concern about Ebola our arrival at the Jomo Kenyatta International Airport (Nairobi, Kenya) was an interesting experience!   We were screened for infection. They focused a temperature sensor on my forehead to be sure I didn’t have a fever, and this was after I had walked down 2 flights of stairs exiting the aircraft, walked across the hot tarmac carrying a heavy bag, and rode in a hot bus to the terminal! Needless to say I was quite “warm” and failed the temperature screening by 0.2 degrees! Fortunately, after having a few minutes to cool off, I was rescreened and allowed to enter the country and head to my conference.

  I was invited here to teach a wound treatment seminar as part of a continuing education program for African surgical residents. The Pan-African Academy of Christian Surgeons (PAACS), an organization of missionary surgeons training African surgeons to stay in Africa to help their own people, is sponsoring 12 programs with residents attending the seminar from countries all across the continent. You might remember the Liberian surgeon who contracted Ebola virus and died in the United States. He was a PAACS-trained surgeon. The surgeon on the cover of Time as one of the People of the Year is also a PAACS-trained surgeon. In a recent conversation, Dr. Bruce Steffes, Chief Medical Officer of PAACS, shared with me that every day in Africa there are 56 million people in need of surgical care, yet most will die never having received it. One hospital represented at the seminar did more than 9,000 operations in 2014 and still could not meet the needs of the population, according to Dr. Jim Brown, Chief of Surgery and PAACS Program Director at Mbingo Hospital, Mbingo, Cameroon. The men and women participating in PAACS training programs are truly making a difference in the lives of Africans.

  The program is scheduled to last 2 weeks with my lectures sprinkled among those about fluid and electrolytes management, management of orthopedic fractures, treatment of trauma in women and children, and other surgical topics. I am honored to have been invited because discussion of wound care issues both acute and chronic has not been an item of interest at previous meetings, even though the hospitals represented treat huge numbers of trauma patients, patients with diabetic foot problems, and many other wounds. Teaching these young surgeons about the treatment of acute and chronic wounds is a joy. They are devouring the information as eagerly as some of the local lions are probably devouring their dinners.

  Teaching in this environment has its challenges. After each lecture, someone will ask pointed questions about the way I recommend treating wounds. The surgeons from Egypt treat diabetic foot ulcers one way, and those from Gabon have another approach. Everyone in the room has a culturally different approach to treating wounds, most based on generations of practice and no evidence. With every statement, I seem to be challenging their treatments and knowledge. I do know it is worth the effort to bring evidence-based wound care to them because we are slowly seeing changes in the ways wounds are treated in this part of Africa. Carolyn Brown, RN, WOCN, has established a wound center at the hospital in Cameroon which is providing evidence-based wound care to patients from all over central Cameroon. Other PAACS hospitals are becoming interested in developing wound programs at their hospitals. This is truly an exciting time.