Cardiac Surgery in Africa: A Student Perspective
Cardiac surgery in Africa has been rapidly evolving, bringing hope to millions suffering from heart diseases on the continent. As a student interested in cardiac diseases, I have witnessed significant advancements over the past years. This progress is promising for students and early-career doctors interested in cardiac surgery. Here, I discuss some of the most exciting developments in the field of cardiac surgery in Africa.
Recently, there has been an increase in the number of patients who can access cardiac-saving surgeries in Africa compared to the early 2000s. Statistically, the surgeon-to-patient ratio in Sub-Saharan Africa (SSA) is 1:14.3 million, while in North Africa, it is 1:1.1 million. Open heart operations were approximately 12 per million in Africa, 2 per million in SSA, and 92 per million people in North Africa. Governments, non-profit organizations (NGO), and international initiatives such as the Cardiac Surgery Intersociety Alliance (CSIA), the African Association of Thoracic and Cardio-Vascular Surgeons (AATCVS), and the Global Cardiac Surgery Initiative have played a crucial role in establishing cardiac facilities and training local surgeons. This progress ensures that more individuals receive timely treatment, reducing the burden of heart disease on the continent. However, more is to be done as there is still a massive gap in patient care, with over one cardiac center per 50 million people.
Advanced surgical techniques are rapidly making their way into African cardiac surgery departments like South Africa and Egypt. Today, the emphasis is on improving surgical techniques as surgeons adopt minimally invasive cardiac surgeries, robotic surgeries, and new surgical approaches. These advancements have helped to improve patient outcomes and contributed to the overall growth and development of cardiac surgery in Africa. For instance, the first robotic surgery in Africa was performed to remove a rib in a thoracic outlet decompression in a 33-year-old male for the relief of pain and restricted movement in his right arm.
Furthermore, the Association of Future African Cardiothoracic Surgeons (AFAC) is available for those passionate about cardiothoracic surgery. AFAC organizes several activities toward opening the way for CT surgery in Africa. African countries are investing in specialized training programs, collaboration, and exchange programs like the “North-South” and “South-South” mentorship programs. This is an essential mechanism for meeting training needs in cardiac surgery, enabling local healthcare professionals to acquire essential skills and expertise in cardiac surgery, like in Ghana, South Africa, and Uganda. Fostering these global connections, African cardiac surgeons gain exposure to diverse experiences and best practices, ultimately elevating the standard of cardiac surgery within the continent.
Finally, with an expansion in the cardiac surgery sector in Africa, there is a growing emphasis on local research and innovation. Cardiovascular research from Africa has increased from 4 publications in 1971 to 3867 in 2020, accounting for ~3% of the global cardiovascular research output. Authors from South Africa (28.1%) and Egypt (24.1%) accounted for more than half of all publications from African countries with collaborators outside Africa like the United States, United Kingdom, France, Germany, and Australia. Integrating research into clinical practice is crucial for the continuous improvement of cardiac surgery in Africa. As such, research organizations like AFAC, WINNERS Foundation, and BMSA Research Club, where I serve as a research fellow, are essential for medical students/ early career doctors. Their involvement and collaboration will improve cardiac surgery research output in Africa while staying focused on the big picture.
To conclude, Cardiac surgery in Africa is undeniably taking another dimension towards increased accessibility to healthcare, advancements in surgical techniques, capacity-building initiatives, and research. This field continues to grow and transform the lives of countless patients by giving them another chance to live and enjoy life with family and friends. As an aspiring and passionate student of cardiothoracic surgery, I am inspired by these developments and optimistic that cardiac surgery will significantly shape the future of healthcare in Africa. Continuous investment in education, research, and infrastructure will ensure that cardiac surgery in Africa reaches new heights, bringing hope and healing to millions of needy individuals.
