The Institute of Ear , Nose and Throat Surgery and Audiology

Beit Cure Hospital Lusaka ZambiaAlice Kirby

Ann O’ConnorHannah O’Driscoll

Uta FoeschlKieran O’Driscoll

Basic Zambian Facts

• Land – locked country• Approx 12 million pop.• Former Northern Rhodesia• Independent since 1964• Mostly rural but most urbanized in Sub Saharan

Africa• Democratic and politically stable• Famous for Victoria Falls and wildlife

Core Health Indicator

Zambia UK

Physicians (number)

1,264 133,641

Physicians (density/ 1000

population)0.1 2.3

Nurses (density/ 1000

population)1.5 12.1

UK Zambia

Total population 59,668,000 11,657,000

Life expectancy at birth M/F (years)

77 / 81 40 / 40

Probability of dying under five (per 1000 live births)

6 182

% population living below poverty line < $1/day

- 64

African Health Issues

• HIV• Malaria• TB• Surgery as a public health Issue• Organisational Issues leading to specialty

crises – burden of acute and chronic suffering

Recent WHO perspective on Surgery

• 11 – 13 % of world health burden is surgical• Surgery is public health issue• Surgery in developing countries is

underfunded• ENT surgery must be regarded as public health

issue in context of retuning people back into the work force and children back into the classroom

Zambian ENT Services

• Based only in (UTH)• 4 Doctors in 2004• Now 2 – 3 doctors• No Audiologist• No peripheral clinic in

2004• Now 1 clinic in Ndola

ENT Zambian Trust Fund

The ENT Zambian Crisis

The Zambian ENT Crisis

The ENT Zambian Crisis

Summary of Findings Mar ‘04• Under equipped• Under-funded• Under- trained• No leadership• Ear issues – mortality/morbidity/ Deafness• Head neck issues - late diagnosis

What Needed To be Done

• Supply equipment• Support Training• Financed short term

locums for ENT Surgeons• Financed Anaesthetic/

Audiological/ Nursing locums

Partnerships/Collaborations up to 2006 and beyond!

Hearing Aids

Amplifon

Bonvox

Audiology Techno

Equipment

Metronics

Eurosurgical

Technosurgical

Local Partnerships

Christian Blind Mission

Local E.N.T Surgeons

University Teaching Hospital

Lusaka Eye Hospital Irish Funding

Rotary Tullamore

Electric Aid (E.S.B)

Gorta

Individual Irish Donors

Integrated Community Groups

SMA Fathers

Sisters of Mercy

Donations from Irish Hospitals

Tullamore General Hospital

Royal Victorian Eye and Ear Hospital Dublin

St.Francis Hospital Mullingar

What To Do Next

Central Hub Development

Peripheral Contact ( ? Mobile Clinic)

Sustainable ENT Service

Partnerships /Collaborations – Keys to success

Education PartnershipsUniversity of ZambiaCOSECARCSI

ENT PartnersENT Zambia

Christian Blind Mission

Hospital PartnersZambian GovernmentCURE InternationalBEIT Trust

Financial PartnersIrish AidGORTA BMZ Germany