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Improvement Efforts in Cape Verdean Surgical Care


In December, I had the chance to travel to Cape Verde for a week with Stephen Odom, MD, Acute Care Surgery and Trauma/Critical Care, to explore further opportunities for long-term collaboration in meeting Cape Verdean surgical needs.

Santiago Island, Cape Verde- Nakul Raykar, MD, Surgery Resident From left: Maria Lopes Da Silva, Senior Advisor to the Cape Verdean Minister of Communities; Nakul Raykar, MD, BIDMC General Surgery Resident; Cristina Fontes Lima, MD, Cape Verdean Minister of Health; Stephen Odom, MD, Acute Care Surgery and Trauma/Critical Care at BIDMC; Alexandra Smith; Ernestina Damoura-Moreira, BIDMC Interpreter Services; Maria Ceu, MD, Chief Clinical Director at Augustino Neto Hospital.

Santiago Island, Cape Verde- Nakul Raykar, MD, Surgery Resident
From left: Maria Lopes Da Silva, Senior Advisor to the Cape Verdean Minister of Communities; Nakul Raykar, MD, BIDMC General Surgery Resident; Cristina Fontes Lima, MD, Cape Verdean Minister of Health; Stephen Odom, MD, Acute Care Surgery and Trauma/Critical Care at BIDMC; Alexandra Smith; Ernestina Damoura-Moreira, BIDMC Interpreter Services; Maria Ceu, MD, Chief Clinical Director at Augustino Neto Hospital.

BIDMC is no stranger to Cape Verde, as a group of physicians, surgeons and translators have been making trips to provide care for the past few years. In fact, later this month, a group of BIDMC physicians and translators will travel to Cape Verde for another medical mission trip.

For me, however, this trip was my first. We were mainly based in the capital city of Praia and worked at Augustinho Neto Hospital (ANH), which serves as one of the two tertiary hospitals in the country. One of the reasons for this trip was to research, explore and build the foundation for future visits. Ernestina Damoura-Moreira, BIDMC Interpreter Services, accompanied us, as did Dr. Odom’s wife, Alexandra, who is a librarian by training and was vital to our research and data collection efforts.

We were focused on conducting an initial baseline assessment on research tools developed by The Lancet Commission on Global Surgery, as well as a trauma assessment modified by Dr. Odom. I worked with Ernestina and Alexandra to also perform qualitative interviews of the core staff of ANH and with individuals from the Ministry of Health.

Hospital staff eagerly welcomed us, as they have been looking for a general surgery team to help with laparoscopy and trauma surgeries. I had the opportunity to assist in several operations performed by Dr. Odom and the Cape Verdean surgeons. This was an amazing experience, as the Cape Verdean surgeons I worked with were highly skilled, and it was a pleasure to learn from them. Working in a low-resource environment, they are forced to have a broad skill set. I watched a young Cape Verdean surgeon perform the most beautiful non-mesh hernia repair I have ever seen.

For the past two years back here in Boston, I have been part of a research group looking at the state of global surgical care. I must say, ANH is a great representation of a hospital in a lower-middle income country. The infrastructure is there, and staff is highly trained. The work ahead of us remains in getting all these parts to work together more efficiently.

Dr. Odom is developing a trauma course in partnership with the Cape Verdean surgical team for all the surgeons in Cape Verde (not just at ANH), and we’ll be proceeding with a full-systems assessment to establish a baseline for future work. Also on the docket is the strategic development of laparoscopic skills training.

I am privileged to work at this institution and with colleagues such as Dr. Odom, Dr. Michael Kearney and Ernestina, who believe in true partnership and collaboration. The Cape Verdean Minister of Health said this: “We want a strong commitment that will continue. We’ve had many missions where they would come, do a little something, and then it would die.”

We hope to use the next several months to expand upon an action plan for system assessments in Cape Verde, in collaboration with The Lancet Commission on Global Surgery and the Ministry of Health of Cape Verde. We’ll return later this year after we’ve developed a plan for building the capacity for trauma and laparoscopic surgery in the country, alongside Cape Verdean surgeons.

The entire experience was wonderful. Ernestina is native to Cape Verde and well connected in the country by her sister, a former Congresswoman. They helped us explore the local area during our visit, too. But fun aspects (amazing food and beautiful beaches) aside, I really enjoyed being in an environment where the surgeons were committed to providing the best care for their patients, despite shortfalls in their infrastructure. I look forward to my next trip, and I’m excited to be a part of something so great.


Nakul Raykar, MD, Surgery Resident

Santiago Island, Cape Verde

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