for AIDS Relief and the National Institutes of Health (NIH)
to address the public health crisis in sub-Saharan Africa.
In Mozambique, a MEPI grant seeks to improve medical
education; increase the capacity for locally driven, multidisciplinary research; strengthen the informatics infrastructure; and recruit and retain qualified medical faculty. 12
The UEM-UCSD surgical research partnership is funded
through the MEPI program with a MEPI linked award. The
specific aims of the surgical research partnership are to identify the best strategies for building emergency and essential surgical capacity in rural areas of Mozambique and to
increase capacity for surgical research at UEM and its allied
institutions via training and partnerships. The partnership
also has benefited from collaborations with the WHO and
the Canadian Network for International Surgery.
It is important to note that surgical research and innovation have always been valued in Mozambique. For example, the training of nonphysician technicians (NPTs), or
técnicos de cirurgia, was pioneered by the Mozambican
surgeon, Prof. Fernando Vaz, MD, to help patients in rural
areas with limited access to surgical care. 13 More than 20
years later, NPTs perform major procedures at rural hospitals, and they tend to practice longer in rural areas than
physicians and have competitive surgical results for common procedures. 14-15 One study found that after seven years,
approximately 90 percent of NPTs were still working in
primary referral hospitals, while almost no medical officers
remained in those facilities. This model has been duplicated
in other countries in sub-Saharan Africa.
Early in the partnership, a surgical research team was
organized with representatives from UEM and UCSD. The
team comprises senior surgical and nonsurgical research faculty from UEM; an epidemiologist from the national Ministry of Health; a lecturer at the Higher Institute of Health
Sciences in Maputo, Mozambique; and surgical faculty from
UCSD. Researchers meet regularly to discuss ongoing projects and to set the research agenda. The UEM-UCSD surgical research partnership also has been fortunate to have a
Fogarty International Clinical Scholar and a University of
California GloCal Health Fellow participate in the research.
Surgical research is conducted in and around three primary referral hospitals in rural Mozambique (see Figure
1, this page). The three hospitals—Chókwè, Nhamatanda,
and Ribáuè—were strategically selected to represent the
southern, central, and northern regions of the country.
Map of Mozambique showing primary referral
hospitals of Chókwè, Nhamatanda, and Ribáuè
It is important to note that surgical research and innovation have
always been valued in Mozambique.