Due to its geographic position in southern Europe, with miles of coastline on virtually all sides of the peninsula, Italy has often represented a “first
approach” for people emigrating from North Africa
and the Middle East to Europe and North America.
Italy’s role as an international gateway means health
care professionals in the country must be trained in
cultural awareness to meet the needs of individuals
representing a spectrum of backgrounds and ethnici-ties. To this end, the department of surgery at Pietro
Valdoni, Sapienza University of Rome, Italy, has long
supported a small rural hospital in the pluvial forest
of South Cameroon located in Central Africa. Saint-Luc, a not-for-profit hospital, is part of the Mission
Catholique de Bimengue, and our surgical residents
do voluntary rotations at this facility.
Surgical rotations in Central Africa
The training program, started in 1988 with leadership
from then-chief of surgery and a co-author of this article, Prof. Sergio Stipa, MD, FACS, provides residents
with a six-month experience in an African mission hospital. Soon after the first residents began their rotations,
they indicated that they found it to be a positive experience. In fact, residents have played a significant role
in promoting the benefits of this particular rotation,
which has developed a strong reputation for preparing
hospital staff to administer care to people from different cultural backgrounds.
Saint-Luc hospital is situated in Bimengue, which is
part of the Cameroon forest (see Figure 1, page 13). The
facility is surrounded for 70 miles by wilderness, which
provides some protection from the urban violence that
is a common problem in many major cities in Central
Africa. Saint-Luc hospital is an eight-hour trip from the
nearest airport, and the road to the mission—built by
German colonizers at the end of the 19th century—is
unpaved and full of holes. With just 30 beds, Saint-Luc is a small facility that serves a population of about
20,000 people. No other medical facility is available to
the people living in the small villages and tribal communities within the forest. The mission and the hospital
were built more than 40 years ago by a Catholic priest
of the Spiritan Congregation from Como, Italy. The
priest manages all of the organizational and economic
affairs of the mission, except for the hospital, which
is managed by the not-for-profit organization Don’t
Forget Africa (DFA).
Care is provided to patients presenting with a variety
of medical issues. Abdominal, obstetric, and urological
surgery are routinely performed on patients in need.
Patients suffering from other medical problems, such
as marsh fever and illness related to intestinal parasites,
also receive care at Saint-Luc.
It is difficult to comprehend how the local population received medical care before Saint-Luc was built.
Most likely, local midwives and nonmedical individuals functioned as primary caregivers.
• Summarizes the challenges
and rewards of a six-month
surgical rotation at an
African mission hospital
• Describes the role of cultural
competency in providing
quality care to individuals
from different backgrounds
• Identifies how this program
enhances resident performance
and confidence levels
• Outlines current and future barriers
facing program administrators