Loma Linda University Health representatives were on hand at Malamulo Adventist Hospital in the southeastern African nation of Malawi earlier in December 2020 to celebrate the facility’s first surgery residency program graduates.
Two graduates, Lijalem Taye Garba of Ethiopia and Constance Ndum of Cameroon, were honored during the ceremony, which marked the latest step for Loma Linda University Health and its parent, the Seventh-day Adventist Church, to develop advanced health care in the region.
Loma Linda University Health president Richard H. Hart said a painful reality exists in many African countries: there are only a handful of surgeons in many countries to meet the 56 million people across the continent who need surgical care each year.
An estimated 93 percent of sub-Saharan Africa does not have access to safe surgical and anesthesia care that is timely and affordable, according to the Pan-African Academy of Christian Surgeons (PAACS). In many regions, there is one surgeon for a population of 250,000, while in other areas, there may be only one surgeon for a population of 2.5 million people. Worldwide, the deaths due to lack of access to safe surgery are three times more than deaths from malaria, tuberculosis, and HIV combined.
“Our surgery residency program at Malamulo is a strategic response to the dire need for surgeons in Africa,” Hart said. “Loma Linda University Health has partnered with PAACS to provide academic oversight and accreditation to the entire organization and its surgical residencies at 10 Christian hospitals across Africa. Malamulo is the only Seventh-day Adventist hospital hosting a PAACS training program, and it is the first Global Campus of Loma Linda University Health.”
PAACS is a non-denominational, multinational organization training medical graduates to become surgeons committed to remaining in Africa. These graduates are certified by the College of Surgeons of East, Central, and Southern Africa (COSECSA). Each mission hospital trains these residents to share the love and gospel of Jesus Christ with their patients under the direction of experienced, board-certified missionary and African surgeons. The goal is to train compassionate, Christ-centered surgeons for Africa. There have already been 107 PAACS graduates, with 100 residents in training across the continent.
From Mission Clinic to Accredited Global Campus
Malamulo began medical services in 1915 and is now recognized as one of the leading teaching hospitals for Malawi and the region — providing high-quality, Christ-centered health care to Malawi’s underserved rural population. The 200-bed facility provides preventative health care and specialized services in women’s and children’s health, infectious diseases, chronic disease management, and surgery. As is common in sub-Saharan Africa, cases include pneumonia, malaria, tuberculosis, HIV complications, dehydration, and meningitis. In the past 10 years, Malamulo has developed into a major surgical referral hospital with patients from throughout southeastern Africa and is supported by the Loma Linda University Health Global Health Institute and Adventist Health International.
Malamulo’s surgery program was launched a decade ago by Ryan Hayton, who moved his family to Malamulo in 2010 to serve as a missionary under Loma Linda University’s Deferred Mission Appointment program.
With the help of Mark Reeves, director of the Loma Linda University Cancer Center, and Carlos Garberolglio, LLU chief of surgery, Hayton established Malamulo as a surgical training site for LLUH surgery residents to rotate outside the United States and earn credit for their international time. The Department of Surgery at Loma Linda University provides this two-month rotation to each of its residents as the first internationally approved site of the Accreditation Council for Graduate Medical Education (ACGME).
Malawi’s Top Surgery Training Site
In the years following, Hayton and a distinguished PAACS graduate, Arega Fekadu, FCS (ECSA), worked to establish a five-year plan to position Malamulo as Malawi’s top surgical specialty hospital and a certified PAACS training site. The hospital began training its first PAACS residents in August of 2014.
“There have been many ups and downs, and some of our enrolled surgery residents did not complete their journey,” Hayton said during the December 13 ceremony. “But we have found success, and today we will graduate two competent, compassionate, Christ-like, certified surgeons, Dr. Constance and Dr. Lijalem. We are very proud of them as excellent Christian surgeons.”
“The PAACS program at Malamulo continues to grow, and six surgery residents are in training with two more to begin next month,” he said.
Before starting the surgery program, Malamulo performed 850 surgeries a year in 2013. “The hospital’s operating theatre has grown, and the team now completes more than 3,000 surgeries each year,” Hayton said as he attributed the growth in part to the efforts of Moses Kasumba, who served in the capacity of assistant program director for Malamulo PAACS and currently as Malamulo's head of surgery and PAACS program director. Hayton returned with his family to Loma Linda in 2019. In addition to his role as associate professor of surgery at the School of Medicine, he serves as program director for the Loma Linda University Global Surgery Fellowship and as faculty for the Pan-African Academy of Christian Surgeons.