Could you tell us a little bit about your background?
My name is Daniel. I’m a tropical doctor from the Netherlands. The specialization into tropical doctor, which -as far as I know- only exists in the Netherlands, takes three years and is focused on providing the medical doctor with the skills needed to be working in a low-resource setting. Surgery and obstetrics are a vital part of the training. I followed my surgical and obstetrics residency in the Netherlands. I did an extra year of Surgery on Curacao, a former Dutch colony in the Caribbean.
What brought you to Masanga?
I decided to become a tropical doctor because I want to give my contribution to improved health in less resourced settings. As a clinician it is possible to reach this goal locally while being there, but I was wondering if the help would be sustainable. Would there still be something left of your work five years after you have been gone?
When I learned about the CapaCare Surgical Training Program, and that they were looking for a Tropical Doctor to fulfill the role as international coordinator in Masanga, I became interested. The job would provide a good mix of tropical medicine, surgery and obstetrics, teaching and education and management. Although I was never trained as a manager, I applied for the job together with Martelien, my partner and also a tropical doctor.
After several months in the job the variety of work has proven to be very interesting. We became fan of the surgical training program and task shifting as one of the answers to fill the huge gap in surgical health providers in Sierra Leone. It is very satisfying to contribute to the health system in the manner we are doing currently.
What are your main duties at Masanga Hospital?
Apart from being a Medical Doctor in Masanga Hospital, I’m also the international coordinator of CapaCare since March 2016. In this role I manage the training program on the ground. This contains selection of new students, coordination and evaluation of the students, international trainers and the local CapaCare team, collaborate with the partner hospitals wherein the students are placed during their rotations and communicating and reporting with the Ministry of Health and Sanitation (MoHS) and our main donor UNFPA. In addition, Masanga is the first training base for all the STP students. Therefore training and teaching during handing overs, clinical work and operations (patient care) is also an essential part of the job.
What are your thoughts about the Surgical Training Program?
With the sustainable millennium goals we agreed upon improved global healthcare. Diseases or conditions that can be treated by surgical interventions are a substantial part of the total burden of disease, and with the proper care many disabilities or deaths may be averted. In many low and middle-income countries the access to safe surgical care is suboptimal and one of the most important factors is the lack in surgical workforce (surgeons, gynecologists and anesthetists).
This is also the case in Sierra Leone, there are just not enough trained specialists in Sierra Leone to do the job. So people suffer, and die from conditions that are perfectly treatable. Think about inguinal hernia’s, hydroceles, stomach perforations and appendicitis. But also, maybe of even greater importance at the moment in Sierra Leone, mothers and babies die from obstructed labour and post-partum bleeding and there are not enough doctors to do a Caesarean.
So the surgeons and gynecologists could use a hand, right? Training of new specialist will take too long and sending more doctors from Holland is not a very sustainable solution.
So CapaCare proposes task shifting or task sharing in Sierra Leone. The burden of disease may be shared with less specialized health workers. It is not a new idea; several other African countries have been doing it for years.
With CapaCare we provide an intensive training of tree years for mainly Clinical Health Officers (CHOs). After graduation we want our trainees to be able to handle the most common surgical and obstetrical emergencies that would lead to death or disability without intervention.
After graduation, the Surgical CHOs are placed in the governmental hospitals to work in the surgical teams under supervision of a surgeon. I believe task sharing in surgery will play a very important part in order to improve the healthcare for the people of Sierra Leone. I’m glad that I can contribute through CapaCare.
How do you like to spend your spare time?
I like to play the guitar, listen to music, do gardening and ride around on my mountainbike through the jungle. When there is electricity we like to watch a nice film or series on the projector. We adapted two pups, Jack and Simba, to keep us company around the house. Finally, we don’t mind to go to a bar to dance and socialize with people.
What are your plans for the future?
During my work for CapaCare I will keep my eyes and ears open for new job opportunities and challenging career perspectives anywhere in the word.