Bringing eye expertise to Ethiopia

(Edmonton) In Ethiopia, where Girum Gessesse is an ophthalmologist, the need for experts in glaucoma is clear: there are more than three million people living with the blinding condition and only 100 ophthalmologists to help. Just three of those eye specialists have in-depth glaucoma training.

Gessesse and a fellow Ethiopian ophthalmologist will bring that number to five after taking part in an international mentorship program based in the ophthalmology department within the Faculty of Medicine & Dentistry, located at the Royal Alexandra Hospital.

“We want to improve our knowledge and skills, and provide better glaucoma care for our patients,” says Gessesse, noting that glaucoma is the second leading cause of blindness in Ethiopia, and that most people don’t develop symptoms until the late stages. “Our long-term goal is to build and establish a centre for excellence in glaucoma care in the southwest region of Ethiopia.”

Gessesse arrived in Edmonton in early March and returns to Ethiopia in late June. He is taking part in the “sandwich fellowship program” developed by Karim Damji, an ophthalmology professor with the University of Alberta and a glaucoma specialist. It’s called a sandwich program because it has various layers of home-based and international training.

Since coming to Edmonton, Gessesse has had the opportunity to be involved in research, do various types of glaucoma surgeries at the Royal Alexandra Hospital and see a variety of cases and different ways to deal with the condition. He has worked closely with faculty members Marianne Edwards, Michael Dorey and Ordan Lehmann.

“This is a very well-rounded program—not only do you gain new skills and knowledge, you also get to do research that will benefit glaucoma care in your home country,” says Gessesse. “This program also creates a strong bond between our institution, myself and my mentors, which is key for future learning.”

Gessesse is in the first part of his training, and his Ethiopian colleague has just finished the first section as well. The second part of their training is to focus on applying their knowledge in their home country; then they will travel to India to learn about glaucoma in children. Damji will travel to Ethiopia to advance their training this winter. The final leg of the mentorship program for the duo will conclude in 2013.

Damji says the goal of the sandwich fellowship program is to develop multiple centres for glaucoma care in Ethiopia and Kenya, and to have these centres work with each other, with the U of A and with clinical colleagues for enhanced patient care, teaching and research opportunities.

“It is humbling and rewarding to be involved in their training, which also opens doors for our students and for research,” says Damji. “I hope the centres will eventually work together to train their own ‘sandwich’ fellows.”

Gessesse works for Jimma University, which has a tertiary training and eye-care centre serving those in cities. An outreach program ensures that much-needed help gets to those in rural regions as well. In Ethiopia, a key problem in dealing with patients is that most patients seek out a physician’s help in the advanced stages of glaucoma, and medications are limited and not affordable. Adherence to prescribed medications is also very low. Surgery remains the only successful treatment option.

Gessesse’s fellowship training is funded by the Royal Alexandra Hospital Foundation, the International Council of Ophthalmology, the charitable organization Light for the World, and ORBIS International.

“The sandwich glaucoma fellowship program will offer a new and evolved way for each of our centres to provide patient care and training, and share expertise,” adds Andrew Otway, president and CEO of the Royal Alexandra Hospital Foundation. “The foundation is extremely excited to be able to support a collaborative program that will touch patients not only at the Royal Alex, but across the globe.”