Kenyan eye specialist hones skills through 'sandwich fellowship' in ophthalmology

(Edmonton) The Faculty of Medicine & Dentistry at the University of Alberta is playing a key role in improving the lives of Kenyan eye patients by training a specialist from Nairobi to better treat glaucoma, the second-leading cause of blindness in that country.

Sheila Marco is in Edmonton for the final part of a training program through the faculty’s Department of Ophthalmology, which she says will equip her with new skills and knowledge to refine the treatment of glaucoma patients back home.

The U of A faculty’s contribution will be multiplied when Marco returns to Kenya later this summer and shares her new knowledge with fellow ophthalmologists there, as well as medical residents and undergraduate medical students she teaches at the University of Nairobi.

Kenya has just 80 ophthalmologists to work with a population of 38 million people and about half of those eye specialists are located in Nairobi, Kenya’s capital. The remaining ophthalmologists are spread throughout the country. In comparison, Canada has 1,200 ophthalmologists for a slightly smaller population.

Marco first came to Edmonton last spring to start her “sandwich fellowship” training, which has various layers of learning. Then, last winter, Karim Damji, an ophthalmology professor from the faculty, headed to Kenya to continue teaching Marco overseas.

In early 2011, Marco trained with glaucoma specialists in India to learn how to do cataract surgery and become more specialized with pediatric glaucoma cases. She is now wrapping up her final portion of her training back in Edmonton to perfect her skills with glaucoma experts in the Department of Ophthalmology—Damji, Marianne Edwards, Ordan Lehmann and Michael Dorey. A new glaucoma surgical technique she learned while in Edmonton will also be part of a randomized clinical trial she will run once she gets back to Kenya.

Marco works at a government hospital and sees 30 to 40 patients per day. She says the training she has received through the sandwich fellowship will help her provide enhanced care to her patients.

“Before coming here, when I ran the glaucoma clinic in Nairobi, I couldn’t make certain decisions because the cases were so complicated. My training through this sandwich fellowship program has given me more experience and knowledge and more confidence to deal with complicated cases. I have now had experience with different types of glaucoma and learned different ways of managing glaucoma cases.

“And I’ve learned how to sit and talk to a patient and determine what is best for the patient from both a doctor’s perspective and from the patient’s perspective. I’ve learned how to take a patient’s social, cultural and other physical issues into consideration when making patient-care decisions. Back home, it’s about prescribing and then going on to the next patient, while here, I’ve been more of a student, absorbing everything that I can. It’s been a great experience.”

Marco’s fellowship training is funded by the Royal Alexandra Hospital Foundation, the International Council of Ophthalmology, charitable organization ORBIS International and the Eastern Africa College of Ophthalmologists.

Damji says the fellowship program is incredibly valuable.

“The value of this program is that it links the fellows’ professional development in an area of great need to their own institution’s capacity development, so that there is a greater likelihood of having the individual stay and flourish. We are developing leaders—Dr. Marco is one such individual—and we hope for outstanding contributions in clinical service, teaching, research and administration.

“We look forward to continued collaboration and a sharing of knowledge, skills and approaches in each of these areas that will benefit the beneficiary institution as well as students and faculty at the University of Alberta.”