0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Commentary |

Out of Africa

Michael G. Sarr, MD
Arch Surg. 2000;135(6):720. doi:10.1001/archsurg.135.6.720.
Text Size: A A A
Published online

Extract

RECENTLY, I had the opportunity to visit South Africa for 2 weeks as a visiting professor in the Department of Surgery at the University of the Orange Free State in Bloemfontein. This area represents the heart of the original European Dutch settlers (now Afrikaaners), the center of the Boer Republic, and one of the areas where the now-hated apartheid movement originated. I found a country dismantling the apartheid regime and struggling with the many new concerns of both the government and the health care providers—how to nationally integrate the very poor and vast areas of this country now functioning as a Third World nation with other less prevalent areas of considerable wealth functioning as a First World nation. Spending only 8 working days there, I fully acknowledge that I received but a glimpse of the true country (and that largely was from the specter of a First World university department of surgery). I found a university medical faculty involved in undergraduate medical student and postgraduate training facing many problems—a bankrupt provincial government (hopefully only for 1 more month), a university hospital closed except for emergencies or life-threatening conditions, a government-directed attempt to deliver health care on a district basis rather than via the previous secondary and/or tertiary care system that had been operational until that time, and the charge to develop a medical training program that would be efficient and appropriate for doctors to treat the problems indigenous to a Third World country (many of whose citizens lack running water and internal plumbing, let alone health care insurance programs for screening mammography, prenatal care, etc). Despite these seemingly overwhelming obstacles (with more undoubtedly to come), I found an obstinate (Boer-like I understand), focused faculty dedicated to developing a new curriculum for 5-year combined university/medical school training designed to maximize efficiency and minimize costs. This new curriculum is designed to produce physicians able to deal with the problems of a Third World country—advanced malignancies, the ravages of human immunodeficiency virus disease, trauma, violent crime, and the lack of even the basics of preventative medicine in many rural areas. The mission of these educators differs immensely from much of surgery's ivory tower approach; yet, their mission is very real and a no less important one for their country.

Topics

africa

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();