Abebe Bekele
3 Publications in AERD
Author Publications
Export PDFTen Questions to Guide Learners Seeking Equitable Global Health Experiences Abroad
By Abebe Bekele
"Global health experiences," clinical and research learning opportunities where learners from high-income country (HIC) institutions travel to low- and middle-income countries (LMICs), are becoming increasingly popular and prolific in the health sciences. Increased interest has been well documented among medical, pharmacy, and nursing learners who are driving these agendas at their institutions. Although such opportunities have potential to mutually benefit the learner and host, in practice they can be exploitative, benefiting HIC learners without reciprocity for LMIC hosts. Given these and other pervasive ethical concerns in global health, efforts to decolonize global health and emphasize equity are being made at the institutional level. Despite progress toward global health equity from institutions, most learners lack the resources and education needed to critically evaluate the numerous global health opportunities or equitably codesign these experiences for themselves. This article offers 10 guiding questions that learners should answer before selecting or codesigning a global health opportunity through a lens of global health equity. These prompts encompass values including motivations, reciprocity, accountability, sustainability, financial implications, self-reflection, bidirectional communication, and mitigating burden and power dynamics. The authors provide tips, pitfalls to avoid, and pragmatic examples for learners working to actualize partnerships and opportunities aligned with the movement of global health equity. With these guiding questions and accompanying reflection tool, learners, faculty members, and their LMIC partners should be better equipped to engage in mutually beneficial partnership through the framework of global health equity. © 2023 Lippincott Williams and Wilkins. All rights reserved.
Exploring Laparoscopic Surgery Training Opportunities in the College of Surgeons of East, Central, and Southern Africa region
By Martin Nyundo
OBJECTIVE: The resource-limited environment in Sub-Saharan countries, with a lack of expert trainers, impedes the progress of laparoscopic training. This study aimed to identify the opportunities and limitations of laparoscopic surgery training in the College of Surgeons of East, Central, and Southern Africa (COSECSA) countries. DESIGN AND SETTING: A multicountry online survey was conducted from January 2021 to October 2021 in COSECSA-accredited training hospitals within 16 countries. Available resources and challenges faced in order to set up well-structured laparoscopic training programs were explored. RESULTS: Ninety-four surgeons answered the questionnaire. The average resources reported per hospital were 3 trained laparoscopic surgeons, 2 laparoscopic towers, and 2 sets of laparoscopic instruments. The training of the majority of these surgeons has been in local institutions (53%), a further 37% within African countries and only 10% outside Africa. Approximately 45% of them declared that laparoscopic modules were planned within the University Curricula, while only 18% of surgeons recognized that laparoscopic modules are only planned within the COSECSA program. About 57% of participants reported that at the end of residency training, graduating surgeons were not able to perform basic laparoscopic procedures. The quoted barriers included: limited laparoscopic equipment, absence of simulation lab, lack of qualified trainers, lack of training programs and time for teaching by skilled doctors, and lack of institutional support. CONCLUSIONS: The well-structured set up of laparoscopic training programs in the COSECSA region is hindered due to the lack of qualified personnel and insufficient resources for the acquisition of equipment and simulation laboratories. Ongoing efforts to set up laparoscopic programs through the development of adaptive curricula, innovative strategies for reduction of equipment cost and adequate training of surgeons are crucial for patient safety and the development of laparoscopy. © 2023 Association of Program Directors in Surgery
Global competency impact of sustained remote international engagement for students
By Abebe Bekele
BackgroundTo provide just equity in academic exchange, as well as to reduce prohibitive travel cost and address environmental concerns, the past paradigm of international student exchange has fundamentally shifted from one directional travel to mutually beneficial bidirectional remote communication between students all over the globe. Current analysis aims to quantify cultural competency and evaluate academic outcomes.MethodsSixty students half from the US and half from Rwanda grouped in teams of 4 engaged in a nine-month project-focused relationship. Cultural competency was evaluated prior to project initiation and six months after completion of the project. Student perspective of project development was analyzed weekly and final academic outcome was evaluated.ResultsChange in cultural competency was not significant; however, students did identify satisfaction in team interaction and academic outcomes were achieved.ConclusionA single remote exchange between students in two countries may not be transformative but it can provide cultural enrichment and successful academic project outcome and may serve to enhance cultural curiosity.
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