LIFEBOX Commits to Transforming Africa’s Surgery System

With surgery safer for 181 million patients around the world, 144,000 trained health providers and 248 million surgeries made safe, LifeBox has announced its commitment of playing a key role transforming surgery skills gaps which normally take 15 for an African to practice as a surgeon.

The plan was announced at the just concluded inaugural Advancing Medical Education in Africa Conference (MedEdAfrica) held in Kigali this March 24-25, 2025.

Lifebox, a non-governmental organisation which makes surgery and anesthesia safer through tools, training, and partnerships, committed to increasing the quality and numbers through providing short courses for nurses.

Lifebox was one of the exibitors at the conference which aimed at rethinking Africa’s medical education to suit the current healthcare needs.

Dr. Nobhojit Roy, Chair of the Centre for Leadership in Global Health Equity at UGHE, and board member at Lifebox said that a way of improving quality medical education Africa’s solution must involve multi-level, fast-track training especially in surgery.

“We will never have enough doctors or surgeons. Africa needs an approach that includes rapid, skill-based training rather than 20-year-long educational pathways,” Roy said.

Dr. Roy stated that using an African model of training nurses to conduct simple surgeries (in-service) this methodology, if replicated, can reduce the cost of surgery and existing human resource gaps.

“This program has seen the first cohort of surgical nurses trained in three areas of safe surgery leadership, hygiene and sterilization and we plan on extending this to other countries on request of the health ministries,” Roy said.

Bitew said that this intervention (in four referral hospitals in Rwanda) has increased safety in surgery.

“We collect data and intervene according to the gaps seen in sterilization, safety equipment maintenance and using a standard check list. For example surgical site infections have reduced by 35% and this can go to 46% with compliance,” Bitew said, ” We are hoping to take this to other facilities in Rwanda, ” Bitew said.

In implementing its projects on the continent, Lifebox collaborates with the ministry of health to intervene in areas where government policy needs support and according to officials this will continue and more projects initiated based on need.

Considering the fact that many African countries are conducting medical education differently from each other, Professor Dr. Senait Fisseha, who gave a conference closing keynote speech called for a Pan-African collaboration where each country will adopt at a minimum a unifying model that is used across the continent where education is aligned with national priorities.

“The choice is our. We can continue to be fragmented, to continue using outdated systems or really build a bold integrated future-ready medical education system that meets the needs of our people,” Fisseha said.

Fisseha stated that Africa must move away from using outdated colonial models of medical education (training) which have restricted scale and innovation- for example the WHO standards of measuring disease burden against medics available, but instead find an African model (such as the Rwandan 4-by-4 model of quadrupling numbers of medics in the next four years.

Rwanda’s Health Minister of State, Dr. Yvan Butare who represented the government of Rwanda stated that African medical schools need to think out of the usual and existing written medical guidelines to do things in an extra-ordinary ways such as creating fellowships that address the main health problems (cancer, cardiovascular and kidney diseases) even when there is no capacity.

For example he said that in order to address the challenge of a workforce shortage and increasing killer disease, government and academia must start a collaborative path through implementing shared medical speciality fellowships (with experts) which will see many patients treated (in surgery) but also in the long have local medics learn from others.

“It takes determination to make such a choice. We in Rwanda spent three months debating on initiating the first kidney transplant fellowship but down the road, we had to take a bold choice. Today we have 44 transplants done yet we had no expertise,” Butera said.

Dr. Thomas G. Weiser, an Associate Professor at Standford School of Medicine School, who also works with Lifebox said that their approach is a model that can be adopted to fill the skills gap in surgery- which is one of the areas that lack experts in Africa.

Weiser suggested that the African medical education curriculum have to be changed in a way that the old system is dropped and replaced with innovative, visionary thinking by young health workers and policy makers.

“The challenge we have with this legacy system is that we know it works but just really very slow. very laborious and takes a long time. So, we need to rethink that so as to accelerate that timeline of training and understanding,” Weiser said.

Prof. Abebe Bekele, Chair of the Conference Organizing Committee, Deputy Vice Chancellor, Academic and Research Affairs, Dean, School of Medicine at UGHE said that surgery is an important component of healthcare anywhere in the world with a 33% need for surgery among admitted patients globally but unfortunately Africa has a 3% health workers’ workforce.

With this, he said that the burden of disease is high especially in the East African region and thus a need for surgery and developing a surgical system that has not been improved since colonial times.

Bekele said that this means there is a lot to be done especially on surgical systems that have very many supply chains including consumables, workforce, policies, and research but are still in the growth process.

Bekele also offered tips on how Africa can turn around the current medical education system to address the status quo.

“This needs investment in training in the long-run and there is no shortcut. So, first off all is training, training them locally, in neighboring countries and internationally. The value is that they will come back in five or six years and train on their own. Second is the supply chain and local manufacturing is key,” Bekele said.

“Countries should think about manufacturing locally but together, they shouldn’t compete and we shouldn’t depend on others to supply us. Third is quality -even if you have the right people you need quality. The fourth is access for everyone. Fourth is research that guides policy and then lastly the human aspect to doing things as a consortium in order to see the change needed,”.

The conference also witnessed the inauguration of a Consortium of Medical Schools -Africa (CMS-A) and committee that will coordinate Africa’s agenda to  transform medical education and collaboration, was also elected and presented to  leading medical educators, leaders, students, healthcare professionals, policymakers, and partners at the conference.