August 2002 Bulletin

Nigerian scholar leaves home for first time to attend OLC course

Brings new orthopaedic techniques home to Nigeria

Olga Salkova, AAOS international programs coordinator, interviews Christopher Amuwa, MD, at the end of his six-day visit to the U.S.

By Carolyn Rogers

Before leaving Nigeria in mid-June to participate in an AAOS surgical skills course on fracture management, 36-year-old Christopher Amuwa, MD, had never been outside of his native country. Dr. Amuwa is one of just 120 orthopaedic surgeons in Nigeria, where the ratio of orthopaedists to the general population is one to 1 million.

Dr. Amuwa made the trip to Rosemont, Ill., as one of four recipients of the new AAOS Corporate Advisory Council Orthopaedic Learning Center (OLC) International Scholarships.

Candidates for the $3,000 scholarships—which are intended for surgeons from developing countries—must be 45 years of age or younger and must have completed all basic and specialty orthopaedic training. Scholars also are required to demonstrate strong leadership potential and possess good English language speaking and reading skills.

Busy six days

Upon his arrival in Chicago on June 19, 2002, Dr. Amuwa was greeted by members of the AAOS staff and a full six-day schedule. His chosen OLC course, "Practical Techniques for Improved Fracture Management" took place June 21-23.

Dr. Amuwa was interviewed prior to the course to gauge his expectations and goals, and again afterwards to see if those expectations were met.

The course met his expectations, and then some.

"It was beyond my expectations, really," he said, adding that the course was "different" than the others he’s attended. "The lecturer had such a deep knowledge of the subject…Highlights were learning about difficult fractures and also new technologies. Every aspect of the course was interesting. The other course participants were very friendly and interested in hearing about Africa and Nigeria."

One of the reasons Dr. Amuwa applied for the scholarship is, as he puts it, "When the axe is dull and its edges unsharpened, more strength is required. But skill will bring success. With improved skills, I am bound to succeed.

"To some extent, this is the beginning point for me," he adds. "I need to continue to build on this experience."

Visits to local hospitals, teaching centers

In addition to participation in a three-day surgical skills course, arrangements are made for scholarships recipients to visit local hospitals and orthopaedic teaching centers.

Dr. Amuwa had the opportunity to shadow local orthopaedic surgeons William Hopkinson, MD, professor of orthopaedic surgery and rehabilitation at Loyola University Medical Center; and Michael Stover, MD, assistant professor in Loyola’s department of orthopaedic surgery and rehabilitation. He began the day doing rounds in the radiology suite and later observed surgical procedures.

Sherwin Ho, MD, associate professor of clinical surgery at the University of Chicago, also spent a day with Dr. Amuwa. Dr. Ho specializes in sports medicine, one of Dr. Amuwa’s special interests. He made clinical rounds with Dr. Ho during the day and later joined the team in operating sessions.

"I was welcomed everywhere I went," he says.

Mutually beneficial experience

Dr. Amuwa planned to share his new knowledge and insights with his Nigerian colleagues upon his return.

"The corporate sponsors should know this can be a mutually beneficial experience," he adds. "If I go back home and demonstrate a new technology and it is embraced, that has a way of coming back and affecting the economy here. There’s a big market in Africa, especially Nigeria."

He is careful to say that he has come to the United States "not on my merit, but to represent a group of people. I’m very grateful, very glad to have had this unique opportunity. I would love to come back for a more extended stay, a fellowship."

Mismanaged care "greatest problem" in Nigeria

American orthopaedists who have the opportunity to interact with the international scholarship winners also have much to gain.

Dr. Amuwa, for example, shared his experiences as an orthopaedist in Nigeria. Pedestrian trauma and children with rickets are among the most widespread orthopaedic problems in Nigeria, he explained. Football (soccer) causes the most sports injuries in his country, and motorcycle accidents are a major problem due to traffic congestion.

However, "mismanaged patient care is our greatest problem," Dr. Amuwa says. "Simple fractures lead to gangrene due to poor care. That leaves the orthopaedic surgeon with no choice but to amputate."

This, in turn, has the unfortunate consequence of scaring people away from orthopaedic surgeons because they become known as "the ones who will cut off your arm."

On the positive side, because women in Nigeria wear sandals, Dr. Amuwa recalls performing only one foot operation in the past six years.

A total of 60 OLC scholarship applications were received from 43 different countries. Finalists were chosen by the review and selections committee of the AAOS Corporate Advisory Council.

The other 2002 scholarship recipients were Ricardo de la Costa, MD, of Phnom Penh, Cambodia; Taras Kouliaba, MD, of St. Petersburg, Russia; and Visit Vamvanij, MD, of Bangkok, Thailand.

All the surgeons participated in OLC courses during spring and early summer. Dr. de la Costa attended "The Shoulder: Current Practice in Open and Arthroscopic Techniques" from May 3-5; Dr. Kouliaba attended "Surgical Treatment of Complex Knee Ligament, Patellofemoral and Articular Cartilage Disorders" from April 12-14; and Dr. Vamvanij attended "Practical Strategies in Spine Surgery" from June 28-30.

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