Oxford University Global Surgery Group

Academic Foundation Programme 

Dr Sharaf Sheik-Ali presenting at ASiT conference

Academic Foundation Programme 

Oxford University Global Surgery Group welcomes Oxford Academic Foundation Programme doctors who would like to incorporate Global Surgery & Anaesthesia as part of their studies. 

Our current team includes: 

Evelyn Thangaraj 2018-2019

Supervisor: Prof Kokila Lakhoo

Somy Charuvila 2018-2020

Project 1) Haemoglobin threshold for surgery in children in Low and Middle Income Countries

Supervisor: Prof Kokila Lakhoo

During the preoperative assessment, some of these children may be noted to have low haemoglobin (Hb). Depending on the level of the Hb, surgeries may be cancelled or postponed which is undesirable. On the other hand, these children may receive blood transfusions to correct their anaemia which can have safety issues from transfusion-transmitted infections. This current practice is prevalent in the absence of evidence to suggest a Hb threshold above which surgery may be deemed safe. The aim of this project is to identify Hb thresholds for safe surgery in the LMIC setting which does not have significant negative impact on the postoperative course.

Literature review completed and pilot study planning underway

Project 2) Development of an online ethics course preparing trainees to undertake surgical work in Low and Middle Income Countries

Supervisors: Miss Roba Khundkar & Mr Noel Peter

It is essential that trainees are aware of ethical issues that are involved in research work in Lower and Middle Income Countries. These include ensuring sustainable and appropriate benefits to both the trainee and the hosting institution, developing cultural understanding, ensuring personal safety, not exceeding own level of training, addressing burdens, allocation of local resources, honesty & integrity, informed consent for research. Failure to address these can lead to failure of projects as well as collaborative arrangements with colleagues. This project aims to develop an easily accessible module which can help with understanding some of the above issues.

 Our former AFP team includes: 

Riana Patel 2018-20

Supervisors: Prof Chris Lavy & Prof Kokila Lakhoo

Projects:

1. Systematic Review of Trauma Education in LMICs: Injury accounts for 5 million global deaths annually, with approximately 90% of these from low- and middle-income countries (LMICs). This project is a systematic review, in collaboration with student researchers interested in global surgery, looking at the effectiveness of trauma education for healthcare professionals in LMICs.
2. Implementing a Peri-Operative Checklist for Paediatric Surgery in Tanzania: This project will involve working with the team at Muhimbili National Hospital in Tanzania to pilot a peri-operative surgical checklist for children undergoing surgery there. This checklist was developed in conjunction with the local team and has the potential to significantly improve safety and efficiency for paediatric patients.
3. Improving global surgery education for trainees (2019, World Journal of Surgery: Global Health)

Murtaza Kadhum 2018-2019

Supervisors: Prof Chris Lavy & Mr Tim Theologis

Projects: 

1. An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment   (2019, Applied Bionics and Biomechanics) - This study is a theoretical scientific analysis of the Ponseti Method, namely focussing on its mechanical aspects and with the overall goal to provide recommendations for its future development.
2. "The effect of time-specific mechanical stretching on calf tendons" - This is a lab based project, in conjunction with the Department of Materials focusing on the mechanical integrity of tendons after mechanical stretch. 
3. "An Accelerated Ponseti protocol to treat clubfoot utilising daily manipulation" - a RCT focussing on providing evidence for an altered treatment regime to improve outcomes in Clubfoot treatment. 
4. Are Primary Trauma Care (PTC) courses beneficial in low- and middle-income countries - A systematic review (2019, Injury)

Cian Wade 2018-2019

Supervisors: Prof Kokila Lakhoo & Prof Mike English 

Project: Periprocedural analgesia in neonates 

I have been leading an international review group aimed at generating evidence-based neonatal analgesic guidelines for implementation in the lower-middle income setting. This has involved a large systematic review of the available evidence relating to analgesics and routine procedures commonly seen in global neonatal care. We have analysed and synthesised this evidence in order to generate an optimal approach to managing pain during routine procedures. This work has since been presented at international conferences and to an expert guideline discussion group in Kenya. After discussions and work to ensure that the recommendations were specific and relevant to the Kenyan healthcare context, we have successfully generated new clinical guidelines on the periprocedural management of neonatal pain. These guidelines are now being implemented across the country. 

Sharaf Sheik-Ali 2018-9

(Pictured in lead image above)

Supervisor: Prof Chris Lavy

Project: "The Healthcare Determinants of Accessibility to CTEV Treatment: A Global Observational Study"

View poster presented at Associations of Surgeons in Training conference 22-24 March 2019, Belfast

ASiT Abstract 2019: The health determinants of accessibility to clubfoot treatment: A global observational Study

Rele Ologunde 2017 

Supervisor: Prof Chris Lavy

Do trauma courses change practice? A qualitative review of 20 courses in East, Central and Southern Africa (2017, Injury)

Dan Yeomans 2017

Supervisor: Prof Chris Lavy

Is overseas volunteering beneficial to the NHS? The analysis of volunteers’ responses to a feedback questionnaire following experiences in low-income and middle-income countries (2017, BMJ Open)

Claire Nugent 2018

Supervisor: Prof Chris Lavy & Mr Tim Theologis

Project: Quantifying the manipulation phase of the Ponseti Method. This audit aims to measure the force that is being applied, by healthcare workers, to the talar head during the manipulation phase of Clubfoot. It is hoped this data may contribute to our understanding of current practice and how to further quantify the ponseti method. Data collection was in Addis Ababa.

Please contact globalsurgery@nds.ox.ac.uk for more details.

Apply for the Oxford AFP: Oxford University Clinical Academic Graduate School

Sergio Navarro (2019) 

Sergio was an MBA student at Oxford 2018-9 with an interest in Global Surgery. 

Projects

1. 'The health determinants of accessibility to clubfoot treatment: A global observational Study' with Sharaf Sheik-Ali, above.
2. Trends in ultrasound use in low and middle income countries: a systematic review (2019, International Journal of Maternal and Child Health and AIDS)
3. The Emerging Role of Global Private Public Partnerships in Zimbabwe
4. Exploration of the use of ultrasound for global surgical interventions in low and middle income countries: a systematic review 
5. Overview of the role of social media in clubfoot treatment globally: an observational study
6. An update on the cost effectiveness of global surgical Bellwether procedures 

Publications

Is overseas volunteering beneficial to the NHS? The analysis of volunteers’ responses to a feedback questionnaire following experiences in low-income and middle-income countries (2017, BMJ Open)

Do trauma courses change practice? A qualitative review of 20 courses in East, Central and Southern Africa (2017, Injury)

An Analysis of the Mechanical Properties of the Ponseti Method in Clubfoot Treatment  (2019, Applied Bionics and Biomechanics)

Are Primary Trauma Care (PTC) courses beneficial in low- and middle-income countries - A systematic review (2019, Injury)

Improving global surgery education for trainees (2019, World Journal of Surgery: Global Health)

ASiT Abstract 2019: The health determinants of accessibility to clubfoot treatment: A global observational Study

Oxford University Global Surgery Group

Contact: globalsurgery@nds.ox.ac.uk

Web: www.globalsurgery.ox.ac.uk

Twitter: @oxglobalsurg