The Institute of Ear , Nose and Throat Surgery and Audiology Beit Cure Hospital Lusaka Zambia Alice Kirby Ann O’Connor Hannah O’Driscoll Uta Foeschl Kieran O’Driscoll Firstly I’d like to thank David Weakliam and the organising committe committee for this great honur in addressing you all today. Its all the more an honor on this historic day when Minister Costello announced our joining the Esther alliance. This presentation as well demonstrating this new venture in Lusaka Zambia is very fitting on such an ocassion as this for it illustrates the success of partnerships and collaborations both nationally and internationally which underpins the success of the project. ----- Meeting Notes (29/01/2012 13:17) ----- Zambia for those who are perhaps unfamiliar is a land locked nation in the northern part of of the southern african region. Its about thesize of france, gemany and the low countries combined.

Basic Zambian Facts Land – locked country Approx 12 million pop. Former Northern Rhodesia Independent since 1964 Mostly rural but most urbanized in Sub Saharan Africa Democratic and politically stable Famous for Victoria Falls and wildlife In 2004 a medical based charity called “ENT Surgery for Zambia Trust Fund” was established This was based on the findings of the consultant’s visit to Zambia earlier that year. That visit highlighted the lack of ENT services for the 11.6 million of its population The level of services has been presented previously at this meeting and BACO 2006. Since its foundation the fund has provided essential equipment, educational support and performed major and minor surgeries in six visits over three years. The outcome of the venture may provide assistance to other sub – Saharan countries in addressing this problem.

Core Health Indicator Zambia UK Physicians (number) 1,264 133,641 Physicians (density/ 1000 population) 0.1 2.3 Nurses (density/ 1000 population) 1.5 12.1 Ratio of nurses and physicians to population is far worse than UK

Life expectancy at birth M/F (years) 77 / 81 40 / 40 UK Zambia Total population 59,668,000 11,657,000 Life expectancy at birth M/F (years) 77 / 81 40 / 40 Probability of dying under five (per 1000 live births) 6 182 % population living below poverty line < $1/day - 64 Life expectancy Probability of dying under age of 5yrs

African Health Issues HIV Malaria TB Surgery as a public health Issue Organisational Issues leading to specialty crises – burden of acute and chronic suffering

Recent WHO perspective on Surgery 11 – 13 % of world health burden is surgical Surgery is public health issue Surgery in developing countries is underfunded ENT surgery must be regarded as public health issue in context of retuning people back into the work force and children back into the classroom

Zambian ENT Services Based only in (UTH) 4 Doctors in 2004 Now 2 – 3 doctors No Audiologist No peripheral clinic in 2004 Now 1 clinic in Ndola

ENT Zambian Trust Fund

The ENT Zambian Crisis

The Zambian ENT Crisis

The ENT Zambian Crisis

Summary of Findings Mar ‘04 Under equipped Under-funded Under- trained No leadership Ear issues – mortality/morbidity/ Deafness Head neck issues - late diagnosis

What Needed To be Done Supply equipment Support Training Financed short term locums for ENT Surgeons Financed Anaesthetic/ Audiological/ Nursing locums

Partnerships/Collaborations up to 2006 and beyond! Equipment Metronics Eurosurgical Technosurgical Med Local Partnerships Christian Blind Mission Local E.N.T Surgeons University Teaching Hospital Lusaka Eye Hospital Irish Funding Rotary Tullamore Electric Aid (E.S.B) Gorta Individual Irish Donors Integrated Community Groups SMA Fathers Sisters of Mercy Donations from Irish Hospitals Tullamore General Hospital Royal Victorian Eye and Ear Hospital Dublin St.Francis Hospital Mullingar Hearing Aids Amplifon Bonvox Audiology Techno

What To Do Next Central Hub Development Peripheral Contact ( ? Mobile Clinic) Sustainable ENT Service

Partnerships /Collaborations – Keys to success Hospital Partners Zambian Government CURE International BEIT Trust Education Partnerships University of Zambia COSECA RCSI Financial Partners Irish Aid GORTA BMZ Germany ENT Partners ENT Zambia Christian Blind Mission