Sunday, 18 March 2012


Nothing like a couple of good acronyms to make things difficult.

TAAAC is the Toronto Addis Ababa Academic Collaboration, the group I will be travelling with in April. TAAAC is an arrangement between the two universities which began with psychiatry and has now extended to other disciplines, including family medicine, emergency medicine and, of course, anesthesiology. The main aim is to support the teaching of Ethiopian residents by sending physicians from the University of Toronto to the University of Addis Ababa three times a year, in February, April and October, to assist with both clinical and classroom teaching. The buzzword is "capacity building". Instead of just going as a service commitment, doing a few cases and helping a few people, we are aiming to increase Ethiopia's ability to train its own physicians and so be more able to treat its own citizens. It has worked for psychiatry, which has helped complete the training of several psychiatrists who now work in Addis and elsewhere in Ethiopia.

CASIEF is the Canadian Anesthesiologists Society International Educational Foundation. It has the same goal of assisting in the education of residents in their own country. It only deals with anesthesia. CASIEF worked in Nepal for many years and set up a self-sustaining training program there. It now works in Rwanda, which only had one medically qualified anesthesiologist left after the genocide. I worked for them in January 2010 (See

The main difference is that CASIEF tries to have one foreign teacher (and perhaps one Canadian resident) in the country at all times, while TAAAC tries to have a small group of three or four anesthesiologists go together three times a year, along with similar sized groups of other medical specialists. They argue that this is less stressful for the visiting professors. In theory, the local staff should continue teaching between our visits, we are just there to help and support them. In Rwanda, it sometimes seemed that the Rwandan staff felt that we were the only ones responsible for teaching. However, we did have the advantage of an apartment which was always reserved for our use,so we could leave local phones, textbooks, and OR supplies locked up in a safe. On this visit TAAAC is getting the use of an office, but I am doubtful that things left there in April will still be around when we go back in October.

Another difference is that for TAAAC I will only be working in one hospital, Black Lion. CASIEF works at the University Hospitals in Kigali and Butare, as well as the partly-private King Faisal Hospital in Kigali. On the one hand, it was interesting to see three hospitals, and the trip between Kigali and Butare is very scenic, on the other hand its nice only to have to learn my way around one site.

TAAAC seems better organized, as there have been several face to face meetings of the team and of the leadership for briefings. The University has policies and procedures in place for foreign trips. One TAAAC leader always goes to ensure each group is orientated and safely set up in Addis. CASIEF recruits teachers from across Canada and the USA, so a lot of preparation and briefing gets done by email.

Both organizations are trying hard to make a difference in Africa, it will be interesting to compare the two approaches.

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