Introducing Endourology To A Developing Country: How To Make It Sustainable

Background: Endourological procedures are not routinely performed in low-income countries in sub-Saharan Africa. The problems that are involved in introducing endoscopic services are low level of medical personnel trained in endoscopic procedures and infrastructure development in these countries.Materials and methods: Recently, endourological facilities were created at the Hawassa Referral Hospital in Ethiopia. This work is the result of close collaboration between the UROLINK and the Hawassa Referral Hospital Link coordinator. Between 2010 and 2012, the UROLINK team visited Hawassa three times to set up endourological services.Results: A local surgeon has been trained in basic endoscopic procedures. Optical urethrotomy and flexible and rigid cystoscopy have been successfully introduced. We discuss the difficulties involved in such a project like initial assessment, providing equipment, maintenance of equipment, and, particularly, training of the surgical team. The follow up from the trips is short and the sustainability of the goal remains to be seen.Conclusions: The introduction of endourological services in Hawassa offers a chance of improving urological care locally. The experience of Hawassa is representative of other low-income countries and may provide valuable lessons. A few key principles (need, equipment, cost, surgical technique, and training) should be kept in mind.