Madaktari Africa Volunteers & JKCI Team Members - 2022

Brief History – Madaktari Africa

Introduction:

Established in 2006, Madaktari Africa is a 501(c) 3, US based, non-profit organization that seeks to establish high quality, sustainable health care in Tanzania. To achieve our goal, we employ the “Train-Forward” model. This “train the trainers” philosophy prepares learners to ultimately become teachers, transferring knowledge and skills to other caregivers. Unlike the traditional medical mission’s approach, where all care is provided by visiting volunteers, efforts are focused on imparting knowledge and skill to local providers. Madaktari volunteers train local medical staff in both medical interventions and education, who in turn share their newly acquired skills with others. As this knowledge transfer grows, it creates a sustainable cycle of medical expertise, lessening dependency on foreign medical assistance. Madaktari’s “Train Forward” model began by training an assistant medical officer in Haydom, Tanzania in neurosurgery, who later trained several colleagues. Following the establishment of Neurosurgery, Madaktari shifted its focus to cardiovascular care. This culminated in the establishment of the first cardiac catheterization lab in Tanzania. As the WHO has identified cardiovascular disease as a rising threat to East Africa, the program comes at a critical time.

Mission:

Madaktari Africa’s mission is to create and support sustainable healthcare in East Africa by using the “Train-Forward” model of knowledge transfer to local providers.

Vision:

That all Tanzanians should have access to high-quality, state of the art healthcare.

Timeline:

2006 – Madaktari Africa is founded by neurosurgeon Dr. Dilantha Ellegala.

Madaktari supports Anesthesia and Neurosurgery programs at the Bugando Hospital in Mwanza by sending volunteers to train the providers and staff, while supporting the Canadian Network of Surgeons in their efforts to train surgeons at BMC. Dr. Susan and Derrick Selby volunteer on the ground for a year. Their specialties include Anesthesia, Intensive Care and Family Medicine. Affiliations include The Medical University of South Carolina (Department of Anesthesia), The University of Virginia, Weill Cornell University, University of Colorado, Duke University, Cornell University, and Harvard University.

2008 – Tanzanian President Jakaya Kikwete, and his personal physician and cardiologist, Dr. Mohamed Janabi, request the assistance of Madaktari in developing invasive and tertiary cardiovascular services in Tanzania. The Medical University of South Carolina's (Charleston, South Carolina, USA) Drs. Eric Powers and Peter Warner respond to the request by visiting Tanzania, meeting with MOH officials, and teaching at Haydom Lutheran Hospital.

2010 – Madaktari’s “Train Forward” program commences at Haydom. The JKCI clinical team visits MUSC for training and cardiac imaging, diagnosis and treatment. Construction of a new heart hospital, on the campus of MUHAS, begins in Dar es Salaam, Tanzania. Madaktari works with Tanzania to hold the first even East Africa Neurosurgery Conference in January 2011. Madaktari supports the neurosurgery programs at Muhimbili National Hospital.

2011 – A formalized MOU between Madaktari and the Tanzanian government is completed. 

Centra Health (Lynchburg, Virginia, USA) is engaged by Madaktari to begin work with the team from MUSC on expanding cardiovascular services in Tanzania and establishing a cardiac catheterization laboratory.  Doctors David Frantz, Thomas Nygaard, Dan Carey, Chris Thompson, Peter O'Brien and Chad Hoyt form the initial Centra team.

Madaktari Africa leads a Walter Reed project at Mbeya Regional Hospital (MRH) funded by the Henry Jackson Foundation (2011 - 2015). This project provides a nephrologist, family medicine physician, dialysis nurse, and a medical technician to the MRH to train Tanzanian doctors, nurses, and technicians in providing dialysis and cardiac care to HIV/AIDS and general medical patients. Madaktari Africa submits a plan to assist the META hospital at Mbeya with OB/GYN, equipment and technicians.

Madaktari works with Clemson University's Department of Bioengineering to develop appropriate technology for the developing world. Teh first project produces a baby blanket warmer for the region. All of the products developed can be manufactured and maintained in Africa. Developers collect equipment data for Mbeye Referall Hosptial and Bugando Medical Center sharing results with hospitals across the region.

2012 – Madaktari Africa, MUSC and Centra Health host the East Africa Cardiology Conference in January, 2012 at the Bank of Tanzania in Dar es Salaam. Over 200 Cardiovascular specialists, nurses, students, and political leaders from MUSC, Centra, Tanzania, and other East African countries attend. Madaktari coordinates the transfer of the complete MUSC Library to the medical school in MUHAS. Madaktari works to establish Neurosurgery, Family Medicine, and Nephrology programs at the schoo, and collaborates with the hosptial board to develop their infrastructure. Madaktari conducts medical equipment surveys at BMC and MRH.

2013 – The Department of Cardiology at MNH is founded. Construction of a cardiac center and a cardiac catheterization lab is completed on the MUHAS campus. Training begins with the Cardiac Cath Lab staff. An extensive educational curriculum, training programs, protocols, etc. are developed. Many hours of staff education, training and program development are completed before the cardiac cath program is inaugurated. A total of three mock cardiac cath procedures are performed before this is done with a live patient by Dr. Peter O’Brien, Dr. Chad Hoyt, Jordan Slayton, RN and the Cardiac Cath Lab team. In close cooperation with Dr. Eric Powers and his team from MUSC, the first cardiac caths and PCI’s are to be performed at the new heart hospital

2014 – The first right heart catheterization and left heart catheterization are performed at the new Cardiac Cath Lab. Development and implementation of a Cardiac Cath Lab data registry begins. 

2015 – The cardiac center is officially renamed the Jakaya Kikwete Cardiac Institute. The first coronary stent procedure is performed at JKCI by Dr. Peter Kisenge and Dr. Peter O’Brien. Dr. O’Brien takes over as Medical Director and President of the Board from Dr. Dilantha Ellegala.

2016 – The 500th invasive cardiovascular case is completed at JKCI. The second East Africa Cardiovascular Conference is held at the Bank of Tanzania building. The first American College of Cardiology Chapter–in–Formation in Sub-Saharan Africa is inaugurated. Madaktari establishes a Cardiac Electrophysiology program, under the leadership of Dr. Michael Valentine from Centra. The first pediatric pacemaker is implanted in Tanzania. Madaktari expands training and advances noninvasive imaging modalities.

2017 – The first cardiac MRI is performed in Tanzania with the guidance of Madaktari and MUSC. A Cardiac Cath Lab is installed in Dodoma. Dr. Matthew Sackett begins proctoring the implantation of ICD’s and CRT devices.

2018 – An extension of the JKCI campuses is added to Mlonganzilla Hospital.

2019 – JKCI is registered with NCDR Cath PCI with support of the ACC. The first radiofrequency ablation and EP studies are performed at JKCI. Three more EP trips are conducted including Dr.  Wayne Alexander – (Winchester, VA) and Dr. Sarfani Durrani – (Medstar Georgetown) for device implants, Dr. Sackett continues with device implants, and also with EP studies with ablation of WPW and atrial flutter.

2020 to 2021 – No trips are undertaken due to the COVID-19 pandemic. The CARTO system is acquired by JKCI. EP training progresses with help from an Egyptian EP team. Dr. Gandye (JKCI cardiologist) obtains EP training in Egypt and China. Dr. Mazen Albaghdadi and Dr. Peter O’Brien assist the team at JKCI with a coronary artery stent procedure via the Remote Clinical System (Alta Group Int. Ltd.). Dr. Albaghdadi and Dr. O’Brien are able to guide the team in Tanzania from their homes in the United States--the first such coronary procedure remotely proctored in Africa.

2022 -- Madaktari Africa travels to Lusaka, Zambia. Dr. Peter O’Brien conducts a series of lectures to physicians and trainees at the National Heart Hospital. A site visit performed, facilitating the arrival of CardioStart (a cardiac surgery NGO that collaborates with Madaktari). 

2022 – Madaktari Africa returns to Tanzania for the first time post-pandemic. Dr. Mazen Albaghdadi visits JKCI, accompanied by interventional cardiologist Dr. Yasir Akhtar (Tennova Medical Group, Knoxville, TN) and his team. Dr. Albaghdadi and Dr. Akhtar return to JKCI later in 2022 continuing work from the previous trip.

2023 – Madaktari Africa partners with the Barrow Neurological Institute (BNI) to bring a neurosurgery “Train Forward” program to the Kilimanjaro Christian Medical Center (KCMC).

Dr. Mazen Albaghdadi takes over as Medical Director and President of the Board of Madaktari Africa from Dr. Peter O’Brien

Dr. Kerry Vaughan is designated the first Franke Global Neurosurgery Fellow of the partnership and arrives in Tanzania for a one-year commitment.

Dr. Thomas Dahle (CentraCare Heart & Vascular Center, MN) arrives and trains JKCI staff members on the new Phillips Ultrasound for ultrasound-guided vascular access, developing JKCI’s peripheral vascular experience, and performs JKCI’s first superficial femoral artery stent. Dr. Dahle completes additional advanced coronary intervention techniques, including CTO and bifurcation work. Dr. Dahle gives multiple departmental lectures on vascular access, peripheral arterial disease and intervention, TAVR, Mitral, and structural heart disease.

Madaktari Africa conducts two more EP trips.

·         Dr. Sackett – Ablations and devices with multiple CARTO cases (WPW, PVC), first fluoro-less ablations 

·         Dr. David Singh (Hawaii), Dr. Nitish Badawar (Stanford) – perform ablations with CARTO,  and the first LBAP devices

2024 – Dr. Mazen Albaghdadi, President of the Madaktari Africa Board of Directors, attends the Cardio-Tan Conference in Tanzania. Dr. Mohamed Janabi, Madaktari Africa Board of Directors member, speaks at the Cardio-Tan Conference in Tanzania.

Madaktari Africa’s partnership with BNI continues, with Barrow Global student-scholar Dr. Habib Rafka joining Dr. Vaughan at KCMC.

Madaktari Africa conducts and/or plans three additional EP trips:

·         Dr. Badawar – Attends Tanzanian EP conference, ablations and devices

·         July – Dr. Sackett, Dr. Sam Omotoye (The Cleveland Clinic) and Dr. George McDaniel (Pediatric EP, University of Virginia)

·         August – Dr. Singh and Dr. Badawar

Madaktari Africa is a 501 (c)3 organisation