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Ndola (Zambia)

The primary aim of The Urology Department in Ndola is to improve urology services through capacity building. 

Background

Zambia, like many of its neighbours, is a presidential republic in Southern Africa with an area of 118,000 square kilometres. It has a population of 18 million. Average life expectancy is 60 for men and 64 for women. 43% of the population are under 14 years of age; infant mortality is 35 per 1,000 live births. ** (see below for UK comparison)

Zambia has a referral-based public healthcare system. There are several levels of care, beginning with health posts up to tertiary and teaching/ academic hospitals. The private sector also offers primary and specialist health care, mostly in urban areas. The National Health insurance scheme was recently rolled out and has a range of healthcare packages.  At least 80% of the population access free healthcare funded and provided by the government through its Ministry of Health. There are four tertiary referral hospitals, the biggest of which is in the capital, Lusaka (University Teaching Hospitals UTH), as well as two tertiary centres in the Copperbelt province of  Zambia (Kitwe and Ndola teaching hospitals).

Zambia has 250 specialist surgeons, mostly general and orthopaedic. The urologist to patient ratio remains high. A considerable proportion of the urological surgery in Zambia is open, and mainly done at the Tertiary centres. Zambia has one of the lowest per-capita/doctor ratios in the world at 0.000025 doctors per 1,000 people (2012). ** (see below for UK comparison)

** UK population: 67 million (2019) - UK area: 242,500 sq Km - Life expectancy: M80 / F84 years (2020) - Age demographic: 18% < 14 years (2019) - Infant mortality: 4 per 1,000 (2018) - Doctors per 1,000 population: 2.8 (2018) - https://data.worldbank.org

The Urology Department

NTH is an 800 bed tertiary hospital catering for central and northern Zambia. Apart from urology, the NTH department of surgery offers general, orthopaedic, plastic, paediatric, neurosurgery and ENT services. The College of Surgeons of East Central and Southern Africa (COSECSA) has accredited the hospital to offer specialists fellowship training programs in urology, general, paediatric and orthopaedic surgery.    

NTH serves as a provincial urology referral center. The top-five urological conditions are prostate cancer, urethral strictures, benign prostate enlargement, bladder cancer, and upper tract stone disease. The urology service has 10 beds, and a three bed surgical HDU; the service comprises two units led by Dr Simon Mukosai and Dr Mumba Chalwe. Both were trained at the University Teaching Hospital - a "Urolinked" Centre. 

Click here for further details & contact information (N.B. available to BAUS members only)

History

Zambian urology has a long, rich, history of evolving from two member teams in the early 2000s to much larger and diverse teams that serve the population today. Several of the consultants and senior trainees have benefited from collaborations through the Urolink partnership as well as training via the COSECSA program. Zambia currently offers three Urology training programs: the MMED Urology under the University of Zambia, the STP Urology under the newly formed Zambia College of Medicine and Surgery (ZACOMS) as well as the COSECSA FCS Urology at the various accredited sites in the country. Ndola Teaching hospital was recently accredited to offer the FCS urology program under COSECSA, as well as the STP urology under ZACOMS and graduated its first two Urologists in 2022.

Local objectives

The main objectives in Ndola are to strengthen endoscopic urological services, to support the establishment of outpatient-based procedures, e.g. prostate and bladder biopsy, and to provide remote support, and mentorship in the management of complex cases by engaging various UK-based experts. Ultimately, the main objective is to support ongoing urological training and education in Zambia.

Local needs

The top priorities for NTH are:

  • To strengthen capacity in urology research;
  • To increase the intake of urology trainees by recruiting at least two trainees each year;
  • To modernize urology care in the Copperbelt: the rate of open surgery is still unacceptably high. Ndola intends to increase capacity for endoscopy and offer more office-based urology; and
  • To increase its resilience in providing endoscopic techniques, by sustaining better equipment provision.

Urolink visits

May 2023: Scoping visit - Nick Campain.

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