By Dr. Greg Basura

Preface by Ozzy Samad: As you may know, a major part of BBF’s work includes sending medicines, medical supplies, and equipment to partners in need all around the world. As a complement to these relief efforts, we also support the impactful work our physician partners who are helping with both the ongoing training of their colleagues both near and far, and the strengthening of health systems where need be.

One such dedicated physician with a passion service to others, is Dr. Greg Basura. Per his bio, Dr. Basura is an experienced neurotologist, educator, and funded surgeon-scientist. He is a leader in global otolaryngology outreach and has worked to develop sustainable educational and clinical initiatives in underserved nations. He is the current Chair of the Humanitarian Committee for the American Academy of Otolaryngology-Head and Neck Surgery. Along with Drs. Johan Fagan and Tashneem Harris in Capetown, South Africa, Dr. Basura helped launch the first otology fellowship in Africa and continues to work closely with the fellows through online education and biannual trips to South Africa. In addition to his clinical and research roles, Dr. Basura is leading global otolaryngology efforts for the University of Pittsburgh Department of Otolaryngology-Head and Neck Surgery, including oversight of our international educational programs and ongoing work in South Africa, Mozambique, and Peru.

BBF’s work with Dr. Basura and his colleagues, includes supporting and expanding his Fellows program in South Africa. Here, otolaryngologists from other countries in Africa come to further their training and return to their home countries to assist patients in need. Dr. Basura envisions having similar Fellows programs in other countries also given the shortage of such specialists. An additional goal is to better equip medical facilities to accommodate surgeries as needed. On an operational level, one of BBF’s first tasks is to ship a donated microscope (please envision a dentist’s chair equivalent with a similarly sized accompanying unit connected to a large arm) to their collaborating medical facility in South Africa. BBF has also shipped surgical instruments to a hospital in Peru to assist with their otolaryngology program and will be supporting the building of a hospital in Mozambique.

This is only the beginning of the partnership and Dr. Basura writes in more detail about his work in South Africa in the article below:

Otologic disease within low-income countries (LIC) poses many challenges. Limited training opportunities for physicians in LICs to gain necessary surgical skills to treat otologic problems within a rapidly expanding population exists. Millions suffering from chronic ear disease (i.e., chronic otitis media with cholesteatoma) and hearing loss in LICs, requires changes in how otolaryngology/head and neck surgeons are trained to meet these demands. A sustainable dedicated otologic surgical training fellowship beyond otolaryngology residency training is one approach/solution to provide focused training in medical and surgical management of ear disease.

The Department of Otolaryngology/Head and Neck Surgery at the University of Cape Town (UCT), in Cape Town South Africa has been a leader in otolaryngology/head and neck surgery training and a model for the development of dedicated surgical subspecialty fellowship training in Africa for nearly 2 decades. Under the direction of Professor and former Chair, Dr. Johan Fagan, head and neck surgical fellowship training has been well established as a proven model for subspecialty surgical training beyond residency for African general surgeons and otolaryngologists. Now, in addition to the one-year head and neck fellowship that was started 18 years ago, one-year fellowship training opportunities have been established at UCT in pediatric otolaryngology, rhinology/anterior cranial base and now, as of March 2022, in otology.

Dr. Tashneem Harris, under the funded support of the cochlear implant company MedEl (Medical Electronics; Innsbruck Austria), initiated the first dedicated otology fellowship program at UCT in South Africa in March 2022. The first fellow, Dr. Erasmas Muganda from Harare Zimbabwe was selected and began training in April 2022. Dr. Muganda completed this one-year dedicated otology fellowship in April 2023 and has returned to Harare to practice with a focused emphasis on otologic surgery including cochlear implantation. At the time of this article, he has performed at least 14 cochlear implant surgeries in his home country of Zimbabwe and in neighboring Botswana. Last year he also led the 6^th annual temporal bone dissection course in Harare that was attended by over a dozen international African trainees.

The second fellow, Dr. Peter Appiah-Thompson, otolaryngologist from Cape Coast Ghana trained at UCT from April 2023-April 2024. He has since returned home to Ghana and is now a sectional leader within his department and actively engaged in specialized otology care.

Dr. Lillian Mohkoh, from Nairobi Kenya is the current and third otology fellow. She is scheduled to complete fellowship training in April 2025 and will return to Nairobi shortly thereafter.

The fourth fellow, Dr. Amina Seguya, from Kampala Uganda will begin her one-year training fellowship in March 2025.

During fellowship, trainees spend a dedicated 1-year at UCT in Cape Town and spend their time in the otology clinic and in the operating theater under the daily direction of Dr. Harris. To supplement their training, Dr. Gregory Basura (otologist from the University of Pittsburgh), delivers a weekly online/virtual lecture series every Friday morning where otology topics and cases are discussed. These lectures cover all topics of otology, audiology, vestibular neuroscience with associated clinical cases to supplement the fellow’s and UCT residents’ training. This hybrid approach to training has been quite effective and has continued from the first to the current fellow.

In addition to the weekly virtual lectures, Dr. Basura started the online African Otological Society (AfOS; www.afotos.org) in November 2023. This monthly held online society is designed to create community within otology and audiology in Africa to expand educational resources and training opportunities. The goal is to establish multiple dedicated otology fellowships across the continent of Africa and ideally the AfOS will serve as an overseeing body to standardize training and to facilitate ongoing training, educational and community opportunities.