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Fette

Andreas Fette, Libyan

German Hospital, Pediatric Surgery, Benghazi/Libya

Background:
So far, only 2 governmental institutions provide specialist pediatric surgical services (SPSS) in Benghazi. Traditionally, each institution focus on our “classical” expertise, the visceral- or newborn surgery, and not on urology or trauma cases. Any medical decision making within Benghazi families is strictly based on their merits and beliefs in “inschallah” and clans. It is further characterized by a sparse body knowledge, the general mistrust in “all doctors”, and the attitude to complain “anytime about everything”. Obviously, due to the difficult political situation during a revolution, no real advances in SPSS could be expected. In this communication we would like to display our role in introducing the “German system”.

Methods:
Start-up of a tailored inhouse training with skill stations, lectures, tutorials and bed-side teaching for all grades of staff. New surgical techniques were implemented on an individual basis. Sustainable, being “the best example yourself” leadership with strict confidentiality on everyones personal standing and progress generated an enormous trust into the “NEW” SPSS system.

Results:
- higher standards of care and staff motivation

- master exams re-held after revolution for the first time

- first laparoscopic-, newborn-, and subspeciality surgeries done in the private sector

- carers and families more convinced and satisfied about SPSS provided

- surgeries performed doubled in numbers, follow-up reached >2/3 of the patients

Conclusion: “German” expertise introduced in a culture-sensitive way allowed for the first positive changes in SPSS in Benghazi/Libya. However, for a full sustainable implementation, there is still a long way to go.