Kabul, Afghanistan


Many decades of war and instability have substantially damaged Afghanistan’s health care sector. Afghanistan has the world’s worst health indicators and Afghanistan ranks one of the lowest in the United Nations Human Development Index. Still many challenges remain to create a functional and sustainable health care system in Afghanistan.

Political instability has caused qualified and skilled professionals to leave Afghanistan over past decades. This brain drain has deprived Afghanistan of the expertise of its most talented people at a time when their skills are desperately needed. The medical students in Afghanistan have been deprived of good quality medical education. Some have graduated in the absence of proper medical curricula and without proper guidance at teaching facilities. The lack of qualified specialists, professors and educators has therefore hampered the development of qualified personnel, and has left the already struggling medical teaching facilities in Afghanistan in an even more fragile state.

The current fragile situation of the Afghan health care system could be substantially enhanced through improved medical education, qualified medical educators and better-trained health care providers. Clearly, without the capability, the knowledge and the right resources to take appropriate actions to establish qualified medical educators, specialist and health workers, Afghanistan will continue to struggle to improve the health situation of its nation. This proposal describes project Laparoscopic simulation training to provide surgical training by use of laparoscopic simulators. The aim is to improve the surgical care in Afghanistan.

Contributing partners in this project
General partners:
• Kabul Medical University
• Ali Abad Teaching Hospital
• Sardar Daud Khan Military Hospital

Partners and sponsors in the Netherlands:
• DEAM-Steerable Laparoscopic Instruments
• Laparoscopyboxx
• VU Medical Centre
• Karl Storz SE
• Radboud University Medical Centre

Project description

We focus to improve the quality of surgery by providing surgical training through laparoscopic simulation training with techniques and equipment suitable for the specific location and local demands of the surgeons, surgical residents and medical students in Afghanistan. At this point the training is still based on a master-apprentice teaching, with varieties of different approaches. To provide a straightforward, the process should be standardized according to surgical skills training and latest scientific evidences as far as applicable to the situation present in the academic or teaching hospitals. Standardizing the process will facilitate the medical staff, making the process more efficient and improving patient care. In addition to the laparoscopic trainers, access to an application will be available to learn and do exercises.

Project phases

1) Three laparoscopic simulators will be placed in a training room at Ali Abad
Teaching Hospital and three at Sardar Daud Khan Military Hospital and access to a training application will be provided.

2) At the start of the project, a team of MCAN members will provide onsite training to the surgical residents and the surgeons. Afterwards, the MCAN members will provide online help if this is needed.

3) After 6 months, the usefulness and the satisfaction of the project is evaluated. In case of a positive evaluation, the project will be continued and probably extended with more simulators and equipment. The aim is to create laparoscopic skills lab in which surgical techniques can be practiced by residents and staff.

The start of this project has been delayed due to the COVID-19 pandemic.

Material used:
Two simulation boxes of the firm Laparoscopyboxx, two fully equipped laparoscopic simulators of DEAM and two laparoscopic trainers of Radboudumc will be provided to the Afghan hospitals. Additional suturing material, tablets, access to the app, and spare gear will be provided as well.

Learn more about Medical Committee Afghanistan Netherlands

MCAN is a volunteering initiative, consisting of a multidisciplinary group of medical doctors and academics living in the Netherlands.