‘For years I’ve been thinking about how I could go back to Africa and help’

Born in Sierra Leone, brought up in Britain, Francis Kaikumba is returning to Africa as part of a scheme to improve training for Africa's surgeons, backed by Irish Aid and the Royal College of Surgeons of Ireland (RCSI).

Surgery was not regarded as a priority in Africa until recently because countries were too poor to be able to afford it, or faced more immediate challenges. That opinion has changed because 11 per cent of diseases affecting Africans can be eased by surgery.

For example, Africa, according to the RCSI, has the world's highest rate of obstetric complications, its population suffers a quarter of the burden of the world's diseases, but has little more than 1 per cent of the world's medical staff.

Surgical education
Kaikumba is travelling to Arusha in Tanzania to take over as chief executive of the College of Surgeons in East, Central and Southern Africa (COSECSA), formed in 1999 to encourage postgraduate surgical education.

“For many years I have been thinking about how I could go back to Africa and help, I come from a very poor part of Africa, Sierra Leone,” he says before his departure. “Growing up here but going back regularly has always given me an element of guilt.

“I have to give something back. Health is always the area that I thought could have been the biggest impact,” says the father of three, who is leaving his post of chief executive of the African Health Policy Network in London to take up the Tanzanian position.

In 2007, COSECSA signed an agreement with Irish Aid and the RCSI. Irish Aid’s seed money has “been very instrumental in shaping the organisation”, says Kaikumba, offering surgeons “a college without walls” where they can sit exams accredited by the RCSI, with training offered by it and Oxford, Canadian and US universities.

Fewer than 1,500 surgeons serve Burundi, Ethiopia, Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia and Zimbabwe, while injury – not disease – is now the main cause of death and disability for children aged five and over.

Brain drain
The brain drain, particularly to the United Kingdom, exacerbates the problem: "For the past 15 years we have seen a significant number of medics, clinicians from various parts of Africa who were trained there, come to the UK to work in the National Health Service."

In reality, however, many of those who have left would be difficult to attract back to their home countries: “Many have established their lives over here, their children are here. It is very difficult for them to go back to working in a country where they will be paid a tenth of what one is paid here, with a much more challenging workload, where the need is greater.”

The solution is obvious, if difficult to bring about: “It is quite simple, in a way. Pay them more. I was shocked to realise that for most of my adult life I have been earning more than surgeons in Africa do every day.

“Most are paid between £10,000 and £15,000 [€11,700 and €17,560]. Sometimes, £20,000; £30,000 is a very good salary, exceptionally good, but it pales into insignificance compared with what people get here,” he says.

Kaikumba hopes to be joined by his wife, Tope Ademosu, and their three children by the end of the year: “We have a one month old, a one year old and a five year old, so it is going to be very challenging.”

For now, Kaikumba, a West African raised in Britain, faces the challenge of settling into the more reserved, conservative culture of East Africa: “As much as I see myself as Sierra Leonean, fundamentally, I know that I am British.

“My values are British; I was brought up in this country. I will always see myself as a British Sierra Leonean, a British-African. A lot of my generation find it difficult to grasp that concept,” says Kaikumba.

“Some of my friends find it a bit mad, a retrograde step. There is no money there, some say. Others can see the value.

“A lot of my African friends are seeing that the tide is turning, that there are opportunities there that are better than here.”