Faculty of Medicine

Training the World

Apr 10, 2019

Emergency medicine students in Addis Ababa with TAAAC volunteers (photo courtesy of Marci Rose)Emergency medicine students in Addis Ababa with TAAAC volunteers (photo courtesy of Marci Rose)
April 7th marked World Health Day. It’s an occasion to celebrate the founding of the World Health Organization (WHO) — and a chance for WHO to highlight an area of concern. This year’s theme is universal health coverage, WHO’s number one goal.

We know that at least half the world’s population does not have full coverage of essential health services, and around 100 million people are pushed into extreme poverty each year because they have to pay for health care. While Canadians take pride in universal health coverage (noting it can be improved), we should not be complacent in supporting coverage worldwide.

One challenge for universal health coverage is a sufficient supply of skilled healthcare workers around the world. Under-resourced nations have struggled to establish training centres that can educate local-born professionals to meet their needs. In response, many resource-rich nations have taken one of two approaches. 

The first is to coordinate volunteer health professionals who complete short stints of service delivery abroad where they deliver care. But this doesn’t build local capacity, and because of their short stays, foreign workers don’t come to know the long-term needs of the population they serve. 

The second approach is to bring budding professionals from under-resourced nations to train in North American and European schools. Here again, no local capacity is built. Also, these trainees become accustomed to a Western lifestyle and some hesitate to return home. In both approaches, without intent, a cycle of dependence is created — either developing nations become dependent on foreign healthcare workers to deliver care, or they are dependent on foreign schools to train their local workforce. 

We decided to take a fresh approach in 2003. Faculty members at Addis Ababa University (AAU) in Ethiopia approached U of T’s Department of Psychiatry with a request: help us open the first psychiatry residency training program in Ethiopia. Thus was born the Toronto Addis Ababa Psychiatry Project, where U of T faculty volunteer time in country as colleagues, not replacements, enabling local learning. It proved to be a workable, effective model for accelerating the creation of medical specialists in Ethiopia.

In 2008, this collaboration became the Toronto Addis Ababa Academic Collaboration (TAAAC), which now includes other medical specialties and U of T faculty in dentistry, engineering, education, library sciences, pharmacy, rehabilitation science, law and social work. Addis Ababa embraced TAAAC as a template for all partnerships with Western universities, and by 2018, this collaboration had helped train more than 250 professionals — with more than 90 per cent remaining in Ethiopia. 

We support AAU by facilitating excellence in academic research and practice, while building on U of T’s commitment to global citizenship and international engagement. Together, U of T and AAU have built a model that could train the world, and that leads us one step closer to achieving universal health coverage.

Brian Hodges
Executive Vice President, Education, University Health Network
Chief Medical Officer
Co-chair TAAAC Governance Committee

Dawit Wondimagegn 
Chief Executive Director, College of Health Science,
Vice President Addis Ababa University
Co-chair TAAAC Governance Committee 

Helen Yifter 
Graduate Program Director, College of Health Sciences, Addis Ababa University,
TAAAC Co-Program Director

Clare Pain 
Associate Professor, Department of Psychiatry
Faculty of Medicine, University of Toronto
TAAAC Co-Program Director

Marci Rose
TAAAC Program Manager 
Wilson Centre, University Health Network, University of Toronto

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