Madaktari Africa is committed to developing local health care capacity in the diagnosis and management of cardiovascular disease in sub-Saharan Africa. The U.S.-based nongovernmental organization uses the train-forward model to build local capacity by training local doctors in the best practices of clinical and procedural aspects of diagnosing and managing all forms of cardiovascular disease.

I became committed to serving with Madaktari Africa after my first mission to Tanzania. I trained local interventional cardiologists and participated in the East African Cardiology Conference, along with Peter O'Brien, MD, FACC, medical director of the organization, and fellow volunteer Eric R. Powers, MD, FACC.

After reading an article in Cardiology about O'Brien and Madaktari Africa's efforts to establish invasive cardiology services at the Jakaya Kikwete Cardiac Institute (JKCI) in Dar es Salaam, Tanzania, I was inspired to reach out to him to volunteer.

The focus of Madaktari Africa in developing a sustainable model of local health care capacity rather than the fly-in-fly-out model of traditional medical missions was the primary reason I was drawn to volunteering.

In addition, as an interventional cardiologist, I was excited to be able to utilize my procedural skills to train local physicians and help patients in Tanzania afflicted with cardiovascular disease.

It was clear that O'Brien and Mohamed Janabi MD, PhD, FACC, his colleague and executive director of the JKCI, were creating something special in Dar – tertiary cardiovascular services to combat the growing epidemic of cardiovascular disease in the region and a cardiology training program among a dedicated group of young physicians and trainees.

These programs encompassed all elements of cardiovascular care, including a burgeoning electrophysiology effort, a program spearheaded by Matthew Sackett Sr., MD, FACC, along with Peter Kisenge, MD, director of the JKCI Cardiac Catheterization Laboratory.

My first visit to the JKCI was extremely rewarding and underscored the impact that can be made by a few dedicated individuals. And I've returned every year since then to volunteer at the JKCI.

On my most recent trip, in July 2019, I was fortunate to be joined by Nino Mihatov, MD, a cardiology fellow at the Massachusetts General Hospital (MGH), and two exceptional nurses, Carly Gay and Marissa Levine, from the Massachusetts General Hospital Cardiac Catheterization Laboratory.

With their support, we continued our efforts to train our physician and nursing colleagues at JKCI in all aspects of the periprocedural management of patients undergoing cardiac catheterization, including performing complex coronary interventions.

Madaktari Africa is committed to improving the quality of care through evidence-based quality improvement initiatives. During our most recent visit, we helped the JKCI develop a quality improvement registry to characterize the demographics and outcomes of their patients undergoing cardiac catheterization.

In 2018, we were delighted to help the JKCI join the ACC NCDR CathPCI Registry, with help from C. Michael Valentine, MD, MACC. Along with being a past president of ACC, Valentine is a volunteer and friend and colleague of O'Brien.

Together these efforts are critical to build local, sustainable, data-driven health care services in a region increasingly burdened by cardiovascular disease.

Keywords: ACC Publications, Cardiology Magazine, Medical Missions, Physician Executives, Cardiovascular Diseases, Quality Improvement, Hospitals, General, Reading, Fellowships and Scholarships, Cardiac Catheterization, Training Support, Registries, Volunteers, Demography, Electrophysiology, Minority Groups, ACC International

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