Regional Dermatology Training Center in Moshi, Tanzania, takes on tropical skin diseases

               

By Donald Lookingbill, MD

As AAD members, we value contributions to public health and collaborations that contribute to the greater good. In my opinion, one of the greatest places to see these values put into action is the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania.

The RDTC was established in 1992 by Henning Grossmann, MD, and is supported by the International League of Dermatological Societies (ILDS) and its member associations, including the AAD. The RDTC provides dermatological training to medical professionals from many countries in the sub-Saharan region of Africa. Located on the grounds of the Kilimanjaro Christian Medical Centre, the RDTC is where students learn how to diagnose and treat skin disease, including tropical diseases, such as leprosy, and endemic Kaposi’s sarcoma. Upon completion of the two-year program, students return to their respective countries as dermatology officers to provide dermatologic services in places where they are sorely needed.

                The Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania, is where students learn how to diagnose and treat skin diseases. In January 2013, David Pariser, MD, led a seminar, “Advances in Tropical Medicine,” that the AAD sponsored. He discussed implications of tropical skin diseases on public health. Pictured are the participants in the AAD's seminar.
 

When I arrived in Moshi in July 1993, I was the first, but not the last, American volunteer to help with the training program. Hospital conditions and clinic facilities — although better than in much of the continent — were spartan, and medicines to treat even everyday illnesses were scarce. Fifteen students — nurses and medical assistants — had just completed their first year of training, and the second class was just starting theirs.

During our six-month stay, my wife, Georgia, and I had the opportunity to help launch a skin-care program for albinos. Tanzania has one of the highest rates of albinism in the world: One in 1,429 people is born albino. Because they live close to the equator where ultraviolet radiation is intense, albinos are susceptible to deadly skin cancers at early ages.

To address this issue, Barbara Leppard, MD — a British dermatologist who volunteered at the RDTC for the first 10 years of its existence — my wife, and I launched the Albino Outreach Programme, which has since become a major initiative of the RDTC. In this program, an RDTC dermatologist, an albino administrator, and several rotating RDTC students run a mobile skin care clinic that regularly visits 10 villages in the Kilimanjaro region. They diagnose and treat skin cancers and pre-cancers, provide patient education, teach preventive measures, and distribute hats and sunscreen. Some of the patients are also engaged in the tailoring of hats and other articles of clothing.

To date, roughly 800 albino patients have been enrolled in the Kilimanjaro region. RDTC graduates have launched similar initiatives throughout Tanzania, as well as in 12 other countries.

Because they live close to the equator where ultraviolet radiation is intense, albinos are susceptible to deadly skin cancers at early ages.

The Albino Outreach Programme has generated some external support as well. For example, Hats On for Skin Health, a worldwide program led by the ILDS and Stiefel, a GSK Company, and supported by the AAD, raises funds to purchase hats and other sun-protective items for albinos in the outreach program.

The RDTC itself has evolved from its humble beginnings in the early 1990s. Since first working at the clinic 20 years ago, I have returned to Moshi nine times and have witnessed remarkable progress. Nearly 300 students have graduated from the original two-year diploma program at the RDTC. More recently, a four-year residency program was started to train dermatologists: It now enrolls five physicians annually. And although Dr. Grossmann is still on the scene, several years ago he turned over the leadership of the program to John Masenga, MD, a Tanzanian dermatologist who had been involved from the start.

Each year, notable dermatologists teach at the center and return to the United States to share what they learn about tropical skin diseases. In January 2013, David Pariser, MD, led a seminar, “Advances in Tropical Medicine,” that the AAD sponsored. He discussed implications of tropical skin diseases on public health. The seminar generated productive discussions among top dermatologists.

As programming has expanded, so have the facilities. Thanks to the fund-raising efforts of Alfred Kopf, MD, founding chair of the International Foundation for Dermatology, an RTDC facility was built on the grounds of the Kilimanjaro Christian Medical Centre. It opened in 1997 and accommodates the outpatient services and teaching needs of the program. Stuart Maddin, MD, and his Rotary Club from Vancouver provided a pharmacy facility that is located behind the RDTC building, and in that same area a new dermatopathology laboratory and a building for sunscreen manufacturing are both now nearly complete. A new, 75-bed, dermatology inpatient ward opens this month. Also, for the last 10 years, visiting volunteer faculty have been provided with housing accommodations in the three two-bedroom cottages that were funded by American pediatric dermatologists, led by Neil Prose, MD.

Despite all of this remarkable progress, this work is far from finished. Scholarships for students are always in demand, and as medical costs continue to climb, the RDTC is in need of ongoing support. Anyone who wants to help can donate to the program, thereby helping to ensure that people on the other side of the world will have access to much-needed skin care and a chance to live longer and healthier lives.

Dr. Lookingbill served as the founding chief of the Division of Dermatology at The Pennsylvania State University College of Medicine from 1975-1997 and chair of the Department of Dermatology at Mayo Clinic Florida from 1997 until 2006.

Email the Member to Member editor at members@aad.org.

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