CHALLENGES OF SETTING UP A COLORECTAL SERVICE
By Ijeoma Aja
10th Nov, 2025.
A little over a year ago, I set off bright eyed and eager back to Korle Bu Teaching Hospital, my alma mater. I had left 6years prior after completing my fellowship in General Surgery eager to move into rural Ghana and do my quota to improve the never-ending dilemma of surgical access for patients. A problem which according to the Lancet commission on Global Surgery results in more deaths than HIV, Malaria and Tuberculosis combined.
Not too long after, I realized yet another dilemma. While my colleagues and I proudly wore our titles as General Surgeons and provided a lot of services some even out of the domain of what a general surgeon does, we were still sorely lacking in the domain of the pelvic floor with a good number of our cases with rectal malignancy having to be referred to the centre in Accra including a very good friend of mine. It was on this premise that I jumped at the opportunuity of a Colorectal Surgery Fellowship organized by the Global Colorectal Surgery Initiative and the Ghana College of Physicians and Surgeons.
The year of intense literature/textbook reviews, evaluation and workup of cases, monthly conferences with faculty from all over the world, radiological and research sessions and the writing of a dissertation have all ended in a haze. I have returned to my secondary facility with no set-up for colorectal surgery and now begins the real task. How does one set up a colorectal service in a place not ready for such subspecialisation, what does it entail? Even more basic, who or what am I? A Colorectal Surgeon, a general surgeon or a general surgeon with colorectal interests?
Now begins a journey of self-reflection and introspection. In this quagmire, I am grateful for my mentors who have not left me, who challenge me with questions I as yet have no answers for. As I go on this journey of building, I fall on the expertise of those who have gone before me, the first colorectal trainee Dr Agbedinu and our mentors especially Professors Lowry, Huang, Moloo and Kwakye who are helping me take baby steps and define my practice.
Watch this space, the best is yet to come.
Picture:
Dr Aja in the endoscopy unit with team performing a colonoscopy at Koforidua Regional