Improving pediatric injury care in Mozambique through research

A picture of Dr. Amado with children in Maputo Central Hospital, received with parental consent. Photo credit Massada da Rocha.
By Dr. Amado has been at the center of the institutional collaboration between Eduardo Mondlane University and the University of California Los Angeles, and she has been mentored by UCLA pediatric surgeon Dr. Dan DeUgarte.
3 min read

Dr. Vanda Amado, pediatric surgeon and researcher in Mozambique, graduated from Eduardo Mondlane University’s (UEM) Faculty of Medicine and completed her Pediatric Surgery Fellowship at the University of Barcelona. Dr. Amado’s clinical interests include trauma, tumor, and neonatal surgery for congenital birth defects. Her clinical research focuses on quality improvement, trauma care, and global surgery. Dr. Amado also plays a leadership role in Mozambique in training surgeons and recruiting young people, with a focus on women, to pursue a career in surgery and to participate in research.

Dr. Amado recently received a PhD in Global Public Health from the Karolinska Institutet in Sweden. Her project focused on acute pediatric injury during the COVID-19 pandemic, concentrating on injury epidemiology and care at the largest hospitals of Mozambique. 

Since 2010, Dr. Amado has been at the center of the institutional collaboration between Eduardo Mondlane University and the University of California Los Angeles, and she has been mentored by UCLA pediatric surgeon Dr. Dan DeUgarte. GHP is excited to congratulate Dr. Amado on her PhD and to follow her next steps!

GHP: Congratulations on earning your PhD! Can you tell us what inspired you to pursue a career in pediatric surgery and to pursue a PhD?

Dr. Amado: My pursuit for higher levels of training was inspired by my first job in a little town in the south of Mozambique called Namaacha. Namaacha is a small rural town (~848 square miles) and it had a very young population when I was practicing medicine there, with nearly half of the population aged 15 years or younger. I was the only medical doctor there at the time, and I was tasked with running the entire health system in the district of Namaacha, which had very limited resources (physical, personal, and financial). Despite being a junior doctor, the lack of medical doctors in the country in general and in rural areas in particular meant that I had important responsibilities in this rural district. I found myself treating many trauma and injury cases in children. This stimulated my curiosity about how to achieve better outcomes. It was clear to me that injury in children was different than in adults, but they were being treated the same in this community. 

Over the years, I have conducted research on pediatric injuries and have thought deeply about the details of these cases. I have also provided training on pediatric injuries for emergency health workers around the country to improve pediatric injury care and reduce morbidity and mortality among children admitted to Mozambican hospitals. However, I still had questions that required further investigation, which is why I decided to do the PhD. There is a lack of quality access to care in cases of pediatric injury and there are massive barriers in pre-hospital care, access to necessary surgical materials, and infrastructure to provide the care.

My doctoral research provided me with the opportunity to really explore how to improve injury care in resource-limited settings. It aimed to contribute to the design of impactful strategies and improvements in pediatric injury care in Mozambique. I want to provide the best possible care to all Mozambican children and my research has focused on those who have been injured!

GHP: How important do you think international collaboration, such as the one between UCLA and UEM, is in advancing pediatric surgical care in developing countries?

Dr. Amado: Working with colleagues at UCLA, such as Dr. Dan DeUgarte, has led to improvements in care for pediatric injury due to sharing knowledge and providing training in novel surgical techniques and sharing much needed surgical supplies.

GHP: What advice would you give to aspiring pediatric surgeons or researchers, particularly those from countries like Mozambique where there are relatively few surgeons or researchers focusing on children?

Dr. Amado: A major problem with pediatric injury care in Mozambique and other low- and middle-income countries is that there is a lack of data demonstrating that pediatric injuries are a crucial public health problem. There is a need for more data on the epidemiology, morbidity, and mortality that results from poorly designed approaches to pediatric care. Research can help health policy respond to the needs of children as well as improve evidence-based approaches to pediatric injury care and the allocation of resources. I encourage clinical staff to do more research that will allow them to advocate for more resources for ours hospitals and to ultimately improve care.