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Colin Madland

Brain Surgery in the African Bush

3 min read

Driving in to work this morning I listened to today's podcast edition of The Current from the CBC, and was impressed with the scalability of empowering students to take ownership and responsibility for their learning.

The episode, available here, and outlined here, covers the story of an American brain surgeon, Dr. Dilan Ellegala, who, like many medical professionals in the west, was volunteering his time to assist some of the 5 billion-with-a-b people in the world who lack affordable and safe access to surgeons. This number comes with a cost of an estimated 17 million lives annually.

A common response to this problem is to send western doctors to remote, 3rd world hospitals and clinics to relieve some of that pressure. The trouble that Dr. Ellegala noticed, however, was that local medical professionals were essentially being ignored by the visiting doctors. At the morning meetings when the medical staff would review the charts and images from the previous night, all the wetsern doctors would be seated at the front of the room, with a clear view of the xrays and other images, while the Tanzanian staff would be standing at the back of the room, unable to see clearly. Following the discussion the western docs would go about their business of visiting patients and doing their doctorly things.

The Tanzanians were completely disenfranshised and excluded from caring for their own patients.

Dr. Ellegala decided to do something different. As a  professor of neurosurgery in the US, Ellegala had a keen appreciation for the skills and temperament required to perform successful neurosurgery and he noticed one of the Tanzanian medical staff, Emmanuel Mayegga, not a doctor, but an assistant, had it. So he decided that by the end of his short trip, Mayegga would be able to perform brain surgery.

Short story even shorter, they began immediately andwithin 6 months, Mayegga, with no medical school background, was able to independently perform brain surgery, something that Dr. Ellegala had trained for a decade after medical school to be able to do competently.

Of course, there were naysayers. Ellegala's colleagues in the US were far less than enthusiastic and supportive, but Ellegala's response was that they could either train locals to perform this surgery, or people would continue to die unnecessarily. So he proceeded.

He even invited the chief neurosurgeons from nearby Kenya and the Tanzanian capital to his remote hospital. They joined the surgeon in surgery, looked at the data that had been collected on outcomes, visited patients and were stunned at the results. in the course of a few days, they had shifted their mental paradigms.

And that is what I contend will transform online learning at TWU and elsewhere. a paradigm shift from students as receptacles to students as co-creators of knowledge who are empowered to share their learning with their communities.

By providing students with the means to take ownership (literally and figuratively) of their learning, we are developing a system where students are trusted, given true agency in decision making, and empowered to affect change in their own communities. And that is why I want Domain of One's Own to become a central anchor in TWU Online (and offline). There is tremendous power in trusting and empowering students.

It's not brain surgery.