Surgeon Denis Foretia was born in Cameroon and has made it his mission to improve surgical care, research, and health outcomes in Africa. In doing so, this assistant professor in the Division of General Surgery at the University of Tennessee Health Science Center is extending the university’s impact overseas and bringing knowledge and experience back to Memphis that stands to improve care at home.
Dr. Foretia came to UTHSC in 2017, drawn by the prospect of helping to build a newly established Global Surgery Institute (GSI) in the College of Medicine’s Department of Surgery. The institute began primarily as overseas medical mission work and has grown in scope and impact in the few years since its birth.
“Right now, our view in global surgery is to seek ways of systematically improving surgical care in hospitals and universities (in other countries) that we affiliate with,” he said. “The view is a long-term one that focuses on helping with the training of staff and the exchange of knowledge with students at UTHSC and our affiliated universities and programs.” Affiliations are being established with institutions in Africa, East Asia, Latin America, and the Middle East. UTHSC faculty, as well as residents and medical students, are active in this work.
Dr. Foretia explains the current GSI philosophy as “transitioning from mission driven to long-term sustainable engagement.”
To increase the university’s presence in Africa, his focus is twofold – partnering with universities and hospitals there to instruct and exchange knowledge, and building relationships with surgeons through major surgical associations, in particular the West African College of Surgeons and the College of Surgeons of East, Central, and Southern Africa (COSECA).
“Bringing knowledge is the thing we have been trying to do,” he said. “This is not a supply dump. We are working with in-country surgeons to help us identify the key things they need.”
Dr. Foretia has traveled to Africa seven times in two years. Two trips to Zambia have helped establish a partnership with Levy Mwanawasa Hospital, a university teaching hospital in Lusaka, the capital city. Through the partnership, he is working with Memphis suppliers to secure equipment to replace outdated machinery for skin grafting and send it directly to a surgeon who needs it. The partnership envisions long-term collaboration in clinical care and research with medical student and resident full involvement.
Dr. Foretia’s next trip to Africa is scheduled for mid-February, this time to Nigeria with the West African College of Surgeons, further building relationships with surgeons in that region.
Dr. Foretia came to the United States in 2001 for undergraduate studies at the University of Maryland Baltimore County (UMBC). He received a full scholarship to Vanderbilt for his medical studies, graduating in 2008.
He did his surgical residency at Emory University. Midway through surgery training, he went to Johns Hopkins University, where he completed a Master of Public Health degree, as well as a Master in Business Administration degree. “I told my wife I had to hurry up and finish and start earning a paycheck,” he said. He returned to Emory to finish his surgical residency.
All of this education fueled his desire to improve conditions where needed. “Growing up in Cameroon, a place where the hospitals do not really have much at all, and then training at a place like Vanderbilt and working at Hopkins, the discrepancy is huge regarding resources and what you can do and how the lack of resources affects the outcome and how it changes people’s lives,” he said.
Initially, he had thought he would be a cardiothoracic surgeon. His master’s work in public health changed that. “I realized that I could not really be happy in life if I didn’t take surgery abroad, outside the U.S., where we could strengthen assistance to be able to deliver surgical care at a higher level.”
During his residency, Dr. Foretia and his wife, who is in investment banking, started the Denis and Lenora Foretia Foundation in Cameroon. The foundation has grown to 24 staff members since its founding in 2012 and helps develop health policy and research in Cameroon.
An opening at UTHSC for a general surgeon with dual responsibility in the Global Surgery Institute drew Dr. Foretia from Baltimore, where he was working, to Memphis. In addition to his busy acute care surgery practice primarily at Methodist Germantown Hospital and Methodist University Hospital, he is one of several leaders of the growing GSI.
Looking to the Future
“My personal goal for the Global Surgery Institute is for us to have an internationally recognized institute that allows our residents to be able to take their knowledge internationally and help develop surgical care around the world,” he said.
It is a gift that gives much in return.
“When we are there, we serve as consultants,” he said. “We scrub in the operating room, we round on the wards, we see patients. It’s extremely important and really beneficial for residents who get to see pathology we don’t see anymore in the West.” For example, in many countries, patients seek treatment late in the disease process or must overcome cultural and other barriers to access health care. This promotes sensitivity when physicians encounter similar situations at home.
“It has been shown that when folks go and train even two weeks abroad, especially at the residency level, it really fundamentally alters the way they deal with costs in a hospital.” Having seen and performed surgeries in places with a fraction of what is available in the U.S., physicians are inclined to be more conscious of costs, waste, and impediments to care, he said.
Under the direction of UTHSC College of Medicine Executive Dean Scott Strome, MD, Dr. Foretia is helping to organize a Multicultural/Global Health Symposium for the campus in the coming months. It will bring all who work in multicultural settings together to acknowledge and share the university’s global footprint.
“UTHSC is offering a lot to the world and transferring a lot back to the UTHSC family,” he said. “Our endeavors around the world are providing real knowledge at the places we are going and also helping us become really good doctors, knowing how to better deal with our patients, especially in areas where they don’t necessarily have access.”