Global surgery: importance, controversy and opportunity
Language – English
Submitted to the One Surgery Index on October 18, 2020 at 10:35 am
Serving those in limited resource settings does not only enhance surgical training, it advances universal access to holistic and affordable care.
An eight-year-old girl succumbs to 60% burns with inadequate dressings and analgesia (MD). A new father loses his wife to post-partum haemorrhage and must then bag-mask his dying baby (NA).
These experiences have lived long in the memory of the authors and have propelled us to play our part in global surgery. But what is ‘global surgery’?
Global surgery is an ‘area for study, research, practice, and advocacy that places priority on improving health outcomes and achieving health equity for all people worldwide who are affected by surgical conditions’.1 In 2015, The Lancet Commission on Global Surgery found that nine in ten people living in low- and middle-income countries (LMICs) are unable to access basic surgical care.2 Its report highlighted significant health and economic disparities for untreated surgical conditions, and recommended core indicators for monitoring universal access to safe, affordable surgical and anaesthesia care when needed.
Those indicators include access to timely essential surgical care, specialist surgical workforce density, surgical volume, perioperative mortality and protection against impoverishing or catastrophic expenditure. The statistics regarding the workforce density are especially concerning, illustrating a considerable shortage of healthcare providers. It is estimated that LMICs, which make up 48% of the global population, only have 20% of the specialist surgeons, anaesthetists and obstetricians in the world, with the poorest nations having only 0.7 specialist providers per 100,000 population.3 Although these figures shed light on the scale of the problem, and reinforce the issues around inequality and access to surgical care, statistics mean little to the individual. We enter our profession not with a yearning to improve a number but to provide holistic care for our patients, locally or globally.
OSI Number – 20674