scholarly journals Quality-driven programming in global surgery: A 30-Year institutional experience delivering safe, timely and effective surgical care

2015 ◽  
Vol 81 (1) ◽  
pp. 189
Author(s):  
L.C. Carlson ◽  
K.W. Hatcher ◽  
R. Ayala ◽  
W.P. Magee ◽  
R. Vander Burg
Keyword(s):  
Surgical Care ◽  
Global Surgery ◽  
Institutional Experience

scholarly journals Development of a Low-Resource Operating Room and a Wide-Awake Orthopedic Surgery Program During the COVID-19 Pandemic

2021 ◽  
pp. 155335062110035
Author(s):  
Justin J. Turcotte ◽  
Jeffrey M. Gelfand ◽  
Christopher M. Jones ◽  
Rubie S. Jackson
Keyword(s):  
Operating Room ◽  
Orthopedic Surgery ◽  
Physical Space ◽  
Surgical Care ◽  
Low Resource ◽  
High Acuity ◽  
Institutional Experience ◽  
Provider Shortages ◽  
Resource Replacement ◽  
Wide Awake

Introduction. The COVID-19 pandemic resulted in significant medication, supply and equipment, and provider shortages, limiting the resources available for provision of surgical care. In response to mandates restricting surgery to high-acuity procedures during this period, our institution developed a multidisciplinary Low-Resource Operating Room (LROR) Taskforce in April 2020. This study describes our institutional experience developing an LROR to maintain access to urgent surgical procedures during the peak of the COVID-19 pandemic. Methods. A delineation of available resources and resource replacement strategies was conducted, and a final institution-wide plan for operationalizing the LROR was formed. Specialty-specific subgroups then convened to determine best practices and opportunities for LROR utilization. Orthopedic surgery performed in the LROR using wide-awake local anesthesia no tourniquet (WALANT) is presented as a use case. Results. Overall, 19 limited resources were identified, spanning across the domains of physical space, drugs, devices and equipment, and personnel. Based on the assessment, the decision to proceed with creation of an LROR was made. Sixteen urgent orthopedic surgeries were successfully performed using WALANT without conversion to general anesthesia. Conclusion. In response to the COVID-19 pandemic, a LROR was successfully designed and operationalized. The process for development of a LROR and recommended strategies for operating in a resource-constrained environment may serve as a model for other institutions and facilitate rapid implementation of this care model should the need arise in future pandemic or disaster situations.

scholarly journals What is ‘global surgery’? Defining the multidisciplinary interface between surgery, anaesthesia and public health

2019 ◽  
Vol 4 (5) ◽  
pp. e001808 ◽  
Author(s):  
Michael Bath ◽  
Tom Bashford ◽  
J E Fitzgerald
Keyword(s):  
Public Health ◽  
Health Systems ◽  
Low Income ◽  
International Health ◽  
Surgical Care ◽  
Global Surgery ◽  
Middle Income ◽  
Geographical Regions ◽  
Working Together ◽  
Major Factors

‘Global surgery’ is the term adopted to describe a rapidly developing multidisciplinary field aiming to provide improved and equitable surgical care across international health systems. Sitting at the interface between numerous clinical and non-clinical specialisms, it encompasses multiple aspects that surround the treatment of surgical disease and its equitable provision across health systems globally. From defining the role of, and need for, optimal surgical care through to identifying barriers and implementing improvement, global surgery has an expansive remit. Advocacy, education, research and clinical components can all involve surgeons, anaesthetists, nurses and allied healthcare professionals working together with non-clinicians, including policy makers, epidemiologists and economists. Long neglected as a topic within the global and public health arenas, an increasing awareness of the extreme disparities internationally has driven greater engagement. Not necessarily restricted to specific diseases, populations or geographical regions, these disparities have led to a particular focus on surgical care in low-income and middle-income countries with the greatest burden and needs. This review considers the major factors defining the interface between surgery, anaesthesia and public health in these settings.

Resource Mobilization for Global Surgery: Lessons Learned From US Government Appropriations Advocacy

2021 ◽  
pp. 000313482110474
Author(s):  
Megan E. Bouchard ◽  
Natalie Sheneman ◽  
Lismore Nebeker ◽  
Michael Nebeker ◽  
Matthew T. Hey ◽  
...  
Keyword(s):  
Global Health ◽  
International Development ◽  
Surgical Care ◽  
Global Surgery ◽  
Lessons Learned ◽  
Resource Mobilization ◽  
Economic Resources ◽  
Agency For International Development ◽  
The Us ◽  
Us Government

The US Agency for International Development (USAID) receives directives and funding through the appropriation process, though until recently, global surgery was not included in its mission. Nevertheless, an estimated five billion people lack access to safe, timely, and affordable surgical care, in large part due to lack of economic resources. Using coalition-based advocacy, the G4 Alliance successfully developed and submitted language that was incorporated into the 2020 Appropriations report language, directing USAID to financially support global surgery. This has significant implications for global surgical investment, yet few advocates are aware of the 2020 Appropriations language, let alone how they can utilize it now to advance global surgery in their respective countries. Here, we describe how advocates navigate the US appropriations process and the ways USAID funds are obtained for the purposes of global health. We also highlight the importance of coalition-based advocacy and provide guidance in how to increase success.

scholarly journals Global neurosurgery: current and potential impact of neurosurgeons at the World Health Organization and the World Health Assembly. Executive summary of the World Federation of Neurosurgical Societies–World Health Organization Liaison Committee at the 71st World Health Assembly

2018 ◽  
Vol 45 (4) ◽  
pp. E18 ◽  
Author(s):  
Gail Rosseau ◽  
Walter D. Johnson ◽  
Kee B. Park ◽  
Miguel Arráez Sánchez ◽  
Franco Servadei ◽  
...  
Keyword(s):  
Global Health ◽  
World Health Organization ◽  
Surgical Care ◽  
Global Surgery ◽  
World Health ◽  
World Federation ◽  
Member States ◽  
World Health Assembly ◽  
The World ◽  
Health Organization

Since the creation of the World Health Organization (WHO) in 1948, the annual World Health Assembly (WHA) has been the major forum for discussion, debate, and approval of the global health agenda. As such, it informs the framework for the policies and budgets of many of its Member States. For most of its history, a significant portion of the attention of health ministers and Member States has been given to issues of clean water, vaccination, and communicable diseases. For neurosurgeons, the adoption of WHA Resolution 68.15 changed the global health landscape because the importance of surgical care for universal health coverage was highlighted in the document. This resolution was adopted in 2015, shortly after the publication of The Lancet Commission on Global Surgery Report titled “Global Surgery 2030: evidence and solutions for achieving health, welfare and economic development.” Mandating global strengthening of emergency and essential surgical care and anesthesia, this resolution has led to the formation of surgical and anesthesia collaborations that center on WHO and can be facilitated via the WHA. Participation by neurosurgeons has grown dramatically, in part due to the official relations between WHO and the World Federation of Neurosurgical Societies, with the result that global neurosurgery is gaining momentum.

scholarly journals Missions, Humanitarianism, and the Evolution of Modern Global Surgery

2020 ◽  
pp. 000313482097918
Author(s):  
Danielle I. Ellis ◽  
Don K. Nakayama ◽  
Tamara N. Fitzgerald
Keyword(s):  
World War Ii ◽  
Global Health ◽  
Medical Care ◽  
International Health ◽  
Surgical Care ◽  
International Committee ◽  
Global Surgery ◽  
World Health ◽  
Red Cross ◽  
Health Organization

Modern global surgery, which aims to provide improved and equitable surgical care worldwide, is a product of centuries of international care initiatives, some borne out of religious traditions, dating back to the first millennium. The first hospitals ( xenodochia) were established in the 4th and 5th centuries CE by the early Christian church. Early “missions,” a term introduced by Jesuit Christians in the 16th century to refer to the institutionalized expansion of faith, included medical care. Formalized Muslim humanitarian medical care was marked by organizations like the Aga Khan Foundation and the Islamic Association of North America in the 20th century. Secular medical humanitarian programs developed in the 19th century, notably with the creation of the International Committee of the Red Cross (1863) and the League of Nations Health Organization (1920) (which later became the World Health Organization [1946]). World War II catalyzed another proliferation of nongovernmental organizations, epitomized by the quintessential humanitarian health provider, Médecins Sans Frontières (1971). “Global health” as an academic endeavor encompassing education, service, and research began as an outgrowth of departments of tropical medicine and international health. The American College of Surgeons brought a surgical focus to global health beginning in the 1980s. Providing medical care in distant countries has a long tradition that parallels broad themes in history: faith, imperialism, humanitarianism, education, and service. Surgery as a focus of academic global health is a recent development that continues to gain traction.

scholarly journals Globalization of national surgical, obstetric and anesthesia plans: the critical link between health policy and action in global surgery

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Paul Truché ◽  
Haitham Shoman ◽  
Ché L. Reddy ◽  
Desmond T. Jumbam ◽  
Joanna Ashby ◽  
...  
Keyword(s):  
Financial Burden ◽  
Surgical Care ◽  
Obstetric Care ◽  
Global Surgery ◽  
Health System Strengthening ◽  
Health Coverage ◽  
Middle Income ◽  
Middle Income Countries ◽  
Private And Public ◽  
Development Goals

AbstractEfforts from the developed world to improve surgical, anesthesia and obstetric care in low- and middle-income countries have evolved from a primarily volunteer mission trip model to a sustainable health system strengthening approach as private and public stakeholders recognize the enormous health toll and financial burden of surgical disease. The National Surgical, Obstetric and Anesthesia Plan (NSOAP) has been developed as a policy strategy for countries to address, in part, the health burden of diseases amenable to surgical care, but these plans have not developed in isolation. The NSOAP has become a phenomenon of globalization as a broad range of partners – individuals and institutions – help in both NSOAP formulation, implementation and financing. As the nexus between policy and action in the field of global surgery, the NSOAP reflects a special commitment by state actors to make progress on global goals such as Universal Health Coverage and the United Nations Sustainable Development Goals. This requires a continued global commitment involving genuine partnerships that embrace the collective strengths of both national and global actors to deliver sustained, safe and affordable high-quality surgical care for all poor, rural and marginalized people.

scholarly journals Surgathon: a new model for creating a surgical innovation ecosystem in low-resource settings

2020 ◽  
Vol 5 (2) ◽  
pp. e002162
Author(s):  
Shivani Mitra ◽  
Joanna Ashby ◽  
Arsen Muhumuza ◽  
Isaac Ndayishimiye ◽  
Isaac Wasserman ◽  
...  
Keyword(s):  
Diffusion Of Innovation ◽  
Surgical Care ◽  
Global Surgery ◽  
Appropriate Technology ◽  
Surgical Innovation ◽  
Innovation Ecosystem ◽  
Low Resource Settings ◽  
Low Resource ◽  
Innovation Ecosystems ◽  
Resource Setting

Innovation ecosystems and emerging technologies can potentially accelerate the access to safe, affordable surgical care in low-resource settings. There is a need to develop localised innovation ecosystems that can establish an initial culture and catalyse the creation, adoption and diffusion of innovation. The surgathon model outlines one approach to seeding surgical innovation ecosystems. International academic institutions collaborated on six global surgery, innovation and ethics-themed hackathons (‘surgathons’) across India and Rwanda between 2016 and 2019. Over 1598 local multidisciplinary students participated, learning about challenges in the delivery of surgical care and ideating solutions that could leverage appropriate technology and resources for impact. Pursuing student ideas and evaluating their implementation past the surgathons continues to be an active effort. Surgathons have unfolded in different permutations based on local faculty, institution and health system context. The surgathon model is a novel method of priority setting challenges in global surgery and utilises locally driven expertise and innovation capacity to derive ethical solutions. The model offers a path for low-resource setting students and faculty to learn, advocate and innovate for improved surgical care.

The Absence of Surgical Care on the Public Health and Global Health Agendas: Insights from a Global Surgery Community

2014 ◽  
Vol 219 (3) ◽  
pp. S57
Author(s):  
Evan G. Wong ◽  
Emmanuel A. Ameh ◽  
Sherry M. Wren ◽  
Wakisa Mulwafu ◽  
Mark A. Hardy ◽  
...  
Keyword(s):  
Public Health ◽  
Global Health ◽  
Surgical Care ◽  
Global Surgery ◽  
The Public

scholarly journals Global Surgery: The Perspective of Public Health Students

2020 ◽  
Vol 12 (8) ◽  
pp. 1
Author(s):  
Brittany A. Hout ◽  
Eric P. Matthews ◽  
Jan-Michael Van Gent
Keyword(s):  
Public Health ◽  
Global Health ◽  
Student Perceptions ◽  
Online Survey ◽  
Health Knowledge ◽  
Traumatic Injury ◽  
Surgical Care ◽  
Cost Effective ◽  
Global Surgery ◽  
Middle Income

Current research has emphasized the importance of increased involvement of medical professionals and global health specialists for the success of global surgery efforts. This quantitative descriptive study aimed to examine public health students’ perceptions of global surgery. A 21- question mixed method online survey was distributed over eight weeks via student email to all students enrolled in the Masters of Public Health Program at A.T. Still University (ATSU) College of Graduate Health Studies. Of 212 students, 35 (16.5%) respondents completed the survey with 30 students reporting interest in global health in their future public health careers. Two-thirds of students erroneously identified infectious diseases as the leading cause of death worldwide, not traumatic injury. Participants identified infectious disease and OB/GYN as the two medical fields to contribute significantly to global health. Surgical care was felt to be the least economically cost-effective medical field for low and middle-income countries (LMICs). As the first project to report perspectives of public health students regarding global surgery, this study highlighted several significant misconceptions concerning global surgery. Like the results from similar studies in medical students, it is alarming that there is such a paucity of community health knowledge surrounding surgery and its effects on global surgical needs. Further research should focus on the effect on student perceptions after curriculum modification include education regarding the burden of surgical disease and role of global surgery.

scholarly journals Global surgery: Improving health in low-income countries

2021 ◽  
Vol 20 (3) ◽  
pp. 483-486
Author(s):  
Orhan Alimoglu ◽  
Nuray Colapkulu
Keyword(s):  
Low Income ◽  
Medical Science ◽  
Surgical Care ◽  
Global Surgery ◽  
Low Income Countries ◽  
Middle Income ◽  
Resource Limited ◽  
Surgical Workforce ◽  
Surgical Conditions ◽  
Definition Of

The aim of this report is to examine the definition of global surgery, discuss the problems and propose some suggestions. Global surgery aims to improve the surgical conditions to maintain a standard and equal surgical care, especially in low- and middle-income countries where burden of surgical diseases are increasing over the years. According to Lancet Commission on Global Surgery, 1.27 million more surgical healthcare workers will be required to provide minimal surgical workforce, by 2030. In resource-limited settings of the world-wide where medical education and post-graduation training programs are disrupted due to brain drain, instable conditions and economic reasons, sustaining a standard and accessible surgical care are possible by training surgeons. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.483-486

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