In the article that I read called Surgery and Global Health: A view beyond the OR, surgical services
seem to be sidelined from the global health scale. The article referred to
surgery as the "neglected stepchild of global public health". This is
an issue because a large amount of the diseases that are killing the poverty
stricken areas of the world are treatable by some type of surgery. As stated by
Dr. Doruk Ozgediz, "Recent evidence shows that surgical conditions account
for up to half of the global burden of disease". The even bigger issue is
that surgery is still not seen as a priority in these areas. It was mentioned
that even the smallest illnesses or diseases that can be treated by a simple
surgery could easily turn into a deadly issue in areas that don't have access
to surgical services.
Going off of the example that was
given in the article, over 500,000 women die each year during childbirth
because medical workers cannot stop the post-partum hemorrhage. This wouldn't
be as big of an issue if surgical services were available in these areas. Not only are there not nearly enough
physicians available in poorer countries to perform surgeries, but also some of
the people that need it the most cannot afford it. This is still one of the
biggest obstacles that is keeping surgical services from helping the people
that need it the most. By having a fee-for-service system in place, the people
who are in the most desperate need of a surgery are unable to receive it. The
biggest advances that have been made in this area were seen in Haiti in 2007.
The district health commissioner for Haiti revealed that all prenatal care and
emergency obstetrical services would be free of charge to the patient. Yet
another issue is that most of the surgical services that are found in poor
countries are also mostly concentrated within the bigger cities.
There are
numerous reasons why surgery hasn't been big on the global scale. Most of the
infectious diseases that would benefit from some type of surgery aren't readily
passed from one person to another. This knocks it way down on a priority list
of public problems and health issues. Another reason why surgery isn't all that
popular is because of the lack of surgeons willing to show attention to these
matters. There has been negligence to surgery on a global scale and that is
hindering the progression of this "movement". There is minimal public
support for the matter, and it will be very difficult for foundations to be
willing to fund programs and implementations that aren't deemed important by
the public. Surgery is also a very complex matter. Not only is there the actual
surgical process, but numerous other things are required such as an operating
room, blood banking, and post-operative care. In order to successfully complete
a surgery they would also require a substantial amount of money, training, and
infrastructure to carry out.
The article
offers some suggestions to bring surgery to the global health forefront. One of
these suggestions is making these surgical services free of charge if money can
be shown to be a barrier to the poor. One of the goals is to bring the
importance of surgical services to the public's attention and to find
organizations that would help fund the efforts. They also mention that it is
crucial that all surgical services are readily available within the public
sector. Hospitals are frequently neglected in developing countries, which
obstructs the expansion of the surgical field.
In order to
make progress in the area of global surgical services, the issue must be
addressed to the public. Before reading this article, I didn't really put much
thought into the fact that global surgical services really aren't that common.
Half of the problem with all of these global
health issues is the fact that we aren't aware of them in the first place. Without
awareness, no progress can be made.
Farmer, P., & Kim, J.
(2008). Surgery and Global Health: A View from Beyond the OR. World Journal
of Surgery, 32, 533-536. Retrieved September 3, 2014.
Ozgediz, D., & Wang, J.
(2006). Surgery and Global Health. Bulletin of the American College of
Surgeons, 91(5), 26-35. Retrieved September 3, 2014.
This is an important point Shelby. And the point of resource availability is striking. Further, standards of surgical care are also important. Emergency style medicine is fine at times but establishing sustainable resource structure needs a lot of effort. Most health initiatives have traditionally focused on preventive medicine and approaches. While, that focus should be maintained, more efforts should be directed towards surgical services too!
ReplyDeleteI did not know that surgery was an issue not often brought into global health. I would like to point out that there are some organizations that put surgery at the forefront--Operation Smile. "Since 1982, Operation Smile — through the help of dedicated medical volunteers — has provided 220,000 free surgical procedures for children and young adults... We train local medical professionals in developing countries and strengthen healthcare systems so more children in some of the poorest areas in the world can be treated."
ReplyDeleteSo even though there is not a lot of surgical efforts being made, there are still some non-profits with a focus on it.
Source: http://www.operationsmile.org/about_us/who-we-are/index.html