The Impact of the Global Surgical Burden
The Catholic Church, the World Health Organization and the United Nations have all named health care as a human right, and national governments and humanitarian groups have responded with improvements in basic care and prevention and treatment of communicable disease. But surgically treatable conditions are responsible for more deaths globally than HIV/AIDS, tuberculosis, and malaria combined. Yet surgery has long been overlooked in the global health community as a form of essential care.
This fall, we are sharing a three-part blog series exploring the need for surgery globally. Today we look at the global burden of surgically treatable diseases. In future blogs we will cover the case for surgery as part of essential health services, and key components needed for access to safe and timely surgical care.
The Global Surgical Burden
Written by: Kelsey Christensen
When you think about global health, surgery may not be the first discipline that comes to mind. Compared to nutrition assistance or vaccination campaigns, it is often regarded as too costly and complex for governments and aid organizations to justify funding. Dr. Paul Farmer, the founder of Partners in Health, even called it “the neglected stepchild of global health”. Not only do you need a surgeon who is trained to perform the procedure, you need an operating room equipped with electricity, tools, and supplies, as well as anesthesiologists to monitor the patient during the operation. So, why should surgery, with it’s high demand for training and resources, be a priority on the global health agenda?
The staggering global burden of surgical conditions is one reason. Today there are five billion people who do not have access to the safe, affordable surgical and anesthesia care they desperately need. In high-income countries like ours, nearly 15% of the population cannot access needed surgery, but in low and lower-middle income countries the burden is much more dire, with an estimated 94% of the population unable to access this type of care (Lancet).
As deaths from infectious disease such as tuberculosis, malaria, and HIV have begun to decline, deaths from surgically treatable conditions are on the rise. In 2010, it was estimated that 16.9 million lives were lost from conditions needing surgical care, compared to 1.46 million deaths from HIV/AIDS , 1.2 million from tuberculosis, and 1.17 million from malaria (Lancet).
Surgery is a good investment. Many simple operations can change a person’s quality of life almost immediately, helping them regain their dignity and livelihood, and allowing them to return to work as a productive member of society. And surgically treatable conditions can impact a wide variety of the population, from a mother needing emergency obstetric care to safely deliver a healthy baby, to an elderly man needing cataract surgery to see again, to a father needing a hernia repair to return to work and provide for his family. And while some surgical treatments are more resource intensive than others, overall surgery is an extremely cost effective treatment in health care, with a cost to benefit ratio of 1:10.
Solidarity Bridge began almost 20 years ago with a simple desire to ease the suffering we saw in our brothers and sisters in Bolivia. Our initial mission trips provided a variety of basic and advanced health care. But our focus shifted toward surgery as we listened to the needs of the local medical community expressed by our partner physicians and our Bolivian counterpart organization, Puente de Solidaridad.
“Normally, Bolivian professionals would need to leave the country for this type of training. But thanks to Puente de Solidaridad and Solidarity Bridge, we can learn new techniques in our own hospital,” affirms our long-time general surgery partner, Dr. Jaime Vallejos. We are privileged to have this opportunity to share resources and exchange experiences with our dedicated and talented partners in Bolivia. Through focused training, key equipment donations, and strategic partnerships we are helping the most vulnerable patients access safe and timely surgical care.
If you would like to learn more about global surgery efforts and progress that has been made around the world in support of safe surgical care, see the links below:
Safe Surgery 2020- http://www.safesurgery2020.org/
The G4 Alliance- http://www.theg4alliance.org/
World Health Organization Global Initiative for Emergency and Essential Surgical Care (GIEESC)- http://www.who.int/surgery/globalinitiative/en/
The Lancet Commission on Global Surgery- www.lancetglobalsurgery.org
Kelsey Christensen is a healthcare professional in the Chicago area with 5 years of experience working in the field of pediatric transplant surgery. She is a recent graduate of Northwestern University’s Master of Science in Global Health program and is currently interning with Solidarity Bridge to learn more about the organization and nonprofit sector work.