On 30 June, RCSEd held an evening symposium on the topic of Global Surgery. The event followed a visit by the President, Mr Michael Lavelle-Jones and Vice-President Professor Graham Layer to Australia for an international joint surgical college meeting on the topic. This comes on the back of increased interest in global surgery following the Lancet Commission last year. The guests were treated to talks from Mr Andrew Leather, Director of the Kings Centre for Global Health, Professor George Youngson, Paediatric Surgeon and Trustee of the Archie Foundation, Mr Trevor Crofts, General Surgeon based in Malawi, Mr Ewen Harrison, Clinical Senior Lecturer and Honorary Consultant Surgeon.
Mr Leather’s opening talk focused on the conclusions of the Lancet Commission and the next steps. The Lancet Commission served to focus the attention of the global health community on what Mr Leather called ‘the neglected surgical patient’. He remarked that the Commission has finished its work, and the impetus now lies with national governments to take on the challenges it highlighted. Mr Leather urged the surgical community to advocate on behalf of their patients and the health sectors within their country. Positives are already emerging, such as the World Bank adopting surgical indicators into the Global development Indicators. However, much remains to be done if we are to tackle the challenge of 5bn people globally without access to timely and affordable surgical care.
Professor Youngson discussed the project he delivered in Kampala in Uganda. This project was carried out directly through a partnership between a charity, the ARCHIE Foundation, and hospital staff in Kampala, Uganda. The aim was to raise money to train staff for a paediatric operating theatre in Kampala. The impressive sum of £72,000, which was raised by Aberdeen school children was supplemented by grants from Johnson and Johnson. Professor Youngson’s key messages were that valuable initiatives can be delivered through direct partnerships between health care staff in high and low income countries. He emphasised that health care staff in low income countries do not lack the training to use good facilities; the standards are just as good, but they do lack the equipment, and local technicians need to be trained on how to maintain the equipment once it arrives. If the right people and facilities are in place, then a project such as this has every chance of success and will quickly begin to save lives. Within the first few hours several lifesaving procedures were carried out there, serving to highlight the great need and success of the facility.
Mr Trevor Crofts, a general surgeon working in Malawi, highlighted some of the massive problems that exist outside of the surgical sphere in low income countries. His message was that there are many avoidable reasons why people in poorer countries end up in surgery. Many of the cases that Mr Crofts and his colleagues face could be avoided with the right drugs, access to drugs, and improvements in basic infrastructure and inequality in countries. Mr Crofts argued that surgeons should be advocating for societal change and public health programmes, just as they are for increased investment in surgery.
Mr Ewen Harrison followed up these three fascinating talks with an introduction to GlobalSurg, an initiative that engages junior doctors and surgical trainees, as well as more senior doctors globally, in digital logging of surgical outcomes. The project uses mobile ‘phone app technology to record surgical data. There are over 3000 doctors in over 60 countries sending surgical outcome data to be analysed centrally. The aim is to create a global surgical community which can publish research and act as a tool for future observational research or randomised trials.
Following the talks, the floor was opened up to the audience, who challenged the panel with a range of questions on how and if global surgical projects should work with governments, how RCSEd and surgical colleges could engage in the global surgery agenda and task sharing. Professor Graham Layer concluded the evening saying there would be a number of challenges for the College going forward, and by expressing a willingness to work with all interested to take this agenda forward.
For more information on RCSEd's work on global surgery contact Catherine Thwaites, International Activities Manager firstname.lastname@example.org
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