Surgery As A Global Health Issue

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Surgery has not always been considered a global health priority, but recently, the global health community has recognised that surgical conditions form a considerable burden of disease around the world. Surgical interventions play a significant role in helping to prevent chronic disability or death for those suffering from severe injuries, emergency abdominal and non-abdominal conditions, obstetrical complications, and for those suffering from conditions such as cataract and club foot, which have an adverse effect on quality of life. 

Surgery never been routinely considered as part of the traditional public health model. However, it has now been acknowledged that no matter how successful prevention strategies may be, surgical conditions will always account for a significant portion of a population’s disease burden. This is particularly relevant in developing countries where there is a higher incidence of trauma and obstetric complications, where conservative treatment is not readily available and where a massive backlog of untreated surgical diseases is routine.

Surgeons in the operating theatre Increasing access to surgery and improving the quality of surgical interventions has the potential to improve maternal health, treating obstetric complications and reduce child mortality. In addition, surgery may even help reduce the number of people living in poverty in third world countries as surgical conditions often put people out of work. An example of this is a survey that found that found that blindness, most commonly due to cataract, was associated with increasing poverty in Pakistan.

Surprisingly though, surgery is often the only solution to prevent permanent disabilities or death from pregnancy related complications, road traffic accidents, burns, falls, congenital defects, infections domestic violence and disasters, access to essential surgical services has yet to be included as part of the basic human right to health. Although the global health community has willingly recognised the importance and role of surgical care as an essential component of obstetric care, it has not acknowledged the importance of increasing the availability of other surgical services to low and middle income countries.

Historically, the global health community did not focus its efforts on surgical care because it was thought of as being excessively expensive and there was the fear that supporting surgical programs may divert resources from more cost-effective, population-based programs. Now, that thinking has changed.  Surgical interventions are no longer seen as overly expensive, and are being seen as a very cost effective alternative.

The World Health Organization has recognised the importance of surgery to global health and has begun to identify low-cost essential operations that significantly reduce the burden of disease. In 2005, the WHO launched the Global Initiative for Emergency and Essential Surgical Care. This programme strives to boost the capacity to deliver effective emergency surgical care in order to reduce death and disability from trauma, road traffic accidents, pregnancy related complications burns and other disasters.

The Bellagio Essential Surgery Group, which is made up of experts in surgery, anaesthesia, epidemiology and health policy, encourages surgeons to partner with public health professionals to promote surgical treatment in low-tech community hospitals as a cost-effective solution to several prevailing health issues. 

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