After watching patients in India die for lack of access to simple surgical procedures, Indian physician Sristi Sharma set out to improve access to surgery around the globe. We’re grateful to her for sharing her thoughts about this topic, and she in turn acknowledges Adam Kushner, founder of Surgeons OverSeas (SOS). Interview by Dayna Kerecman Myers, Associate Editor of GHN.
In the developing world, what is a bigger obstacle to access to surgery: infrastructure, or cost?
A lack of education—among people and caregivers as well as policy makers—is the biggest obstacle to global surgery. Thoughts of surgery immediately conjure images of high-tech set ups, and expensive and complicated procedures. But surgery is not limited to the operating theater. Simple surgical interventions are not costly and require little infrastructure. For the most part, a little knowledge, some training and some policy changes are all that would be required.
How do you respond to the sentiment that surgery is important but shouldn't be considered global public health?
The figures are quite clear. In Sub-Saharan Africa alone, about 56 million people need basic surgical care — care that trained community health workers could provide. The lack of surgical care contributes to huge economic losses for those countries affected. As we move towards health care for all, surgery is just another cost-effective method to reaching that common goal. Unfortunately, until recently the surgical side of health care has been completely ignored.
What incentives would inspire surgeons in low- and middle-income countries to stay and practice in their home country?
Brain-drain is one of the most important issues faced by the global health field, and surgery is no different. Better salaries and benefits would be a big incentive; people who cannot earn a living or practice professionally will look elsewhere for work. But I think an opportunity for career growth, regular interaction with other surgeons/experts, and adequately staffed, functioning setups are major incentives that would help as well. In fact, a large-scale, disruptive transformation of health systems would help.
Read Sristi’s recent article in The Guardian: Going under the knife: surgery access should be available to all.