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Bidwell SS, Kim GJ. ALL-SAFE: A novel approach to global surgery collaboration. Am J Surg 2024:115884. [PMID: 39147638 DOI: 10.1016/j.amjsurg.2024.115884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/23/2024] [Accepted: 07/31/2024] [Indexed: 08/17/2024]
Affiliation(s)
- Serena S Bidwell
- Department of Surgery, Stanford Health Care, Stanford, CA, 94305, USA.
| | - Grace J Kim
- Department of Surgery, Michigan Medicine, Ann Arbor, MI, USA.
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Impending Backlog of Cleft Palate Patients Due to COVID-19. Ann Glob Health 2022; 88:9. [PMID: 35087709 PMCID: PMC8782091 DOI: 10.5334/aogh.3534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has placed an unprecedented strain on healthcare systems worldwide, but while high-income countries (HICs) have been able to adapt, low- and middle-income countries (LMICs) have been much slower to do so due to a lack of funding, skilled healthcare providers, equipment, and facilities. The redistribution of resources to combat the pandemic in LMICs has resulted in decreased surgical volumes at local surgical centers as well as a dramatic reduction in the number of humanitarian aid missions. Despite recent global investment in improving the surgical capacities of LMICs, even in the pre-COVID-19 era there was a vast unmet surgical need. This deficit in surgical capacity has grown during the pandemic and it will be a significant struggle to overcome the resulting backlog of patients. A topic of particular concern to the authors is the effect that the pandemic will have on the delivery of time-sensitive surgical care to patients with cleft palate deformities as delay in providing care can have enormous physical and psychosocial consequences. This paper draws increased attention to the lasting impact that the COVID-19 pandemic may have on cleft palate patients in LMICs. SSRN Pre-print server link: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3898055
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Chahine EM, Shah ND, Al Abyad OS, Vyas RM, Hamdan US. Emergency Response Protocols for Overseas Outreach Settings: Global Smile Foundation Strategy. Cleft Palate Craniofac J 2021; 59:1086-1091. [PMID: 34636659 DOI: 10.1177/10556656211049998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Non-governmental organizations (NGOs) aim to alleviate unmet global disease burden and promote collaboration between visiting and host countries. Well-executed emergency response protocols are foundational to providing safe and quality care in an unpredictable global setting. Global Smile Foundation (GSF) instituted a protocol in 2012 based on over three decades of cleft care experience. Here, we update this protocol and provide information on how to address special circumstances such as humanitarian crises and disease outbreaks. The GSF response protocol was developed in conjunction with surgeons, anesthesiologists, nurses, and administrators to ensure all team members are adequately prepared to respond to emergency situations in global outreach. This protocol provides information on pre-departure preparation, onsite setup, operative precautions, and post-departure debriefings. Emphasis is placed on a standardized, reproducible workflow that accounts for necessary site-specific adjustments. Strategies include emergency simulations, site-specific safety checklists, standardized operating room protocols, and well-defined individual responsibilities. The authors also provide anticipatory guidance in addressing unexpected circumstances, such as disease outbreak and natural disaster, during global outreach. In conclusion, a proactive and systematic approach to emergency response and prevention is vital to minimizing morbidity and mortality during surgical outreach initiatives. The GSF protocol represents a reproducible approach that other organizations can adopt and adapt to their unique needs.
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Affiliation(s)
| | - Nikhil D Shah
- 12244Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Raj M Vyas
- Department of Plastic Surgery, 8788University of California Irvine, Irvine, California, USA
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Cairo SB, Pu Q, Malemo Kalisya L, Fadhili Bake J, Zaidi R, Poenaru D, Rothstein DH. Geospatial Mapping of Pediatric Surgical Capacity in North Kivu, Democratic Republic of Congo. World J Surg 2021; 44:3620-3628. [PMID: 32651605 DOI: 10.1007/s00268-020-05680-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Despite recent attention to the provision of healthcare in low- and middle-income countries, improvements in access to surgical services have been disproportionately lagging. METHODS This study analyzes the geographic variability in access to pediatric surgical services in the province of North Kivu, Democratic Republic of Congo (DRC). On-site data collection was conducted using the Global Assessment of Pediatric Surgery tool. Spatial distribution of providers was mapped using the Geographical Information System and open-sourced spatial data to determine distances traveled to access surgical care. RESULTS Forty facilities were evaluated across 32 health zones; 68.9% of the provincial population was within 15 km of these facilities. Eleven facilities met a minimum World Health Organization safety score of 8; 48.1% of the population was within 15 km of corresponding facilities. The majority of children were treated by someone with specific pediatric surgery training in only 4 facilities; one facility had a trained pediatric anesthesia provider. Fifty-seven percent of the population was within 15 km of a facility with critical care and emergency medicine (EM) capabilities. There was one pediatric critical care provider and no pediatric EM providers identified within the province. Location-allocation assessment is needed to combine geographic area with potential for greatest impact and facility assessment. CONCLUSIONS Limitations in access to surgical care in the DRC are multifactorial with poor resources, few formally trained surgical providers, and near-absent access to pediatric anesthesiologists. The study highlights the deficits in the capacity for surgical care while demonstrating a reproducible model for assessment and identification of ways to improve access to care.
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Affiliation(s)
- Sarah B Cairo
- Department of Pediatric Surgery, John R. Oishei Children's Hospital, 1001 Main Street, Buffalo, NY, 14203, USA. .,Department of Surgery, Maine Medical Center, Portland, ME, USA.
| | - Qiang Pu
- Department of Geography, University At Buffalo, The State University of New York, Buffalo, NY, USA
| | - Luc Malemo Kalisya
- HEAL Africa Hospital, COSECSA Training Program, Goma, North Kivu Province, Democratic Republic of Congo
| | - Jacques Fadhili Bake
- HEAL Africa Hospital, COSECSA Training Program, Goma, North Kivu Province, Democratic Republic of Congo
| | - Rene Zaidi
- HEAL Africa Hospital, COSECSA Training Program, Goma, North Kivu Province, Democratic Republic of Congo
| | - Dan Poenaru
- Department of Pediatric Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, QC, Canada
| | - David H Rothstein
- Department of Pediatric Surgery, John R. Oishei Children's Hospital, 1001 Main Street, Buffalo, NY, 14203, USA.,Department of Surgery, University At Buffalo, The State University of New York, Buffalo, NY, USA
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A Guide to Developing Safety Protocols for International Craniofacial Outreach Programs During the COVID-19 Era. J Craniofac Surg 2021; 32:e108-e110. [PMID: 32694480 DOI: 10.1097/scs.0000000000006822] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The ongoing COVID-19 outbreak has created obstacles to health care delivery on a global scale. Low- and middle-income countries (LMICs), many of which already suffered from unmet surgical and medical needs, are at great risk of suffering poor health outcomes due to health care access troubles brought on by the pandemic. Craniofacial outreach programs (CFOP)-a staple for craniofacial surgeons-have historically provided essential care to LMICs. To date, there has not been literature discussing the process of resuming CFOP mission trips. Herein, we propose a roadmap to help guide future journeys, as well as summarize practical considerations.
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Azizzadeh K, Hamdan US, Salehi PP. Effect of Coronavirus Disease 2019 and Pandemics on Global Surgical Outreach. JAMA Otolaryngol Head Neck Surg 2020; 146:783-784. [PMID: 32614435 DOI: 10.1001/jamaoto.2020.1520] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Usama S Hamdan
- Global Smile Foundation, Boston, Massachusetts.,Department of Otolaryngology-Head & Neck Surgery, Tufts University School of Medicine, Boston, Massachusetts
| | - Parsa P Salehi
- Department of Surgery, Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, Connecticut
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Riggs J, Chung KC. Postoperative Management of Hand Surgery in the Low- and Middle-Income Countries. Hand Clin 2019; 35:403-410. [PMID: 31585600 DOI: 10.1016/j.hcl.2019.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The prevention and treatment of hand injuries in low- to middle-income countries needs to be a priority. Surgical outreach trips are a primary avenue for patients to receive interventions. Challenges include language and cultural barriers, poor infrastructure, and limitations in a patient's ability to follow-up. Strategies to maximize patient functional outcomes include cultural competence, patient education resources, overcoming communication barriers, and using task-shifting strategies. Local therapists' knowledge and clinical skills can be enhanced. With improvements in data collection, therapists may contribute to gaining knowledge of outcomes in low- to middle-income countries.
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Affiliation(s)
- Jeanne Riggs
- Michigan Medicine Plastic Surgery Clinic, Domino's Farms, Lobby A, rm 1108, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA; Department of Physical Medicine and Rehabilitation, Michigan Medicine, 325 East Eisenhower Parkway, Ann Arbor, MI 48108, USA
| | - Kevin C Chung
- Section of Plastic Surgery, University of Michigan Medical School, The University of Michigan Health System, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-5340, USA.
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Abstract
Global outreach in hand surgery can be exceptionally rewarding for volunteers and their organizations, patients and their communities, and the host medical community. Success can be defined by individual cases that restore function and provide opportunities for a patient and family to contribute to society; however, the broader missions of medical collaboration, education, cultural exchange, and personal growth are critical factors toward building trust and establishing continuity of care for long-term success. Each outreach site and brigade encounters challenges; however, careful planning facilitates optimal conditions and reasonable expectations for enhancing outcomes.
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Zitzman E, Berkley H, Jindal RM. Accountability in global surgery missions. BMJ Glob Health 2018; 3:e001025. [PMID: 30687523 PMCID: PMC6326286 DOI: 10.1136/bmjgh-2018-001025] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/07/2018] [Indexed: 12/27/2022] Open
Affiliation(s)
- Elena Zitzman
- USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Holly Berkley
- Department of Obstetrics and Gynecology, Naval Medical Center San Diego, San Diego, California, USA
| | - Rahul M Jindal
- USU-Walter Reed Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Global surgery: current evidence for improving surgical care. Curr Opin Otolaryngol Head Neck Surg 2017; 25:300-306. [DOI: 10.1097/moo.0000000000000374] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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