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Nwagbata A, Dutta R, Jayaram A, Thivalapill N, Jain S, Faria I, Alty IG, Gadgil A, Roy N, Raykar NP. Beyond the Ivory Tower: Perception of academic global surgery by surgeons in low- and middle-income countries. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002979. [PMID: 38483892 PMCID: PMC10939292 DOI: 10.1371/journal.pgph.0002979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/12/2024] [Indexed: 03/17/2024]
Abstract
Interest in global surgery has surged amongst academics and practitioners in high-income countries (HICs), but it is unclear how frontline surgical practitioners in low-resource environments perceive the new field or its benefit. Our objective was to assess perceptions of academic global surgery amongst surgeons in low- and middle-income countries (LMICs). We conducted a cross-sectional e-survey among surgical trainees and consultants in 62 LMICs, as defined by the World Bank in 2020. This paper is a sub-analysis highlighting the perception of academic surgery and the association between practice setting and responses using Pearson's Chi-square test. Analyses were completed using Stata15. The survey received 416 responses, including 173 consultants (41.6%), 221 residents (53.1%), 8 medical graduates (1.9%), and 14 fellows (3.4%). Of these, 72 responses (17.3%) were from low-income countries, 137 (32.9%) from lower-middle-income countries, and 207 (49.8%) from upper-middle-income countries. 286 respondents (68.8%) practiced in urban areas, 34 (8.2%) in rural areas, and 84 (20.2%) in both rural and urban areas. Only 185 (44.58%) were familiar with the term "global surgery." However, 326 (79.3%) agreed that collaborating with HIC surgeons for research is beneficial to being a global surgeon, 323 (78.8%) agreed that having an HIC co-author improves likelihood of publication in a reputable journal, 337 (81.6%) agreed that securing research funding is difficult in their country, 195 (47.3%) agreed that their institutions consider research for promotion, 252 (61.0%) agreed that they can combine research and clinical practice, and 336 (82%) are willing to train HIC medical students and residents. A majority of these LMIC surgeons noted limited academic incentives to perform research in the field. The academic global surgery community should take note and foster equitable collaborations to ensure that this critical segment of stakeholders is engaged and has fewer barriers to participation.
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Affiliation(s)
- Arinzechukwu Nwagbata
- Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Trauma, Burn, and Critical Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Rohini Dutta
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
| | - Anusha Jayaram
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Neil Thivalapill
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Samarvir Jain
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
| | - Isabella Faria
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Isaac G. Alty
- Department of Trauma, Burn, and Critical Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Anita Gadgil
- The George Institute for Global Health, New Delhi, India
| | - Nobhojit Roy
- WHO Collaborating Centre for Research in Surgical Care Delivery in Low-Middle Income Countries, Mumbai, India
- The George Institute for Global Health, New Delhi, India
- Karolinska Institutet, Stockholm, Sweden
| | - Nakul P. Raykar
- Department of Trauma, Burn, and Critical Care, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
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Barthélemy EJ, Affana CK, Asfaw ZK, Dams-O'Connor K, Rahman J, Jones S, Ullman J, Margetis K, Hickman ZL, Dangayach NS, Giwa AO. Racial and Socioeconomic Disparities in Neurotrauma: Research Priorities in the New York Metropolitan Area through a Global Neurosurgery Paradigm. World Neurosurg 2022; 165:51-57. [PMID: 35700861 DOI: 10.1016/j.wneu.2022.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022]
Abstract
The New York Neurotrauma Consortium (NYNC) is a nascent multidisciplinary research and advocacy organization based in the New York Metropolitan Area (NYMA). It aims to advance health equity and optimize outcomes for traumatic brain and spine injury patients. Given the extensive racial, ethnic, and socioeconomic diversity of the NYMA, global health frameworks aimed at eliminating disparities in neurotrauma may provide a relevant and useful model for the informing research agendas of consortia like the NYNC. In this review, we present a comparative analysis of key health disparities in traumatic brain injury (TBI) that persist in the NYMA as well as in low- and middle-income countries (LMIC). Examples include: (a) inequitable access to quality care due to fragmentation of healthcare systems, (b) barriers to effective prehospital care for TBI, and (c) socioeconomic challenges faced by patients and their families during the subacute and chronic post-injury phases of TBI care. This review presents strategies to address each area of health disparity based on previous studies conducted in both LMIC and high-income country (HIC) settings. Increased awareness of healthcare disparities, education of healthcare professionals, effective policy advocacy for systemic changes, and fostering racial diversity of the trauma care workforce can guide the development of trauma care systems in the NYMA that are free of racial and related healthcare disparities.
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Affiliation(s)
- Ernest J Barthélemy
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA; Center for Health Equity in Surgery and Anesthesia, University of California San Francisco, San Francisco, California, USA.
| | | | - Zerubabbel K Asfaw
- Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York
| | - Kristen Dams-O'Connor
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jueria Rahman
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York; Department of Neurosurgery, NYC Health + Hospitals/Elmhurst, Queens, New York
| | - Salazar Jones
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York; Department of Neurosurgery, NYC Health + Hospitals/Elmhurst, Queens, New York
| | - Jamie Ullman
- New York Neurotrauma Consortium, Inc., New York, New York; Institute for Neurology and Neurosurgery at North Shore University Hospital
| | - Konstantinos Margetis
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York
| | - Zachary L Hickman
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York; Department of Neurosurgery, NYC Health + Hospitals/Elmhurst, Queens, New York
| | - Neha S Dangayach
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Neurosurgery, Icahn School of Medicine at the Mount Sinai Hospital, New York, New York; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Al O Giwa
- New York Neurotrauma Consortium, Inc., New York, New York; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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Martinez JG, González M, Hernández Q, Rodríguez MA, Torregrosa N, Gil E, Cascales PA, Delgado MA, Sancho J, Lopez‐Lopez V, Rodriguez JM. Goiter surgery recommendations in sub‐Saharan Africa in humanitarian cooperation. Laryngoscope Investig Otolaryngol 2022; 7:417-424. [PMID: 35434333 PMCID: PMC9008146 DOI: 10.1002/lio2.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- José Gil Martinez
- Department of General Surgery University Clinical Hospital Virgen de la Arrixaca Murcia Spain
| | - Miguel González
- Department of General Surgery University Hospital Reina Sofia Murcia Spain
| | - Quiteria Hernández
- Department of General Surgery University Clinical Hospital Virgen de la Arrixaca Murcia Spain
| | - María Angeles Rodríguez
- Department of Maxillofacial Surgery University Clinical Hospital Virgen de la Arrixaca Murcia Spain
| | - Nuria Torregrosa
- Endocrine Surgery Unit, Department of General Surgery General University Hospital Santa Lucía Cartagena Spain
| | - Elena Gil
- Department of General Surgery University Clinical Hospital Virgen de la Arrixaca Murcia Spain
| | - Pedro Antonio Cascales
- Department of General Surgery University Clinical Hospital Virgen de la Arrixaca Murcia Spain
| | - Miguel Angel Delgado
- Endocrine Surgery Unit, Department of General Surgery Getafe University Hospital Getafe Spain
| | - Joan Sancho
- Endocrine Surgery Unit, Department of General Surgery Consorci Parc de Salut Mar de Barcelona Barcelona Spain
| | - Victor Lopez‐Lopez
- Department of General Surgery University Clinical Hospital Virgen de la Arrixaca Murcia Spain
| | - Jose Manuel Rodriguez
- Endocrine Surgery Unit, Department of General Surgery University Clinical Hospital Virgen de la Arrixaca Murcia Spain
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Salgado LS, Campos LN, Yabrude ATZ, Buda AM, Amaral VF, Ribeiro LLPA, Barbosa FS, Pimentel RCS, Mishaly A, Neto JB, Bezerra AH, Alonso N. Assessing Brazilian Medical Student Awareness About Global Surgery: A Survey-Based Study. J Surg Res 2021; 271:14-23. [PMID: 34814048 DOI: 10.1016/j.jss.2021.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/24/2021] [Accepted: 10/10/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Global surgery is an interdisciplinary field that advocates for access to equitable, affordable surgical services for all people. Engaging medical students in the field can strengthen the surgical workforce in low- and middle-income countries. We aim to investigate Brazilian medical students' acknowledgment of global surgery and their preferred learning platforms. MATERIALS AND METHODS We performed a cross-sectional study through an anonymous Portuguese survey on Google Forms, consisting of 30 mixed multiple-choice and five-point Likert scale questions. Students enrolled in a Brazilian medical school from the second to sixth academic year fulfilled inclusion criteria. The association between qualitative variables was assessed using Chi-square, Fisher's exact test, or binary logistic model. RESULTS We received 1,345 responses from 208 medical schools. Only 20.9% (282/1,345) of participants reported awareness of global surgery, who were predominantly female. 96.5% (1,298/1,345) declared interest in knowing more about global surgery and participants indicated social media (71.6%, 202/282) as the prevalent manner to gain awareness on it, followed by webinars (63.5%, 179/282). Extracurricular classes were the most preferable option among students (61.4%, 827/1,345) to get acquainted with the field, followed by internships (59.4%, 812/1,345), workshops (57%, 767/1,345), and social media (53.4%, 730/1,345). The main obstacles to pursue a global surgery career were lack of national opportunities (32%, 431/1,345) and adequate training (25.4%, 341/1,345). CONCLUSION We outlined the most strategic pathways to raising awareness on global surgery among Brazilian medical students, providing relevant insights on its education in similar settings.
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Affiliation(s)
- Lucas S Salgado
- União Educacional do Vale do Aço, School of Medicine, Ipatinga, MG, Brazil.
| | - Letícia N Campos
- Universidade de Pernambuco, Faculty of Medical Sciences, Recife, PE, Brazil
| | - Angela T Z Yabrude
- Universidade Regional de Blumenau, School of Medicine, Blumenau, SC, Brazil
| | | | - Vivian F Amaral
- Faculdade de Medicina de Marília, Department of Medicine, Marília, SP, Brazil
| | | | - Felipe S Barbosa
- Faculdade de Medicina de Marília, Department of Medicine, Marília, SP, Brazil
| | | | - Asher Mishaly
- Universidade Nove de Julho, School of Medicine, São Paulo, SP, Brazil
| | - João B Neto
- Faculdade de Medicina da Universidade de São Paulo, University of Sao Paulo, São Paulo, Brazil
| | | | - Nivaldo Alonso
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil
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Carney PR, Ma M, Theiss LM, Chidi AP. Introducing the American Journal of Surgery Virtual Research Mentor: A primer for aspiring surgeon-scientists. Am J Surg 2021; 223:1015-1016. [PMID: 34785031 DOI: 10.1016/j.amjsurg.2021.10.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Patrick R Carney
- University of Wisconsin School of Medicine and Public Health, 750 Highland Ave., Madison, WI, 53705, USA.
| | - Meixi Ma
- Department of Surgery, University of Alabama at Birmingham School of Medicine, 1808 7th Ave. S., Birmingham, AL, 35233, USA.
| | - Lauren M Theiss
- Department of Surgery, University of Alabama at Birmingham School of Medicine, 1808 7th Ave. S., Birmingham, AL, 35233, USA.
| | - Alexis P Chidi
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA.
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Sebopelo LA, Bourcier AJ, Dada OE, Adegboyega G, Nteranya DS, Kanmounye US. Retrospective review of Google Trends to gauge the popularity of global surgery worldwide: A cross-sectional study. Ann Med Surg (Lond) 2021; 71:102950. [PMID: 34703591 PMCID: PMC8524754 DOI: 10.1016/j.amsu.2021.102950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/13/2022] Open
Abstract
Introduction Global surgery is a growing movement worldwide, but its expansion has not been quantified. Google Search is the most popular search engine worldwide, and Google Trends analyzes its queries to determine popularity trends. We used Google Trends to analyze the regional and temporal popularity of global surgery (GS). Furthermore, we compared GS with global health (GH) to understand if the two were correlated. Methods This is a retrospective cross-sectional study examining Google Trends of GS and GH. We searched the terms "global surgery" and "global health" on Google Trends (Google Inc., CA, USA) from January 2004 to May 2021. We identified time trends and compared the two search terms using SPSS v26 (IBM, WA, USA) to run summary descriptive analyses and Wilcoxon rank-sum tests. Results The ten countries most interested in GS were India (5.0%), the United Kingdom (5.0%), Ireland (4.0%), the United States (4.0%), Australia (3.0%), Canada (3.0%), New Zealand (3.0%), Germany (2.0%), South Africa (2.0%), and Nigeria (1.0%). GS became more popular after 2015 (2.3% vs. 1.3%, P < 0.001) and was consistently less popular than GH (1.6% vs. 45.3%, P = 0.04). The difference between GS and GH interest levels increased after 2015 (45.4% vs. 42.9%, P = 0.04). Conclusion GS is less popular than GH, more popular in high-income countries, and has become more popular after 2015 when the Lancet Commission on Global Surgery published its seminal report. The World Health Organization passed resolution WHA 68.15. Future advocacy efforts should target low- and middle-income countries primarily.
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Long KL, Galukande M, Kyamanywa P, Tarpley MJ, Dodgion C. Developing Research Potential and Building Partnerships: A Report of the Fundamentals of Surgical Research Course at the College of Surgeons of East, Central, and Southern Africa. J Surg Res 2020; 259:34-38. [PMID: 33278795 DOI: 10.1016/j.jss.2020.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/05/2020] [Accepted: 11/01/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Approximately a decade after the inaugural Fundamentals of Surgical Research Course (FSRC) at the West African College of Surgeons meeting (2008), the Association for Academic Surgery expanded the course offering to the annual meeting of the College of Surgeons of East, Central and Southern Africa (COSECSA). After the second annual offering of the course in 2019, participants were surveyed to assess the impact of the course. METHODS A survey was distributed to the attendees of the 2019 second COSECSA FSRC course, held in December 2019 in Kampala, Uganda. Approximately 80 people attended at least a portion of the full-day course. Forty-nine participants completed the voluntary survey questionnaire distributed to assess each session of the course at course completion. RESULTS Ten different countries were represented among the attendees. Of the 49 evaluations, 35 respondents were male and six were female. Eight respondents did not identify a gender. Surgical residents comprised 19 of the 49 attendees, and one of the 49 attendees was a medical student. Thirty-five respondents indicated that their views of surgical research had changed after attending the course. CONCLUSIONS The second annual FSRC at COSECSA confirmed significant interest in building research skills and partnerships in sub-Saharan Africa. A wide variety of learners attended the course, and a majority of the sessions received overwhelmingly positive feedback. Multiple conference attendees expressed interest in serving as faculty for the course moving forward, highlighting a viable path for sustainability as the Association for Academic Surgery develops an international research education platform.
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Affiliation(s)
- Kristin L Long
- Division of Endocrine Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin.
| | | | - Patrick Kyamanywa
- Department of Surgery, Kampala International University Western Campus, Kampala, Uganda
| | - Margaret J Tarpley
- Department of Surgery, Vanderbilt University, Nashville, Tennessee; Department of Medical Education, University of Botswana, Gaborone, Botswana
| | - Christopher Dodgion
- Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
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Padmanaban V, DaCosta A, Tran A, Kunac A, Swaroop M, Zhang WW, Sifri ZC. Closing the Gender Gap in Global Surgery: Trends at the Academic Surgical Congress. J Surg Res 2020; 257:389-393. [PMID: 32892135 DOI: 10.1016/j.jss.2020.08.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/22/2020] [Accepted: 08/02/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Female researchers are underrepresented in academic surgery. While they are increasingly producing original research, they lag male researchers in productivity. This disparity is not well understood within the nascent field of global surgery. The following study examines gender parity in global surgery research presented at the Academic Surgical Congress and within subsequent publications. METHODS Abstracts presented at the Academic Surgical Congress (ASC) between 2015 and 2019 in "Global Surgery" sessions were reviewed to obtain title, the first author (FA) and senior author (SA). The authors were classified by gender. The Scopus database was queried by two reviewers for abstracts with corresponding publications, citations, and journal impact factors. Statistical analysis was conducted using chi-square analysis and t-tests where appropriate. RESULTS Of a total of 6635 abstracts, 218 global surgery abstracts over a 5-year period were identified. Of these abstracts, 96 (44%) had female FAs, while 56 (26%) had female SAs. When comparing gender, female (44%) FAs and male (56%) FAs were equally represented. While SAs were significantly less likely to be female (26% versus 74%, P < 0.0001), female senior authorship increased significantly within the study period. Output with respect to publications, citations, and journal impact factors were equal by gender. CONCLUSIONS This study presents 5 y of gender trends in global surgery scholarly work presented at the ASC. Despite an overall predominance of male senior authors, the paradigm is shifting with a recent trend to gender parity. Male and female authors have equal output and are equally impactful. Findings of gender equity in academic global surgery are encouraging, and further study of other disciplines are warranted.
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Affiliation(s)
- Vennila Padmanaban
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
| | - Angela DaCosta
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Ashley Tran
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Anastasia Kunac
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Mamta Swaroop
- Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Wei Wei Zhang
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Ziad C Sifri
- Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
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Mañón VA, Demian N, Aziz SR, Marchena JM. Answering the Call. Oral Maxillofac Surg Clin North Am 2020; 32:457-470. [DOI: 10.1016/j.coms.2020.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Global Surgery: Effective Involvement of US Academic Surgery: Report of the American Surgical Association Working Group on Global Surgery. Ann Surg 2019; 268:557-563. [PMID: 30004921 DOI: 10.1097/sla.0000000000002934] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
: There is an unacceptably high burden of death and disability from conditions that are treatable by surgery, worldwide and especially in low- and middle-income countries (LMICs). The major actions to improve this situation need to be taken by the surgical communities, institutions, and governments of the LMICs. The US surgical community, including the US academic surgical community, has, however, important roles to play in addressing this problem. The American Surgical Association convened a Working Group to address how US academic surgery can most effectively decrease the burden from surgically treatable conditions in LMICs. The Working Group believes that the task will be most successful (1) if the epidemiologic pattern in a given country is taken into account by focusing on those surgically treatable conditions with the highest burdens; (2) if emphasis is placed on those surgical services that are most cost-effective and most feasible to scale up; and (3) if efforts are harmonized with local priorities and with existing global initiatives, such as the World Health Assembly with its 2015 resolution on essential surgery. This consensus statement gives recommendations on how to achieve those goals through the tools of academic surgery: clinical care, training and capacity building, research, and advocacy. Through all of these, the ethical principles of maximally and transparently engaging with and deferring to the interests and needs of local surgeons and their patients are of paramount importance. Notable benefits accrue to US surgeons, trainees, and institutions that engage in global surgical activities.
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Odera A, Tierney S, Mangaoang D, Mugwe R, Sanfey H. Women in Surgery Africa and research. Lancet 2019; 393:2120. [PMID: 31226043 DOI: 10.1016/s0140-6736(19)31106-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/21/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Agneta Odera
- Women in Surgery Africa, Royal College of Surgeons Ireland, Dublin 2, Ireland
| | - Sean Tierney
- Arusha, Tanzania; Surgical Affairs and Institute of Global Surgery, Royal College of Surgeons Ireland, Dublin 2, Ireland
| | - Deirdre Mangaoang
- Arusha, Tanzania; Surgical Affairs and Institute of Global Surgery, Royal College of Surgeons Ireland, Dublin 2, Ireland.
| | - Rosemary Mugwe
- College of Surgeons of East, Central and Southern Africa, East, Central and Southern Africa Health Community, Royal College of Surgeons Ireland, Dublin 2, Ireland
| | - Hilary Sanfey
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA
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Harris MJ, Junkins SR. A Philosophical Primer for Your First Global Anesthesia Experience. CURRENT ANESTHESIOLOGY REPORTS 2019. [DOI: 10.1007/s40140-019-00304-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hedt-Gauthier BL, Riviello R, Nkurunziza T, Kateera F. Growing research in global surgery with an eye towards equity. Br J Surg 2019; 106:e151-e155. [DOI: 10.1002/bjs.11066] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/12/2018] [Accepted: 10/30/2018] [Indexed: 11/09/2022]
Abstract
Abstract
Background
Global surgery research is often generated through collaborative partnerships between researchers from both low- and middle-income countries (LMICs) and high-income countries (HICs). Inequitable engagement of LMIC collaborators can limit the impact of the research.
Methods
This article describes evidence of inequities in the conduct of global surgery research and outlines reasons why the inequities in this research field may be more acute than in other global health research disciplines. The paper goes on to describe activities for building a collaborative research portfolio in rural Rwanda.
Results
Inequities in global surgery research collaborations can be attributed to: a limited number and experience of researchers working in this field; time constraints on both HIC and LMIC global surgery researchers; and surgical journal policies. Approaches to build a robust, collaborative research portfolio in Rwanda include leading research trainings focused on global surgery projects, embedding surgical fellows in Rwanda to provide bidirectional research training and outlining all research products, ensuring that all who are engaged have opportunities to grow in capacities, including leading research, and that collaborators share opportunities equitably. Of the 22 published or planned papers, half are led by Rwandan researchers, and the research now has independent research funding.
Conclusion
It is unacceptable to gather data from an LMIC without meaningful engagement in all aspects of the research and sharing opportunities with local collaborators. The strategies outlined here can help research teams build global surgery research portfolios that optimize the potential for equitable engagement.
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Affiliation(s)
- B L Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Partners In Health/Rwanda, Kigali, Rwanda
| | - R Riviello
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - F Kateera
- Partners In Health/Rwanda, Kigali, Rwanda
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15
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Morris AM, Lee CNH. Common Issues in the Unique Environment of Global Surgical Health Services Research. JAMA Surg 2018; 153:979-980. [DOI: 10.1001/jamasurg.2018.1981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Arden M. Morris
- Stanford–Surgery Policy Improvement Research and Education Center, Stanford University School of Medicine, Palo Alto, California
- Department of Surgery, Stanford University School of Medicine, Palo Alto, California
| | - Clara Nan-hi Lee
- Department of Plastic Surgery, College of Medicine, The Ohio State University, Columbus
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Exploratory Analysis into Reasonable Timeframes for the Provision of Neurosurgical Care in Low- and Middle-Income Countries. World Neurosurg 2018; 117:e679-e691. [DOI: 10.1016/j.wneu.2018.06.111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/12/2018] [Accepted: 06/14/2018] [Indexed: 11/18/2022]
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