Blog post by Garreth Wood, Chairman, Kids Operating Room
Imagine being a surgeon that only gets to access an Operating Room, one day a fortnight.
Imagine, when you do get to operate, having to operate with the wrong instruments, the wrong drugs and broken machinery.
Imagine telling a parent that their child has to live in pain and disability, because there is a three-year waiting list for them to get the operation they need.
Imagine having studied medicine for 5 years and then trained for another 5 years to become a paediatric surgeon, only to watch as a child dies from a ruptured appendix because there is no room for the them in your hospital.
Imagine you can only choose 4 children a week to operate on, from a surgical list of 1000s of dying children that need life-saving operations you know you have the skills to provide.
Imagine taking a holiday knowing, you are the only paediatric surgeon in your country, and by taking time off, more children will likely die.
Imagine knowing, that 10 out of every 11 children in the world can’t access safe and affordable surgery if they need it.
Imagine a child who can’t go to school, because of a simple treatable condition. And what that means for their whole life.
Imagine if we stood back and did nothing.
You cannot have universal health coverage without surgery!
5 times more children die from surgically treatable conditions than from HIV, Malaria and TB combined. Imagine if I just told you straight up, what’s going on and what needs to happen!!!
- In low- and middle-income countries, there are very few dedicated places that children can access the surgical care they all-too-often need. These are the same countries where 10 in every 11 children live.
- There are not nearly enough surgeons or anaesthetists trained to care for children in these countries and sending foreign doctors to provide short-term care rarely does anything to change that.
- There are very few Bio-Medical Engineers that can fix broken equipment. Or figure out a way to use the poorly donated kit they’ve been lumbered with. There are even fewer who can stop it breaking in the first place through a proper maintenance schedule.
And yet too many foreign NGOs perpetuate the ‘mission’ model of care or refuse to invest in infrastructure that the local doctors tell us they need. This breeds dependency and hospitals across Low-and middle-income countries are frankly, too reliant on surgical teams flying in from high-income countries.
At the heart of our strategy is a stead-fast belief that local surgical teams should care for their own nation’s children. That is surely the only sustainable solution! Yes, there is a role for training and yes there is a role for support – but the days of delivering care entirely separate from the local system is disrespectful, it fails to build any local capacity and it drives up dependency.
How we decide our policy and how we proportion future investment is all focused on achieving the complete opposite of this. We want to be told we are no longer needed.
We want to invest in training local doctors to be great local surgeons and we want, wherever possible, for that training to be what is usually called ‘South to South’ training. In other words, the best person to train a surgeon in Africa is an African surgeon working with the local College of Surgeons.
We are all here because we want to improve Children’s Surgical Services for children. If you’re reading this you presumably want children to stop dying these pointless, needless deaths too. I believe the best way to do that is to invest in infrastructure and training. Give the existing, local teams the kit they need to care for their own nation’s children. If there is no local team, then fund the training of one and then give them the tools to do the job.
Of course, the local Ministry of Health needs to be involved – they will need to employ these people and provide consumables. But together we can build a new level of care, a new confidence and a new future for countless children. And before you say that won’t happen, my experience is that it is possible and does happen.
Still think infrastructure isn’t the right way to go? Then stop and look around the world right now. What has everyone been desperate to get? Critical care infrastructure and every possible person they can to work it. Medical and nursing students graduating early and moved straight into the front line in hospitals across the UK and beyond. Prime Ministers and Presidents appealing to companies to build infrastructure for these people to use.
When our health is threatened in the West it seems people and equipment are not a problem. Children die every day in Africa, Latin America and South East Asia because we don’t think their health emergencies deserve the same response.
It’s time to end this.
Imagine a world where everyone believed that access to surgery is a basic human right.
Imagine that you stepped forward and joined me. And together we work towards a day, when every child has equal access to safe surgery.
Chairman and Co-Founder, Kids Operating Room
Paediatric surgery included in Namibia's healthcare strategy going forward