For my first post of 2016, I thought I’d dive head first
into a topic that has weighed heavily on my heart since starting my work with
Mercy Ships – surgery and its effect on Global Health. I’ll start by saying
that this is a huge, deep subject which I will only touch the surface of so I
understand if I lose some of you along the way. I will not be offended at all but
I urge you to keep reading as it’s something I believe will help you understand
Mercy Ships better and make you love this organization as much as I do :)
As most of you know, Mercy Ships primary focus is surgery
and the Africa Mercy is a surgical focused hospital ship. Half of our hospital is
operating rooms and the rest is made up of wards meant to care for patients pre
and post-operatively. This means we can only treat about 10 or so types of
diseases (which effect a huge portion of the population, but I’ll get to that
later!). I’ve heard many who question our focus, myself included. Why limit
ourselves to such a specific target when people are dying every day of all
kinds of other diseases? This especially comes up in our screening process
where hundreds of sick and injured people might show up to be turned away
because they don’t fit our surgical scope. As hard as it is to see suffering
and not be able to help, I’ve had to come to terms with two reasons why it must
be this way.
Number 1: One of the core values of Mercy Ships is “to be
people of excellence in all we say and do”. One way we live this out is that
our leadership and assessment teams have chosen to focus on a few things and do
them REALLY well. By choosing a small amount of diseases to treat, our surgeons
can excel in those specific techniques and our hospital can ensure that each
patient gets the best care possible. Basically, the easiest way I can explain
it is that you have to choose between doing a little good for a lot of people
or doing a lot of good for fewer people…but don’t get me wrong, it’s still a
lot of people (we have yet to run out of patients that need what we can provide!).
Number 2: A focus on surgery can change a country in bigger
ways than just the people who receive treatment. Over the past five months, I’ve
heard at least 3-4 presentations about how surgery will be the key to the
future of global health. Now, I understand we might be slightly biased because
surgery is the focus of our organization ;) However, the rest of the world is
starting to agree with us! It all started last year when the Lancet, the
leading medical journal in the UK, published a group of articles called the
Commission on Global Surgery. It was a huge study with huge results, basically
summarized by this video:
See, surgery really is important! Dr. Mark Shrime, a surgeon
from Harvard School of Medicine who comes to serve on Mercy Ships several times
a year, wrote an article about this for the New York Times a few months ago. He
also gave a presentation on it during his last visit here and that became one
of the reasons I feel so strongly about this subject today. The whole article can
be found here: http://www.nytimes.com/2015/09/26/opinion/how-surgery-can-fight-global-poverty.html?_r=0.
I highly encourage you to read it. It’s not very long and he hits on a few really
important ideas way better than I can. Here’s a couple of my favorite quotes:
“Despite the fact that nearly one-third of human disease is amenable to surgery, it remains overlooked in much of the world…To put this in perspective, H.I.V., tuberculosis and malaria — which have captured the global conversation — currently make up less than one-tenth of the global disease burden, combined.”
“Moreover, reliable surgical infrastructure strengthens entire health systems. It is not enough to prevent maternal deaths during childbirth if a health care system cannot care for the children after birth. It is not enough to treat tuberculosis successfully if the patient then dies from a perforated appendix. Surgical scale-up is not and has never been envisioned to exclude other global health priorities — surgery is necessary to meet all global health priorities.”
“For developing nations, it (surgery) is an economic issue. For the world, it is a moral issue, a question of equity. Surgery has been called the “neglected stepchild of global public health.” To achieve the recently approved global development goals, world leaders must explicitly develop systems to bring access to safe, affordable and timely surgery to those who need it.”
Do you want to know what the best part is? Mercy Ships has
been doing this for almost 40 years and is pioneering the way to meet these
global goals! Even better, we have an entire department committed to training
and building up the capacity of the healthcare in the countries we visit so we
can leave a lasting impact that reaches beyond the people who receive surgery
in our hospital. As much as I love working in our hospital and caring for each
patient who comes through our doors, I realize that this is only a small part
of the mission of Mercy Ships. We are only in each country for a few months and
can only treat a small portion of the population; but when we train surgeons, nurses
and anesthesiologists or repair broken and abandoned operating rooms (just a
few of the many projects our ‘off-ships’ team is working on) we are leaving things
that will continue to make a difference for years to come.
All this can be summarized by one of my favorite quotes from
our Chief Medical Officer, Dr. Gary Parker, “We cannot change the whole world,
but we can change the whole world for one person”.
There is so much need in the world and it’s easy to get
discouraged by all that we cannot help, but when I look at each patient we get the
privilege to care for or the surgeons who are learning new ways to help their
own people, I see that it’s worth it to change the world for that person!
Finally, you might be wondering why I’m bringing this up
right now (besides the fact that I’ve been meaning to write about this for
months). Well, so sorry (or azafady as they say here in Madagascar), but that reason will have to wait for next time – and it’s
a really exciting reason so check back soon!!
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