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A global surgical problem

We live in the lucky country. Australia. The land of opportunities and state of the art medical and surgical facilities. We, as patients and consumers, expect and demand a well-resourced system and highly competent healthcare practitioners who deliver the best possible care.

Poor countries do too. What separates us is the lack of investment and opportunities not only from government level but from a small scale level as well; the will to change the system in order to improve the care to the people.

Poor countries are equipped with basics, at most. There are no ambulances to take you to the hospital, you might have to walk for days, in pain and atrocious conditions. On arrival to the hospital you will not be triaged. You wait, along with hundreds of other patients until your name is called. You enter the open space, no privacy, no chat to your doctor. The focus is on your problem to be fixed, and fixed quickly so that the next patient can be helped. The diagnosis is made with simple blood tests and imaging (if you are lucky), and treatment initiated by a medic who may not have the knowledge of the latest treatment guidelines. If you require surgery it will cost you, perhaps your whole farm, your livelihood. You decide against it, take your chances and make your journey back home.

We certainly live in the lucky country, to simply be born into a world that functions well. Is it fair? Is it just? Why is it still a problem? The questions I ask myself is why has this gap widened and continues to widen? Is it the advances in technology or the economic burden of disease? Why has Public Health ignored the needs of surgical care and the increased demands of the surgical health systems?

I remember walking through the crowded Mae Tao clinic in Thailand, where basic suturing equipment were running low. Surgery is the definitive management of many of world’s worst diseases, yet funding is low. Cataracts are a significant burden of morbidity, yet surgery can be performed within a day with excellent outcomes. So why is it still a problem?

Poverty, poor education, housing and nutrition all contribute to the state of health and wellbeing. A significant proportion of funding is required for the implementation of an effective research system, but who will deliver? We know that 11% of the global burden of disease is attributed to surgical condition, fixable with surgeries, yet the problem lingers.

But you can help and here’s how to do it. Next time you visit a developing world take a stroll down to the local hospital. There are many volunteer opportunities ranging from medical to administrative. If you’re short for time a simple donation to the hospital will make a significant difference. If you’re living in Australia, then simply familiarise yourself with the global burden of disease and use your skills to make a positive change. We are all responsible for the shaping of this world and a simple act can go a long way. So let’s start today!

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