Leader:
Kelly McQueen, Fellow, Harvard Humanitarian Initiative
Participants:
Ellen Agler; Nadine Semer; Rossella Miccio; Michael Stabile; Thomas Weiser; Alexandra Mihailovic; Stephen Sullivan; Kathryn Chu; Richard Murphy; Samuel Broaddus; Masahiro Morikawa; David Mooney; Susan Briggs; Lori Warrens; Sathyanarayanan Doraiswamy; Deborah Baglole; Kathleen Casey
Burden of Surgical Disease Website:
You may visit the Burden of Surgical Disease Website by clicking here.
State of the Art:
The global burden of surgical disease is largely unknown. However, the scope of the problem (unmet surgical need) is thought to be large based on WHO data and other estimates. Recent efforts are underway to improve data collection and evaluation necessary for accurate surgical epidemiology and estimates on burden of surgical disease. Health care infrastructure in many low and middle income countries challenges not only surgical delivery but also collection and evaluation of data pertinent to understanding unmet surgical need and surgical outcomes. International organizations (IO), non-governmental organizations (NGO) and private volunteer organizations (PVO) provide surgical services in many low and middle income countries and have a unique ability to collect data, report on infrastructure and advocate for surgical needs. However, many of these organizations are overwhelmed with delivery of care and response to humanitarian crises, disasters and other emergencies related to conflict and war. Therefore the data from these settings is often partially or poorly collected, rarely evaluated and infrequently shared between organizations.
Objectives:
- Improving global surgical epidemiology, especially as it relates to trauma, obstetrical and surgical emergencies;
- Providing standardization for improving and evaluating surgical outcomes provided by IO/NGO/PVOs; and
- Provide an opportunity for collaboration between organizations and support other efforts (such as WHO and the Global Burden of Surgical Disease) with similar goals for nationally-based surgical evaluation.
Potential Deliverables:
- Survey results from 100 international surgical organizations providing services worldwide;
- Provide examples of field successes improving surgical safety and improving data collection;
- Provide strategies for estimation of surgical unmet need and prioritization of resources for surgery
- Establish a network for future dialogue between organizations supplying surgical services; and
- Propose an agenda for establishing and disseminating global standards and surgical best practices.
Advance Reading:
- Burden of Surgical Disease Website
- An Estimation of the Global Volume of Surgery: A modelling strategy based on available data
- A Surgical Safety Checklist
- Guide to Anaesthetic Infrastructure and Supplies at Various Levels of Health Care Facilities
- Health impact assessment and short-term medical missions: A methods study to evaluate quality of care
- Population Health Metrics for Surgery: Effective Coverage of Surgical Services in Low-Income and Middle-Income Countries
- Surgery and Global Health: A View from Beyond the OR
- Surgical Services for Children in Developing Countries
- The Burden of Surgical Conditions and Access to Surgical Care in Low- and Middle-Income Countries
- The Global Burden of Musculoskeletal Injuries: Challenges and Solutions
- Tool for Situational Analysis to Assess Emergency and Essential Surgical Care
- WHO Generic Essential Emergency Equipment List
- Bickler SW, Spiegel DA. Global surgery--defining a research agenda. Lancet. 2008 Jul 12;372(9633):90-2.
- Bruce J, Russell EM, Mollison J, Krukowski ZH.The measurement and monitoring of surgical adverse events. Health Technol Assess 2001;5(22).
- Debas H, Gosselin R, McCord C, Thind A. Surgery. In: Jamison D, ed. Disease Control Priorities in Developing Countries. 2nd ed. New York, NY: Oxford University Press; 2006.
- McQueen KA, Burkle FM Jr, Al-Gobory ET, Anderson CC. Maintaining baseline, corrective surgical care during asymmetrical warfare: a case study of a humanitarian mission in the safe zone of a neighboring country. Prehosp Disaster Med. 2007 Jan-Feb;22(1):3-7; discussion 8.
- McQueen KA, Magee M, Crabtree T, Romano C, Burkle FM: Application of outcome measures in international humanitarian aid: Comparing indices through retrospective analysis of corrective surgical care cases. Prehospital Disast Med 2009;24(1):31-38.
- Ozgediz D, Galukande M, Mabweijano J, Kijjambu S, Mijumbi C, Dubowitz G, Kaggwa S, Luboga S. The neglect of the global surgical workforce: experience and evidence from Uganda. World J Surg. 2008 Jun;32(6):1208-15.
- Spiegel DA, Gosselin RA. Surgical services in low-income and middle-income countries. Lancet. 2007 Sep 22;370(9592):1013-5.
- Taira BR, Kelly McQueen KA, Burkle FM Jr. Burden of Surgical Disease: Does the Literature Reflect the Scope of the International Crisis? World J Surg. 2009 Mar 17. [Epub ahead of print]