Equitable Access to Comprehensive Surgical Care: The Potential of Indigenous Private Philanthropy in Low‐Income Settings

Abstract

Local philanthropy can sustain and grow the provision of free, high-quality surgical care in low-income settings, and encourage the development of hybrid government-philanthropic models of surgical care.

Global Outreach Using a Systematic, Competency-Based Training Paradigm for Inguinal Hernioplasty

“…For this reason, solutions-based approaches to global surgical missions are advisable, with needs assessments individualized to the hosting communities. 12,19,20 By providing education to designated regional experts, accountability and ethical infractions are avoided, and the community develops an independently functional means of surgical care delivery. 21,22 Our program provides a focused surgical training program while cultivating relationships with regional health care organizations and governments to build surgical capacity in developing communities throughout the Western hemisphere.…”

“…Financing was provided using a US-based donation structure; however, we recognize that local communitybased philanthropic organizations may offer additional support to local surgical care professionals. 19 In addition, support from enthusiastic local surgeon partners, hospitals, and public health administrations were crucial to the mission, as were low-cost data management and reporting systems. Computers, mobile telephones, and high-speed Internet access are valuable resources in making the educational program accessible with a relatively low degree of database maintenance.…”

“…In recent evaluative studies, short-term medical missions performed poorest in domains of education, efficiency, sustainability, and preparedness in providing care, whereas self-contained temporary platforms and specialized surgical centers are more cost-effective and result in improved outcomes. For this reason, solutions-based approaches to global surgical missions are advisable, with needs assessments individualized to the hosting communities . By providing education to designated regional experts, accountability and ethical infractions are avoided, and the community develops an independently functional means of surgical care delivery .…”

“…As a foreign organization in participating communities, we found local coordinators to be a vital asset in arranging logistics and establishing relationships with individuals in our hosting communities. Financing was provided using a US-based donation structure; however, we recognize that local community-based philanthropic organizations may offer additional support to local surgical care professionals . In addition, support from enthusiastic local surgeon partners, hospitals, and public health administrations were crucial to the mission, as were low-cost data management and reporting systems.…”

A Banner Year for Global Surgery: Now How to Make it Make a Difference on the Ground

“…These include several that provide greater detail on the avertable burden estimates developed by DCP3, such as papers on the health burden from surgical conditions in general [6] from congenital anomalies [7] and which give further details on the cost-effectiveness of different aspects of providing care for surgical conditions [8,9]. These also include papers that give further details on derivation of estimates of the proposed minimum rates of surgery per population from the Lancet Commission [10], recommendations on how surgical services can be strengthened within LMIC health systems [11] and other aspects of the work of the Lancet Commission [12,13]. Regarding the WHA resolution, an article in this volume gives further details on the origin of the resolution, its specific recommendations, and, importantly, how the surgical community can make use of this resolution [14].…”