The Expanding Role of Education and Research in International Healthcare

Abstract

A recent report of the Lancet Commission on Global Surgery has continued to emphasize the importance of surgery in global health. Plastic surgeons have been involved in humanitarian care of children in developing countries for many years. The ability to repair children with cleft lip and palate in resource-poor settings has made this desirable for many plastic surgeons. A number of philanthropic plastic surgery organizations arose to deal with the problem in a more structured way. Dr. Donald Laub at Stanford established Interplast (now ReSurg) in 1969. Dr. Bill and Kathy Magee established Operation Smile in 1982, and many others have followed. The unifying theme of these organizations has been the desire to provide safe and effective surgical care to children who would otherwise be forced to live out their lives with deformity. Most care has been for children with clefts, but efforts have expanded to include hand surgery and burn reconstruction. The initial effort was provided through surgical missions. A paradigm shift has occurred as sustainability and local capacity have become paramount. Education and training of local colleagues and assistance in surgical safety infrastructure are expanding the reach of plastic surgical care around the globe. The inauguration of in-country permanent surgical centers allows high-volume outcomes research, as well as unique educational collaboration between plastic surgeons of both the developed and developing world.

Global Surgery Education and Training Programmes—a Scoping Review and Taxonomy

“…Less commonly, exchanges involved LMIC surgical trainees travelling to HIC hospitals [ 43 , 59 ] or bi-directional exchanges [ 60 , 61 ], and in just one case a LMIC-LMIC trainee mobility programme [ 62 ]. HIC institutional support for surgical training in LMICS — either through support for the delivery an existing formal training programme [ 15 , 53 , 56 , 58 , 63 – 68 ], or additional training delivered to trainees enrolled in a formal training programme [ 17 , 18 , 48 , 69 – 71 ], or delivered outside of a formal training programme [ 16 , 19 – 21 , 61 , 72 – 77 ]. Provision of qualified HIC surgical care providers as trainers in LMICs [ 15 , 61 , 78 ], or the training of such HIC providers to work successfully in low resource environments [ 79 , 80 ].…”

“…HIC institutional support for surgical training in LMICS — either through support for the delivery an existing formal training programme [ 15 , 53 , 56 , 58 , 63 – 68 ], or additional training delivered to trainees enrolled in a formal training programme [ 17 , 18 , 48 , 69 – 71 ], or delivered outside of a formal training programme [ 16 , 19 – 21 , 61 , 72 – 77 ].…”

The Impact of Social Stigma for Children with Cleft Lip and/or Palate in Low-resource Areas: A Systematic Review

“…5–11 The inability to fully participate in the workforce translates into a substantial economic burden and lost productivity. 6 Psychological distress naturally follows, with children being more affected than adults. 5,9,23 Depending on the cultural context, the impact of cleft disease may or may not have an impact on marital status.…”

Cleft Lip and Palate Research in Low- and Middle-income Countries: A Scientometric Analysis

“…LMIC researchers and stakeholders have partnered with LMIC and high-income country (HIC) institutions to improve the quantity and quality of global plastic surgery research. 20 Their contributions to global CLP research (ie, research on CLP epidemiology, education, advocacy, health policy, and service delivery in LMICs) and the interactions between LMIC and HIC researchers have not been studied before. This study focused on research done on CLP in an LMIC, whether it was done by an LMIC or HIC.…”