Center for Equity in Global Surgery

Global solutions for global surgery

Mission

We will create equitable access to qualitysafe, and holistic surgical, obstetric, and anesthesia care for vulnerable populations provided through integrated, compassionate, and community-centric approach.

Background

The most marginalized communities are often those in rural locations where access to safe, affordable surgical care is exponentially worse than in high-resource settings.1 Numerous universities across North America and the United Kingdom (UK) offer Global Surgery modules as part of their wider surgical training or global health programs. However, few of the universities leading the movement in global surgery are based in Africa. This represents a loss of a key perspective and contextual expertise, as well as inherent bias and inequity in opportunity for both African trainees and faculty development. Furthermore, local communities and patient populations who are being targeted by research and clinical efforts frequently are excluded from the development of research questions and the opportunity to learn the results of the research done on their behalf.

It has been shown that training African residents in high quality residency programs in rural settings helps to retain them in rural hospitals ( Van Essen et al, 2019; PAACS, 2018).2,3 Many African trainees are interested in building research and advocacy skills as evidenced by the success of groups such as InciSion and the International Association of Student Surgical Societies. We believe in strengthening local leaders in the contexts in which they will work. By empowering them with the education and resources needed to provide equitable surgical care, we will address these challenges together as the Center for equity in Global Surgery (CEGS).

The Five CEGS Pillars

1. Fellowship

a. Provide equitable opportunity for outstanding individuals to train in global surgery in an innovative Low- and Middle- Income Country (LMIC) context, mentored by a diverse, accomplished faculty.

b. Serve as a regional, community-based, global surgery fellowship site in partnership with other renowned global surgery centers.

  • Trainees from low-resource environments often lack access to opportunities available to the wider global surgery network. This center seeks to level that field and provide a more affordable and relevant experience to LMIC trainees, and provide a model for other such sites to be developed across the world. 
  • Global surgery advocates and those interested in a career in global surgery from HICs will have the opportunity to intern or rotate at the UGHE center.
  • Facilitate equitable cross-cultural learning between trainees as they work on projects and initiatives driven by the felt needs of the local community rather than those driven by the interests of outsiders or funders.
  • Help guide passionate and motivated trainees to engage in equitable, thoughtful, and responsible engagement while learning directly from mentors who live and work in the places that they hope to help.

2. Research and Innovation

a. Contribute to research in global surgery from an institution and with investigators physically located in the environment it aims to serve.

  • Develop research ideas driven by local context and felt needs
  • Provide training in global surgery research skills for local surgical care providers

b. Implementation Science

  • Lead clinically oriented interventions that are pillars to safe surgery and anesthesia
  • System-based surgical care programs to promote holistic, multidisciplinary care for patients with surgical problems
  • Generate new quality improvement initiatives to develop a culture of continual striving for improvement
    1. Programs in surgical site infection control and prevention 
    2. Efficient use of the Safe Surgery Checklist and training in non-technical skills for surgery (NOTSS)
    3. Global Surgery Safe Surgery interventions

Examples include:

  1. Programs in surgical site infection control and prevention 
  2. Efficient use of the Safe Surgery Checklist and training in non-technical skills for surgery (NOTSS)
  3. Global Surgery Safe Surgery interventions

c. Serve as an incubation center for new ideas for dedicated medical technology companies working to build sustainable, cost-effective, and safe operating theatres in LIMCs.

d. Design and implement state-of-the art simulation and community-based training opportunities for the surgical workforce.

3. Policy, Advocacy, and Financing

a. Serve as a center of excellence to help African countries develop National Surgical, Obstetric, and Anesthesia Plans (NSOAPs) and monitor outcomes and evaluate them for ongoing opportunities for improvement

  • Key international partners will be essential in this endeavor
  • Act as a meeting location for African surgical leaders and health ministers to connect on regional advancements and best practices

b. Draw on the expertise of other departments at UGHE to develop policy around financial risk protection in accordance with local contexts

c. Serve as regional expert through traditional social media and written publications to spread surgical content

d. Seek to help integrate and unify a wide array of stakeholders in the global surgical advocacy space

4. Global Convenings

a. Serve as an African hub for collaborations and exchange of ideas.

b. In partnership with other regional global surgical advocates, lead global surgical conferences, workshops and discussions.

  • Host NSOAP Workshops & Conferences
  • Research conferences in Global Surgery
  • Policy and commission meetings 
  • Leverage student enthusiasm through organizing student-focused events

c. Convene a running webinar series that brings together global surgery players, trainees, and enthusiasts from across the globe around topics that are crucial to the future of equitable access to surgery in Low- and Middle- Income Countries.

5. Education and Training

a. MGHD (Master of Global Health Delivery, Global Surgery Track)
Develop and deliver a contextual graduate Global Surgical educational curriculum for LMICs aimed at producing Global Surgery researchers, implementers, policy  makers and advocates through a competency based program,  that is integrated into the existing cutting MGHD program.

b. MBBS (Medical Bachelor, Bachelor of Surgery)
Support the implementation of a practical undergraduate curriculum for medical students that produces graduates who are competent in basic surgical procedures, anesthesia and critical care delivery as a means to improving access to surgery in the region.

c. Simulation based trainings

 

d. Continuing Medical Education/Continuing Professional Development (CPD) 

 

This is for surgical providers, anesthesia care personnel, and obstetric/gynaecology care workers.

3. Partnerships

  1. Program in Global Surgery and Social Change (PGSSC), Harvard
  2. World Health Organization (WHO)
  3. College of Surgeons of East, Central and Southern Africa (COSECSA)
  4. College of Anesthesiologists for East Central and Southern Africa (CANESCA)
  5. Inshuti Mu Buzima (IMB) – Rwanda
  6. Steven C. and Carmella R Kletjian Foundation Inc
  7. Rwanda Surgical Society – Rwanda
  8. Rwanda Nurses and Midwives Associations – Rwanda
  9. Rwanda Society of Anesthesiologists- Rwanda
  10. Lifebox
  11. Gradian Health System
  12. Butaro District Hospital – Rwanda
  13. University of Cape Town – South Africa
  14. Centre for Global Surgery, Stellenbosch University – South Africa
  15. Duke University – Duke Institute of Global Health, Center for Global Surgery
  16. Stanford University
  17. Royal College of Surgeons, Ireland
  18. Operation Smile
  19. University of California, San Francisco
  20. NIHR Global Health Research Unit on Global Surgery- Rwanda Hub
  21. Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston
  22. Intare Surgical Interest Group -Rwanda
  23. Capsule, Brighton and Sussex Medical School
  24. University of Utah- Center for Global Surgery
  25. Leipzig University – Germany
  26. Resurge International
  27. Sterile Processing Education Charitable Trust (SPECT)