International Women’s Day – making safe surgery and anaesthesia happen

It’s late on a Monday and l’ve been scrolling through my Twitter feed for the past hour. I don’t normally spend this much time on one Twitter session but it’s almost as if I’m reading a book that I just can’t put down! The reason for this: it’s the night after International Women’s Day. March 8th, a date that has become increasingly important on my calendar over the last few years.

For me, this one day in the year is symbolic of a global effort to recognise and celebrate the achievements of women and girls all over the world, and to shine a light on the injustices they continue to face. And since joining Lifebox Foundation as a Communications Assistant in January, I’ve learned about a new one: unsafe surgery.

For the first time in history you’re more likely to be killed by a surgically treatable condition than a communicable disease, but in low resource settings surgery can be a challenge to access and desperately unsafe.  And all too often, women bear the brunt.

Social media has become a powerful tool for sharing these experiences.  And across great distances, it mobilises us all, encourages us to advocate for change. Sometimes it begins with just one story.

Carolina Haylock Loor - IWD2015

So when my colleague Sarah and I were planning our social media campaign for International Women’s Day this year, we really wanted to share the stories of some of the colleagues we work with around the world.  Women whose stories, from the forefront of the global crisis in unsafe surgery, show change in action.

I’m still new to the world of a surgery and anaesthesia, but I quickly saw why this year’s IWD theme, ‘Make it Happen,’ is so fitting.  Unsafe surgery is a global crisis, and our colleagues around the world aren’t waiting to be told to fix it.  They’re busy taking action.

Take Dr Ronke Desalu who works as a consultant anaesthetist at Lagos University Teaching Hospital. “I work in a 770 bed teaching hospital,” she explained, “and along with some colleagues was instrumental in establishing the use of the WHO Surgical safety checklist in my hospital.”

Ronke Desalu- IWD2015

This essential checklist has been proven to reduce surgical complications and mortality by 40 percent.

Or Dr Sandra de Iziquierdo from Guatemala, who told us that this year she aims to “introduce the use of pulse oximeters in five public hospitals with the highest maternal mortality rates.”

Sandra de Izquierdo - IWD2015

Distribution of pulse oximeters, training and education is a crucial part our work here at Lifebox – this robust tool means that anaesthesia providers in low-resource settings can confidently monitor their patients’ oxygen and blood saturation levels during surgical procedures.

Over the last two weeks our Twitter and Facebook pages have been bursting with action, with ambition, with compassion and with the voices of women at the forefront of safer surgical care in their communities.  There is so much work for them to do.

Kayser Enneking - IWD2015

What l have learnt over the last month at Lifebox is that it is not simply a matter of whether people in low-resource settings have access to surgery, but whether they will even survive it. Anaesthesia is up to 1,000 times more dangerous in low-resource countries than in high-recourse ones. Unsafe surgery is a global crisis that not only affects patients and their families but it also has implications for the doctors, health workers and medical teams who attend to them.

As I sat there scrolling, tweet after tweet, the resounding message about gender equality I took away is this – we must do more.  But then I thought about that day a few weeks back, when we emailed our colleagues to ask, ‘what are you doing right now to make surgery and anaesthesia safer?’  The answers came back so suddenly, so powerfully, so engaged.  These women are already working to make it happen.

Who are these brilliant individuals, advocating for global surgery at home and on the world stage?  Click here to find out!

Happy International Women’s Day.  Here’s to our safe surgery and anaesthesia champions!

Anna

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Got any bright ideas?

At 8:30 a.m. on a Saturday morning?  After a long journey to London from Leeds/Cardiff/Newcastle/St. Andrews?  About my – sorry, have I got this right – my innovative solutions for implementing universal health coverage?

Got any coffee?

Maybe that’s what you’d say, you older people with your groggy eyes and your cynical morning breath.  Medsin members are different.  They don’t just show up like warm bodies – they show up to participate.  What’s more, they bring their own coffee mugs.

Medsin is a student network and registered charity with a vision for “a fair and just world in which equality in health is a reality for all.”  It’s driving towards this ideal future with global health’s stealth weapon: medical students.

With a network of more than 30 branches across universities in the U.K., the organization is focused on education, advocacy and community action.  And this weekend several hundred of them gathered at Barts and the London for their annual global health conference.

We were delighted to spring out of bed and join them!

Lifebox trustee Dr. Isabeau Walker hosted one of 40 workshops as part of a dynamic programme that spanned neglected tropical diseases, the condom revolution, mathematical innovation in medicine, women’s rights, HIV, maternal health, access to drugs, post-2015 agenda, mental health, universal coverage, partnerships…

Workshop crowd

We were told there would be innovation

It was a relief to see that while surgery may be the long-neglected stepchild of global health, it’s not out in the cold with Medsin – the workshop room was packed.

But it’s also clear that when it comes to global surgery, there’s a huge amount of education to do – even amongst those most attuned to the issues at stake.

Isabeau Medsin workshop“If you were in an accident in the U.K., what’s the likelihood that you’d get surgical treatment?” asked Dr Walker, using her own broken arm as a prime example.

100%, the room agreed.

“And if you were in Uganda?  What are the chances that you’d get an operation?”

“40-60%?”

“Would it shock you if I said it was less than 4%?”

Yes.  Of course it would, and it did, because the actual number of lives lost every day to death, disability, pain and social isolation for lack of safe, simple surgical care is almost incomprehensible.  Especially when we know how to save them.

So it was a great privilege to spending our morning with a diverse group of people – nurses, new medical students, on-their-third-degree students  – resolving to challenge this. We talked appropriate technology, safe surgery and the different ways to make a difference to the global health crisis of this decade, and certainly the one to come.

It was also the grand debut of our Lifebox Toolkit, specially designed for medical students to get up to speed on the facts about unsafe surgery, the science behind the WHO Checklist and pulse oximetry, and the opportunities for getting involved.  Lifebox Rep?  Lecture?  Elective?  We have something for everyone!

Screenshot 2014-04-04 14.11.15

Our Whitechapel hosts were recently renovated, and the new Barts and the London is shiny and blue and whirring with emergency helicopters headed for the roof.

Newhospital

The old building dates to 1740, and the original Barts  – apparently the oldest hospital in Europe – all the way back to 1123.  Looking out the window you see a medical world in flux; a dead building crumbling in front of the new.

Oldhospital

Basically the perfect scene for a conference on innovation!  And for looking in a wider, more futurely direction.  Appropriately enough while we were talking global surgery in one hemisphere, Lifebox’s Dr Ed Fitzgerald was in another, actively laying foundations for it with Mercy Ships and a team at Hôpital General de Dolisie, in the Republic of Congo.

We were so pleased to join the friendly faces and portholes on board the MV Africa Mercy again, after our last visit in Guinea, and to work together to deliver pulse oximeters and training in oximetry and the WHO Surgical Safety Checklist.

Congo_Mercy Ships_training

More to the Medsin point: it goes to show this conversation about unsafe surgery in low-resource settings isn’t abstract.  It isn’t forward planning and it isn’t just an interesting concept worth kicking around.

In the U.K., risk of dying from anaesthesia is 1 in 200,000. In West Africa, it’s as high as 1 in 133.

Congo_Mercy Ships_oximetersUnsafe surgery is a crisis that is happening now.  Obstructed labour and road traffic accidents can’t be put on pause till we have a solution, and so day after day, healthcare workers are forced to deliver emergency C-sections and trauma repair without the resources they need to do them safely.

Patients are forced to chose between unsafe surgery or no surgery, which is no choice at all.

Lifebox provides the essential equipment and training that starts to make surgery safer as soon as it reaches the operating theatre.  Medsin members traveled down to London because they want to make a difference.  You don’t have to wait until graduation – you can start right now.

Download the Lifebox toolkit here and get started. This crisis belongs to you.

 

Honestly, people in love.  

They glow.  And they’re so happy all the time.

(c) This Sweet Love Photography

We might just find it annoying, if people in love weren’t so beautifully generous in their joy!

Three happy couples, six friends of Lifebox, have taken a day that is supposed to be all about them and made it about the difference they can make to other people, by putting the Lifebox surgical safety mission on their wedding registry.

“Your presence, love, and support are the most meaningful gifts we could ever hope to receive,” wrote University of California, San Francisco anesthesiology resident Kirsten Rhee, and her fiancé-now-husband Rob Steffner.  And of course they meant it, but…

“…if you do choose to give, one option is to donate on our behalf to Lifebox. The global surgical and perioperative burden of disease is too often neglected by the international public health community. However, Lifebox is one organization that we believe is making significant in-roads by supporting creative and sustainable solutions to a problem that does not get the exposure or support that it deserves.”

Kristen Dowling and Austin Enright, an American business major and a Canadian medic felt the same way.

“We look at it like this,” explained Kristen (avert your eyes from the glow).  “We’ve all had times in our lives when things are good, and we’ve all had times in our lives when things aren’t.  We’re so fortunate to have an amazing support system to celebrate with us in the good and help out in the bad.  At this time of celebration, we thought it would be great to share our support system with those that are in need.”

Louise Finch, a British anaesthetist, has seen that need first hand.  She was part of the very first Lifebox training and distribution workshop in Uganda, July 2011, and spent three months criss-crossing the country at rickety speed to ensure that all 80 recipients of Lifebox pulse oximeters were successfully using the machines six months later.

“Louise has first hand experience of how much the anaesthetic providers value these oximeters and the huge impact they have on patient safety,” wrote her fiance, Andy Bates.  “When we started planning our wedding we realised that we had everything we needed but that some of our friends and family might still want to give something to mark the occasion. We thought that making our guests aware of Lifebox offered a positive solution.”

All of us at Lifebox are touched, grateful and frankly giddy that at such a personal time in their lives, these couples are entrusting us to mark the occasion by making a direct difference to the quality and safety of patient lives worldwide.  Without getting mushy, we think that’s a fine testament to love.

A mother watches her child, prepped for surgery and safely monitored, at a hospital in Ethiopia.

“I can’t imagine knowing that your child (family member/friend) is sick and instead of hoping that the surgery works, you also have to hope that the surgery is safe,” said Kristen.  “Lifebox, through their extensive research and amazing reach within the medical community, helps to make surgeries safer.  It’s as simple as that.”

Participants at a Lifebox workshop in Mbarara, Uganda last year

Thank you from all of us at Lifebox.  And congratulations!