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Why Is This Work Important?

Increasingly it is being recognized that surgical disease is a huge unmet need in the developing world. The Lancet Commission on Global Surgery reported that 28–32% of the global burden of disease can be attributed to surgically treatable conditions (1). A Bulletin from the World Health Organization noted that in some low and middle income countries that an estimated 85% of children will have a surgically treatable disease by the age of 15 years old (2). While broad programs aimed at medical diseases have been undertaken, little attention has been paid to the totality of surgical problems in vulnerable populations.

A 2015 synopsis of Disease Control Priorities published by the World Bank (3) found that the provision of essential surgical services could avert 1.5 million deaths per year and that these surgical procedures are among the most cost-effective health interventions possible. While a medical intervention such as treatment with a medication helps only as long as the patient continues to take the medicine, a surgical intervention fixes a problem forever.

When you can provide an essential surgery for a child, you have changed that child’s entire life for the better. For instance, the most common cause of adult bowel obstruction in the developing world is an incarcerated hernia. If you can fix that hernia when the patient is a child, you have prevented him from a lifetime of pain, suffering, and a potentially lethal obstructive episode, requiring emergency surgery. When researchers look at the lifetime impact of having a hernia (Disability Averted Lifetime Years, DALY), they find that repairing that hernia is one of the most cost-effective interventions of any medical or surgical treatment (3).

Many organizations are working to help developing nations to build the infrastructure necessary to help with these problems and OKD is in support of all these efforts. However, in the meantime, there are a lot of children in Guatemala and other countries that need surgical care now. One may reasonably ask, what effect can a small group of doctors and nurses have on the enormity of this worldwide problem.

For the more than 750 children that we have helped in Guatemala and the thousands we hope to care for in the future, they would say we can have a big impact.

Meara J.G., Leather A.J.M., Hagander L., Alkire B.C., Alonso N., Ameh E.A., Bickler S.W., Conteh L., Dare A.J., Davies J., et al. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386:569–624. doi: 10.1016/S0140-6736(15)60160-X. [PubMed] [Cross Ref]
Bickler SW, Rode H. Surgical services for children in developing countries. Bulletin of the World Health Organization. 2002;80(10):829–35. [PMC free article] [PubMed]
Essential Surgery. Disease Control Priorities, Third Edition (Volume 1).Editors: Haile T Debas, Peter Donkor, Atul Gawande, Dean T Jamison, Margaret E Kruk, and Charles N Mock. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2015 Apr 2. ISBN-13: 978-1-4648-0346-8ISBN-13: 978-1-4648-0367-3

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