Newspaper article International New York Times

Surgery Can Fight Poverty

Newspaper article International New York Times

Surgery Can Fight Poverty

Article excerpt

The United Nations has developed admirable goals to end global poverty and hunger, but they can't succeed without expanding access to surgery.

Earlier this year in Madagascar, a man in his 60s named Sambany made international news after volunteer surgeons from Mercy Ships removed a 16-pound tumor from his face. For decades, he had sought treatment at 10 hospitals, most of which lacked surgeons. He was ostracized, then physically unable to work. His family had to sell a rice field just to pay for the cost of getting to the hospital (the surgery itself was provided free).

Last week, the United Nations adopted 17 proposed sustainable development goals, which reflect the resolve of world leaders to "end poverty and hunger everywhere; to combat inequalities within and among countries; to build peaceful, just and inclusive societies."

Although admirable, these goals cannot be achieved without explicitly addressing one of the most crucial needs facing the world: a lack of access to surgery. The aim of universal access to "health care and social protection, where physical, mental and social well-being are assured," will come to nothing without it.

Most of the world lacks access to safe, affordable and timely surgical care.

Every year over 80 million people worldwide face financial catastrophe if they get surgery. And while the individual cost of getting surgery is great, the societal cost of inaction is staggering. If nothing is done to increase surgical access, developing nations are projected to lose $12.3 trillion from their gross domestic products between now and 2030.

Currently, infectious disease interventions are the main focus of global health policies, because many countries lack the personnel, facilities and infrastructure to carry out surgical interventions successfully.

Despite the fact that nearly one-third of human disease is amenable to surgery, it remains overlooked in much of the world.

This is shortsighted. After all, the treatment of solid tumors in the United States began with surgeons: William Stewart Halsted described the surgical removal of breast cancer in 1894, well ahead of chemotherapy. Surgery and early detection alone drove substantial drops in breast cancer mortality. Today over 60 percent of cancer diagnoses benefit from surgical intervention.

Surgery is more than just facial tumors, breast cancer and trauma; it is a crosscutting intervention, involved in every disease category from infections to blindness, from congenital abnormalities to maternal conditions, from the neurological to the cardiac to the neoplastic. To put this in perspective, H.I.V., tuberculosis and malaria -- which have captured the global conversation -- currently make up less than one-tenth of the global disease burden, combined.

Why, then, has surgery been ignored? …

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