Qualifying the Need for Strengthening and Expanding Surgical Healthcare

Roughly two billion people worldwide lack access to emergency and essential surgical care based solely on hospital and operating room density¹. When timeliness, affordability, and safety of care is factored in, this number increases to 4.8 billion people². Surgical care includes anesthesia, obstetrics, and surgical support services. As healthcare expands into historically neglected areas, safe surgical care that is integrated into emerging health care systems and strengthened in existing markets can prevent 1.4 million premature deaths per year from causes that have a surgical remedy. Conditions that have a primarily surgical remedy include intra-abdominal emergencies, obstructed labor, symptomatic hernias, fractured bones and more. When surgical care for these conditions and others is unavailable or substandard, the result is frequently preventable disability or premature death.

Historically, in low- and middle-income countries, surgical care was considered costly, wasteful, and a secondary healthcare need. For these reasons, among others, current surgical care in these places is a significantly undersized and weak sector of healthcare that often provides substandard care. Safe surgical care is a cost-effective way to significantly decrease the global burden of disease from causes that have a surgical remedy. Additionally, surgical care is the financial backbone of hospitals - surgery and associated laboratory and imaging services generate up to 70% of the total health care revenues of a hospital. This pays for non-surgical, maternal, trauma, burn, and other less-profitable areas of care. Quality, safe surgical care that is expanded into new markets and strengthened in existing ones will increase both surgical and non-surgical healthcare capacity.

A well-functioning surgical department not only increases treatment options for patients, but it also adds clinical diversity to the staff and is a catalyst for hospital-wide advancements. Professionalism, knowledge, skills, standards of care, and more diffuse through a hospital and improve patient care in every department. Providers advance and mature professionally as they care for surgical patients in a - now higher - level of care. Hospitals known for quality care attract new providers and staff who are also committed to a high standard of care. Well-functioning surgical departments model excellence in care, which is matched by others, generating systemic improvements that upgrade the entire hospital.

Surgical teams are on the frontline of healthcare. They add a solid level of resilience and disaster-response capacity to a facility, and they couple their specialized knowledge and skills with efficient and practiced group management. These attributes are critical for well-organized, effective responses to system straining events such as pandemics, epidemics, or war. Surgical teams are problem-solvers. They routinely evaluate changing situations then make sound decisions. They are experts at sterile technique, infection control, resource allocation and are practiced in crisis management. These skills are transferrable and have been applied to situations outside the walls of the operating theatre. Surgeons were the first responders that halted the global spread of Ebola, and will be crucial for global healthcare challenges in the future. Strengthening surgical care in developing regions will increase their surgical and non-surgical healthcare capacity, advance providers, improve their quality of care, build resilience, and enable effective frontline responses to emerging challenges.