By Nathan Douthit
Access to safe, affordable surgery is an essential aspect of global health. Eight million people are killed or injured every year due to inadequate availability of surgical services. Five billion are at risk due to lack of access to these services. Despite investment in surgery providing a 10:1 benefit:cost ratio for developing economies, surgery remains “the neglected stepchild of global health.”
The case report “Penetrating cardiac injury: sustaining health by building team resilience in growing civilian violence” by Pol et al addresses some of these issues. The report includes two cases, both of young men. This represents a demographic at greater risk for perpetrating and being victims of violence. The case report addresses the issue raised by the greater availability of cheap firearms, so called ‘desi-kattas’ in India. Readily available firearms represent a risk for global health in both developed and developing nations. Pol et al discuss the importance of government initiative to curb violence as well as to build multi-disciplinary surgical teams capable of handling the surgical emergencies created by these underlying issues. One third of the global burden of disease is addressed surgically, and without these systems in place, needless death and disability will occur.
BMJ Case Reports invites authors to draw more attention to problems created by violence and conflict and the need for surgery in global health as well as the successes in this field. Case reports can expose:
-Increasing prevalence of surgical disease in developing countries
-Complications associated with delayed presentation
-Issues faced by vulnerable populations in the developed and developing world
-Management of surgical care in limited resource settings
-Violence and conflict and their effect on the health of populations
The Lancet Commission on Global Surgery discussed the importance of supporting research in developing countries by partnering with local practitioners in the developing world. This literature can be submitted by students, physicians and other medical professionals and will be necessary in helping to develop solutions to these global health problems.
Selected references on conflict, resilience and surgery within BMJ Global Health Case Reports:
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Selected references outside of BMJCR
- Ng-Kamstra JS, Greenberg SL, Abdullah F, Amado V, Anderson GA, Cossa M, Costas-Chavarri A, Davies J, Debas HT, Dyer GS, Erdene S. Global Surgery 2030: a roadmap for high income country actors. BMJ Global Health. 2016 Apr 1;1(1):e000011.
- Stewart F. Root causes of violent conflict in developing countries. BMJ: British Medical Journal. 2002 Feb 9;324(7333):342
- Bruno E, Shrine MG. Surgery: The Neglected Stepchild of Global Health. The New York Times: Opinion. 2016 Apr 20. Accessed online at https://kristof.blogs.nytimes.com/2016/04/20/surgery-the-neglected-stepchild-of-global-health/?_r=0 on 2017 June 4
- Weinberger SE. Curbing Firearm Violence: Identifying a Target for Physician Action. Annals of internal medicine. 2016 Aug 2;165(3):221-2.