A call for more access to surgery worldwide

Two-thirds of the world’s population—about five billion people—have no access to safe and affordable surgery, according to The Lancet Commission on Global Surgery. In an April 26, 2015 Lancet article, Atul Gawande of Harvard T.H. Chan School of Public Health put a human face on this problem by describing the experiences of Dr. Shrikant Jaiswal, the first and only anesthetist in Umarkhed, a town in India near where Gawande’s father grew up.

In the article, Gawande—professor in Harvard Chan’s Department of Health Policy and Management and director of Ariadne Labs—described how Jaiswal does his best to handle surgical cases without adequate staff, equipment, or medications. He also described how, in general in India, low pay in public hospitals translates to shortages of surgeons in those institutions, although most of the population cannot afford private treatment.

“Surgery is an indivisible, indispensable part of health care, but it is treated as a luxury,” Gawande wrote. “Without public investment, only large cities in low-income and middle-income countries usually have enough prosperity to develop general surgical capacity.” He added, “There is a clear need for discovery of how societies can most effectively increase provision of essential surgery, as well as its quality and safety.”

Gawande also spoke about how best to improve access to surgery globally at The Lancet Commission’s launch on April 27 at London’s Royal Society of Medicine. Watch a video featuring Gawande’s London talk (at 3:16).

Read Atul Gawande’s article in The Lancet: Global Surgery