Global Burden of Surgical Conditions

Excerpt

Approximately 2 billion people lack access to emergency and essential surgical care (Funk and others 2010). Most of the need is in rural and marginalized populations living in low- and-middle-income countries (LMICs), where the poorest one-third of the world’s population receives only 3.5 percent of all surgical procedures (Weiser and others 2008). The lack of surgical care takes a serious human and economic toll and can lead to acute, life-threatening complications. In other instances, poor-quality care results in chronic disabilities that make productive employment impossible and impose a burden on family members and society.

The failure to appreciate the role of surgery in addressing important public health problems is the main cause of disparities in surgical care worldwide. Yet, surgically treatable conditions—such as obstructed labor (Alkire and others 2012; Ndour and others 2013); injuries (Abdur-Rahman, van As, and Rode 2012; Mock and others 2012); intra-abdominal emergencies (Stewart and others 2014); correctable congenital anomalies, such as clubfoot and cleft lip or palate (Mossey and Modell 2012; Wu, Poenaru, and Poley 2013); symptomatic hernias (Beard and others 2013); cataracts (Rao, Khanna, and Payal 2011); osteomyelitis (Bickler and Rode 2002; Stanley and others 2010); and otitis media (Monasta and others 2012)—contribute to premature deaths or ill health of populations.

In this chapter, we explore surgery’s multifaceted contribution to global public health. We begin by providing an overview of the public health dimensions of surgical care in LMICs and examine the current challenges of making a comprehensive assessment of the global burden of surgical diseases. Next, we estimate the public health impact in LMICs if basic and selected subspecialty surgical care could be scaled up to meet standards that currently exist in high-income countries (HICs). Finally, we attempt to define where surgical care fits among other global health priorities and discuss areas toward which future research should be focused. Our analysis uses the 21 epidemiology regions from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010.