Error Traps in Global Anesthesia

Abstract

Anesthesia is increasingly acknowledged as a neglected priority in global health, and pediatric anesthesia is especially important due to the high proportion of children in the least developed countries with a large unmet burden of surgical disease. Pediatric anesthesiologists involved in global health may encounter several common "error traps" that could either lead to missed opportunities to build on recent advancements in global anesthesia or potentially cause harm. We present a number of these "traps" based on the literature and our experience from both sides of global health partnerships in East and Southern Africa, India, and the Caribbean. These error traps include failing to appreciate the public health "big picture"; failing to consider a health-systems approach, prioritizing quantity-based outcomes at the expense of quality, having priorities driven by partners in the "Global North"; failing to make programs sustainable, failing to invest in the retention of anesthesia providers, not realizing that not all global health is international health, and unethical practices. Our goal is to spark debate on ongoing controversies and to inform pediatric anesthesiologists who are working or considering a career in this field.

Keywords: anesthesia; ethical dilemmas; ethical relativism; global health.