Global Health Realities, Issues Addressed at 2014 Symposium

By Lin Lofley

Dr. Mark Harris
Dr. Mark Harris

Speaking to attendees at UT Southwestern Medical Center’s 2014 Global Health Symposium, Dr. Mark Harris, Associate Professor of Anesthesiology at the University of Utah School of Medicine’s Center for Global Surgery, talked about the universal need for addressing and expanding medical education.

“Right now, 56 million people in sub-Saharan Africa need surgery,” Dr. Harris said. “Not ‘would quite like it,’ not ‘perhaps one day might need it,’ but actually need it right now.”

Undergoing surgical procedures in many “low-income countries” remains risky and hard to access, but it need not be that way, he told participants of the Feb. 8-9 symposium, sponsored by the Office of Global Health at UT Southwestern. Now in its third year, the event’s theme for 2014 was “Transformative Global Health: Impact and Accountability.”

“A billion global citizens do not have access to the basic surgical care that you and I take for granted,” Dr. Harris said. “We’re not talking about elective surgery. We’re talking about hernias, ruptured appendices, C-sections, and the like.

“The problem is that there aren’t enough people to do the work that needs to be done. Not only are there not enough providers, but the population growth indicates that they’re not getting any closer. In many of these nations, not only are they not catching up; they’re actually losing ground.”

Dr. Harris said that his own specialty was an area in which expanded education and better equipment could have a profound effect. Using a map to illustrate the disparities in anesthesiology outcomes worldwide, he pointed to Togo, the African nation of nearly 7 million people, which records nearly 1,400 avoidable anesthesia-related mortalities per 200,000 cases. In high-income nations, meanwhile, that figure is 1 per 200,000 cases.

“We don’t kill people in high-income countries; in low-income countries they do it all the time,” he said. “But it’s not because they’re stupid, or lazy, or they lack compassion. It’s because they’re often poorly trained, inexperienced, and they have inadequate equipment.”

Dr. Harris talked about a teaching consortium at Komfo Anokye Teaching Hospital in Kumasi, the second-largest city in Ghana. There, a continuing medical education program conducts annual classes for anesthesiologists.

“We’ve been doing it for 12 years now, and last year we had 360 people present for the training,” he said. “The thing I’m most proud of is that for the last three years I haven’t had a thing to do with it. They have us in to speak to the students, but the curriculum is all their own. Our plan from the beginning was that we would help our colleagues in Ghana get this up to speed, and then we’d step away. That’s what has happened.”

Dr. Fiemu Nwariaku, Associate Dean for Global Health at UT Southwestern and the symposium’s director, said that the weekend’s presentations examined the impact and accountability of transformative global health activities.

“The sessions reviewed methodology and mechanisms to measure real-time impact. We want to measure impact, relevance of results, and importance of pilot projects,” he said. “Over the past decade, global health activities have expanded tremendously in scope and content. The number of participants and the diversity of health activity worldwide also have seen significant increases. However, little is known about the impact of new and existing global health programs, and we need to be able to measure that.”

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Dr. Nwariaku holds the Malcolm O. Perry, M.D., Professorship in Surgery.

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