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Who benefits from reconstructive surgery in a resource poor country?

Disability in a poor country means destitution and marginalisation, perhaps even total exclusion from society, starvation and death.

Being given the opportunity to receive reconstructive surgery means that:

Children born with correctible deformities are not put out to die, but are accepted by their society and thrive.

People who have been the victims of trauma do not succumb to infection from open wounds, survive walk and use their hands, can work again and support their children and elders.

People with cancer receive reconstructions instead of only ablations; an operation might be refused if the resulting defect is socially unacceptable or renders the patient unable to care for themselves. We can reconstruct them to a functional level, maintaining form and social acceptance.

What are the advantages to stakeholders of training surgeons in reconstructive surgery in resources poor countries?

Key: there = resource-poor country, here = UK

Patients there

  • Local access to appropriate medical treatment
  • Able to provide for themselves and their families
  • Social acceptance

Patients here

  • Surgeons and staff with broader clinical experience and skill set
  • Knowledge of rare, but now more frequently imported diseases (more travel abroad)

Surgeons (and other medical and paramedical staff) there

  • Education
  • Independence
  • Able to provide for their patients appropriately

Surgeons (and other medical and paramedical staff) here, who have been out

  • Highly developed clinical skills (have to rely more on clinical acumen there than costly investigations, which are not available)
  • Team work (you may not know the rest of the team, but have to make it work from Day 1, and maintain it for two weeks)
  • Leadership (as above)
  • Better knowledge – able to diagnose a tuberculous ulcer in an elderly lady in Surrey (where it is rare), only it is because commonly seen in Africa
  • Experience in more complex clinical problems (disease progresses further without treatment in resource-poor countries, due to lack of available treatment)
  • Better lateral thinking (you may not have exactly what you need to treat your patients abroad, but you have to make it work, with what you have) Better outcomes (no second chances for patients there, so your solutions and surgery has to be perfect)
  • Better teachers (the ultimate test of your teaching skills is whether your student becomes independent)
  • Respect for and knowledge of other cultures (you are a guest)

Hospitals there

  • Availability of appropriate care for local population
  • Possibility of improvement in equipment and staffing levels and training
  • Potential to become national centres for reconstructive surgery with added income Provide medical treatment for locally-based multinational corporations, which might invest in the hospital, with further added benefits to the local population

Hospitals here

  • Better trained staff
  • Better teams/team work
  • Staff pride and sense of achievement
  • Point of focus
  • Prestige for facilitating International education and aid
  • International contacts and enhanced reputation (my blog from Sierra Leone in 2013 via the Royal Free had 1800 hits worldwide)

Nation/economy there

  • Better work force (people who could not work before because of their injuries can now work)
  • Greater independence from outside aid Recognition
  • Enhanced reputation
  • Potential increased income and better economy

Nation/economy here

  • The more developing countries can become self- sufficient in medical care, the less we need to give Staff benefits in hospitals (as above)

Donors

  • In-country companies will have specialist medical treatment available locally, rather than having to expensively repatriate their workers
  • Donors who originate from the countries in question have the opportunity to give something back to their country of origin, which will lead to better living conditions there and better medical treatment, delivered locally
  • Feel good factor
  • Tax deductible donations
  • Raising charitable profile of company

Collaborators (Medical instruments, transport etc)

  • Feel good factor
  • Testing their instruments etc. under the most challenging conditions
  • Enhanced reputation through kudos
  • More likely to be remembered by medical staff in procurement contracts in the UK, thus benefiting their company’s sales (All other things being equal I would, if asked, be more likely to use sutures from a company which donated something – the laws of reciprocity)