Image Description: An OUGSG seminar.
Global surgery is a newly emerging field of global health which aims to provide safe and affordable surgical, obstetric and anaesthesia care worldwide. It seeks to improve health outcomes and achieve health equity for all people who need surgical and anaesthesia care, with a special emphasis on underserved populations and populations in crisis. The global burden of disease which is amenable to surgical intervention, such as trauma, cancer, and complications from childbirth, is substantial and growing. Despite this, there remain gross disparities in access to safe surgical care worldwide and the concept of global surgery is still alien to many underserved countries with limited resources, especially those in austere environment and war zones. Surgery is an integral, indivisible component of a properly functioning healthcare system, and we have a collective responsibility to ensure people have access to safe, high-quality surgical and anaesthesia care.
Public awareness of the principles of global surgery has dramatically changed in the last few years, with recent attention on efforts to meet the global need for surgical care. In 2013, a group of healthcare professionals established The Lancet Commission on Global Surgery, commissioned to develop and assemble the best evidence on the state of surgery worldwide. In addition, it aims to study the economics of operative care delivery and to develop strategies for improving access.
In 2015, the Commission reported that 5–billion people worldwide lack access to safe, affordable surgical and anaesthesia care when they need it. This report estimated that a minimum of 143 million additional surgeries are needed each year to save lives and prevent disability. Low-and middle-income–countries (LMICs) have the greatest burden of untreated surgical disease. The Commission has a plan to close the gap in global surgery provision between high-income–countries (HICs) and LMICs by delivering 5000 operations per 100,000 population by the year 2030.
Surgery is an integral, indivisible component of a properly functioning healthcare system, and we have a collective responsibility to ensure people have access to safe, high-quality surgical and anaesthesia care.
To address the needs of global surgery, Oxford Global Surgery Group (OUGSG) was established in 2017 by a group of clinicians and researchers based in Oxford. They have been working together to contribute to the provision of high quality surgical care globally, particularly in LMICs through teaching, research and capacity building.
In 2017 clinicians from Oxford–University–Nuffield–Department–of–Surgical–Sciences(NDS),–Nuffield–Department–of–Orthopaedics,–Rheumatology–&–Musculoskeletal–Sciences(NDORMS),–Nuffield–Department–of–Clinical Neurosciences(NDCN)–and–Nuffield–Department–of–Women’s–and–Reproductive–Health–(NDWRH) formed the OUGSG with the aim to bring together clinicians and researchers interested in Global–Surgery,–Anaesthesia–and–Obstetrics under one umbrella. This allowed better co-ordination and support of research and education within related fields. The group is led via a Chair and steering committee with leads from each of the four University departments and functions through a core faculty. The overall work and aims of the group are supported by a wider network including clinicians, academics and administrators. The aims of the group are as follows:
- To promote, advocate for and advise on best practice in Global Surgery particularly in the fields of research and training.
- To work closely and under local guidance of colleagues in LMICs
- To provide a forum for meaningful networking between those actively engaged in and those seeking opportunities in global surgery
Research and education within the field of Global Surgery are the main priorities of OUGSG, some examples are given below.
OUGSG is actively engaged in undergraduate and postgraduate education including the following (full details: https://www.ndorms.ox.ac.uk/globalsurgery/education):
OUGSG Undergraduate Training: The Special Study Module (SSM) aims to provide an introduction to the deficit and inequalities in surgical care worldwide. Students are attached to and supervised by Consultants within the Oxford Global Surgery Network. They are expected to attend departmental research meetings and Global Surgery teaching programmes. Students are encouraged to liaise with those involved in Global Surgery related clinical, research and training activities. Each student will be expected to undertake a short project based on their area of interest.
OUGSG Postgraduate Training: Postgraduate training involves the Oxford Academic Foundation Programme. Oxford University Global Surgery Group welcomes Oxford Academic Foundation Programme doctors. Trainees join the team for a 4-month research block and take part in a formal teaching programme alongside their supervised research project.
OUGSG Weekly Seminars: These weekly seminars usually involve an internal or external speaker on a thursday morning in the NDS seminar room at 8am. These seminars are open to all and allow our wider network to present their research. The seminars are the weekly focal point for the group allowing networking, education and establishment of research collaborations.
OUGSG Global Surgery Course: This five-day course, run by Oxford University Global Surgery Group, is suitable for those interested in global surgery in all disciplines. The first four days comprises presentations, discussions and seminars looking at major topics in global surgery such as burden of disease, manpower issues, training, partnership, supplies, service management and research needs. The University of Oxford Department for Continuing Education offers 20 Credit Accumulation and Transfer Scheme (CATS) points for the course.
OUGSG members are involved in research both within and outside of the UK with collaborators and partners based in many countries. OUGSG has particular strong links with the College of Surgeons in East, Central and Southern Africa (COSECSA). Examples of OUGSG research includes:
The Tanzanian Tumour Project: a pilot investigating surgery-associated morbidity and mortality in children with intra-abdominal solid tumours. This is an Oxford Tanzania Collaboration, led by Professor Kokila Lakhoo. She is also the recipient of the Carnegie Fellowship with the aim to developing a Research Hub in paediatric surgery in Johannesburg, South Africa collaboration.
Professor Chris Lavy and Surg Africa’s Scaling up Safe Surgery for District and Rural Populations in Africa project which will scale up the delivery of accessible, elective and emergency surgery at district hospitals to national level programmes in three African countries: Malawi, Zambia and Tanzania.
Image Credit: OUGSG