The team
The Global Surgery Student Interest Group is a national student working group consisting of students from NUS Yong Loo Lin School of Medicine (NUS Medicine) and Lee Kong Chian School of Medicine (LKCMedicine). Under the mentorship of two experienced surgeons, Prof Russell Gruen and Prof Lee Chuen Neng, this student working group was pioneered by me and Leong Kwong Fei, then students from NUS Medicine and LKCMedicine, respectively.
The group is currently expanding to involve more students in planning activities to advocate for global surgery, an emerging concept which aims to provide affordable, accessible and safe surgical and anaesthetic care for those in need.
We hope to not only advocate for such activities to give students a better appreciation of global surgery, but to also take it a step further and connect existing opportunities to keen students, while hopefully creating new opportunities for future batches.
The inaugural student-initiated Global Surgery Workshop 2017 was conducted last August, allowing surgeons and trainee doctors across Singapore to come together to share about their personal experiences in surgical mission work.
The concept of global surgery
Taking reference from the report overview of Global Surgery 2030:
"In January 2014, President of the World Bank, Dr Jim Yong Kim, called for a 'shared vision and strategy for global equity in essential surgical care,' stating 'surgery is an indivisible, indispensable part of health care.'" This call came at a pivotal time for global health. As focus transitions from the Millennium Development Goals to a set of Sustainable Development Goals, commitments to Universal Health Coverage and a broader focus on building resilient health systems, the global community must develop strategies to reach these new aims.
Global Surgery 2030, the landmark initial report of The Lancet Commission on Global Surgery, describes the role of surgical and anaesthesia care in improving the health of individuals and the economic productivity of countries. Developed by a multidisciplinary team of 25 commissioners and collaborators from over 110 nations, the report presents findings on the state of surgical care in low-income and middle-income countries (LMICs), as well as a framework of recommendations, indicators and targets needed to achieve the Commission's vision of universal access to safe, affordable surgical and anaesthesia care when needed.
These findings create a powerful argument to (1) governments in LMICs to strengthen surgical services and the national health systems that provide them, (2) global health and development organisations to include indicators of surgical care within existing health goals and monitoring systems, (3) funding agencies to invest in surgical care as a tool for poverty alleviation and general welfare gains, (4) international partners to support local leaders in their efforts to provide equitable surgical care, and (5) the general public to lobby for access to surgical services for all.1
Essentially, five key messages were emphasised in the Lancet report. They include:
- Five billion people lack access to safe, affordable surgical and anaesthesia care when needed;
- 143 million additional surgical procedures are needed each year to save lives and prevent disability;
- 33 million individuals face catastrophic health expenditure due to payment for surgery and anaesthesia each year;
- Investment in surgical and anaesthesia services is affordable, saves lives and promotes economic growth; and
- Surgery is an indivisible and indispensable part of healthcare.
The inaugural student-initiated Global Surgery Workshop
Prior to the workshop, we planned the direction and steps for the team – not only for this event itself, but also for the long-term sustainability of this initiative. Prof Gruen, then vice-dean and current Professor of Surgery at LKCMedicine, and executive director, NTU Institute for Health Technologies, was one of the commissioners of the Lancet Report, and hence provided us with a very clear insight of the importance of advocating for global surgery, and how best we could do so at the student level. Prof Lee, chairman of the University Surgical Cluster – National University Hospital (NUH), was also instrumental in guiding the direction of the team and advising on practical steps we can take to reach out to the student population.
The inaugural student-initiated Global Surgery Workshop was held on 12 August 2017 and witnessed the gathering of about 80 students. These students heard the personal experiences shared by surgeons across the nation (Prof Gruen, A/Prof Philip lau, Assistant Prof Bettina Lieske and Dr Chua Wei Chong) and enthusiastic young doctors (Dr Ng Jun Jie, Dr Lin Zhi Min, Dr Linus Chua and Dr Jeffrey Leow).
The shared experiences include that of A/Prof lau's motorbike journey with A/Prof Mikael Hartman from Singapore to Sweden in the name of breast cancer research and education; Assistant Prof Lieske's previous involvement in mission work in Kissizi, Africa; and Dr Chua's surgical mission experience with Tan Tock Seng Hospital. In addition, the trainee doctors shared about their experiences with NUHS' SOUL (Surgical Outreach for Underprivileged Localities) Project to countries around the region, and the challenges that they had encountered.
It was through these stories shared that we students had a deeper appreciation of not only what available opportunities there are for surgical mission work, but also the challenges surrounding them. The event was well received by both students and speakers, and we definitely look forward to organising subsequent similar initiatives for our peers!
Our personal takeaways
It has no doubt been a very fulfilling journey for this project to have come this far, having successfully concluded the workshop. We are very thankful for the mentorship of Prof Gruen and Prof Lee, for imparting their invaluable advice as we continue to steer the future direction of the project.
It has truly been a privilege to be able to pursue fulfilling experiences such as this during our time as students, before we graduate and start working as doctors. Surely, with dedicated mentors and students in the Global Surgery Student Interest Group, we hope to spearhead more of such meaningful activities in time to come.