Global engagement
Myron Yaster MD, Faye Evans MD, and Zipporah (“Zippy”) Gathuya MD
Ron Litman’s Pediatric Anesthesia Article of the Day has an executive council to guide and write the daily reviews of the pediatric anesthesia literature that arrive in your mailboxes daily. We have editor/reviewers in cardiac anesthesia, regional anesthesia, pain, critical care, airway management to name a few. Today, we are adding Drs. Faye Evans (Boston Children’s Hospital) and Zipporah (“Zippy”) Gathuya (Kenya) to our team with the responsibility of alerting us to developments in Global Health. Today’s PAAD comes from the April issue of the ASA Monitor which has several articles devoted to Global Health and Engagement.
I’ve got to admit that I’ve been leery of mission trips that provide individuals without access to safe surgery and anesthesia with life changing surgery like cleft lip repair. There’s no question that this is important work but I’ve personally been more interested in developing sustainable partnerships and infrastructure which can improve health access to greater number of people (“give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime”). As discussed at the recent annual meeting of the Society for Pediatric Anesthesia, “Updates from Mission Driven Mentoring Program (MDMP) Award Recipients” the need to train PEDIATRIC anesthesiologists in Africa is of extreme importance to all of us. The April issue of the ASA Monitor provides a detailed list of resources for both types of involvement, mission work and developing and training pediatric anesthesiologists and is possible whether you are in training, in a clinical academic or private practice, or in retirement. It has also emphasized that this engagement needs to be two-way which is of utmost importance.
Finally, whenever we present articles on this topic, I like to end my introduction to the PAAD with a request to consider donating to LIFEBOX, a global nonprofit with the goal of making surgery and anesthesia safer worldwide. To date over 33,000 pulse oximeters have been provided to limited resource countries and yet the need remains huge. In this holiday season I would urge you and your anesthesia group to donate. https://www.lifebox.org/ Myron Yaster MD
Original article
Ana Maria Crawford, MD, MSc, FASA; Kumar G. Belani, MBBS, MS, FACA, FAAP, SAMBA-F; Elizabeth T. Drum, MD, FAAP, FCPP, FASA. Global Engagement – What Does It Mean? ASA Monitor April 2023, Vol. 87, 16–17. https://pubs.asahq.org/monitor/article/87/4/16/137943/Global-Engagement-What-Does-It-Mean
“Global engagement is a broad term, representing many things to different people. Some assume “global” always implies global health, as exemplified by individuals and programs teaching and working for the benefit of limited-resourced settings. Some think global engagement means clinical service, where teams travel abroad to provide patient care. Others think of themselves or their global colleagues, born or raised in other countries and now practicing in the United States, still engaging with colleagues in their native countries. Others recognize the global diversity of patients, reflecting on how best to care for people with different cultures, religions, or languages. Lastly, it seems impossible not to mention the global advocacy coming from all sectors and industries during the pandemic”.
In my past life, I (MY) found that US Agency for International Development was not really interested in surgery, trauma, or anesthesiology. Higher on their agenda was clean water, vaccination, treatment of communicable diseases such as HIV, TB, malaria etc. Nevertheless, the need for safe surgery and anesthesia is important and life changing. “As anesthesiologists, we are perioperative, pain management, and critical care medicine physicians, and are invaluable advocates for patients, whether preparing for surgery or pandemics. Anesthesiologists also offer expertise on public health challenges such as safety of blood products, physician oversight, and the coordination of care. Nongovernmental organizations, industry, hospitals, and ministries of health are all stakeholders with which anesthesiologists engage”. Thus, the need is great. You may wonder, “why should I be involved and how can I get involved”?
Crawford et al. provide some important answers. First, “global engagement contributes to a multiplicity of perspectives, strengthening our anesthesia community. Anesthesia practices are filled with globally diverse patients deserving of culturally competent care. Further, our practices are filled with colleagues from across the globe, knowledgeable and willing to share their culture. International medical graduates make up 25% of the physician demographic in the United States”. Second, “global engagement improves our mental health and well-being – good news in a rising tide of burnout”. Third, “globally engaged physicians are more likely to work with underserved populations. We need not leave our communities or country to serve vulnerable populations. Mission trips can be taken at a local homeless shelter or free clinic. One can also travel internationally within the U.S. There are 574 federally recognized Native American nations within our borders, many suffering worse health outcomes than the lowest-income countries.” Finally, “global engagement is an opportunity for anesthesiologists to expand their commitment toward the ultimate goal of good health and well-being for all people. Globally informed engagement not only strengthens advocacy for patients but also adds value to our preeminence as physician leaders”. Many years ago when I (FE) first met Dr.Atul Gawande (in addition to be the current Assistant Administrator for Global Health is also the founder of Lifebox) I asked if he was interested in global health. I am reminded of his answer even today- “I am interested in everyone having access to good quality healthcare regardless of where they live.” Global engagement is a necessity to making global health a reality.
You and I can do it! Let us know your thoughts and Myron will post in a Friday Reader Response.