When we have a need to address or a problem to solve -- whether hunger or unmet surgical need -- what if we surveyed our assets first, even before defining the scope of the problem?
And once we defined the scope of the problem, what if we thought about how to deploy and bolster those assets to address the need?
If we apply “asset protection” thinking to surgical services in a place like Africa, we would begin with the surgeons who are there right now.
What surgeons, you might ask? Africa doesn’t have any surgeons, right?
Well, in the 10 countries served by the College of Surgeons of East, Central and Southern Africa (COSECSA), there are approximately 1,600 surgeons. As about 850 are fellows or members of COSECSA, we know they are well-trained surgeons, too.
Surprised? I was, because that’s more than just a good start. It is an existing network of surgeons who are in the trenches every day providing services to patients.
It is also in direct opposition to the perception that “no one is doing anything about it.” Someone is doing something about it already, and that someone is the African surgeon committed to working in his or her home country, who has the cultural knowledge to succeed in that environment, and is committed to Africa for the long term.
Most importantly, that surgeon is in a better position than visiting surgeons from abroad to help patients both on a day-to-day basis and for the long term.
And, frankly, without that surgeon, no one gets access to care when they need it, no matter their ability to pay. Without the presence of that surgeon, the patient is disempowered, helpless and dependent on charity.
How would you feel if you needed an emergency appendectomy but no one was there to provide it? I know how I would feel, and where I would be – dead in the second grade in 1980. Glad I didn't have to wait on a foreign surgeon to do a mission trip to rural Kansas!
Solventas is saying that the primary question shouldn't be how to help the patients – that’s the surgeon’s job, and they would do it if they could – it really should be, “What are we doing to help the surgeons?” Do they have the supplies and equipment they need? Are there sufficient job opportunities to keep them in Africa?
Surgeons like COSECSA’s fellows and members are the clear starting point to lead those 10 countries out of the surgical shortage they face, but in many cases, they do not have the tools to do their job.
The surgeons on the ground are the assets that need to be protected and supported, not just by helping surgical organizations like COSECSA, but also -- and especially -- by providing healthcare management training.
Knowing how to earn a living being a surgeon in a low-resource environment like Africa is almost as important as surgical training. If there is no living to be made, that surgeon will use their skills elsewhere.
Perhaps no one is doing anything about that problem – until now.