Vector Volume 11 Issue 1 - 2017

Surgery: Luxury or Necessity?
[Feature Article]
Maryam Ali Khan (Pakistan), Zineb Bentounsi (Morocco), Nayan Bhindi (Australia),
Helena Franco (Australia), Tebian Hassanein Ahmed Ali (Sudan),
Katayoun Seyedmadani (Grenada/USA), Ruby Vassar (Grenada), Dominique
Vervoort (Belgium) -InciSioN international team members
InciSioN, the International Student Surgical Network, is a student-led organisation of
medical students and young doctors from around the globe with one shared passion,
Global Surgery. InciSioN embodies the aim of educating about, advocating for, and
performing research in Global Surgery. Among the 33 members of InciSioN, we share 23
countries spanning over 12 time zones, in 5 continents, and speak over 15 languages.
The seminal report published by the Lancet
Commission on Global Surgery (LCoGS) in
April 2015 highlighted that an estimated 5
billion people continue to lack access to
safe and affordable surgical and anaesthetic
care when required.[1] Often, surgical care is
associated with costly procedures and stateof-the-art
equipment. While that might be true
for a subset of procedures, there are many
lifesaving procedures that are considered
basic public health needs and can be
performed cost-effectively with a simpler set
of equipment. Through domains of research,
education and advocacy, the relatively recent
movement of Global Surgery endeavours to
address and alleviate these vast disparities in
surgical equity, particularly in low and middleincome
countries (LMICs). Here, we would like
to evaluate surgical care on a global scale
from a basic public health standpoint.
Basic surgical care and safe surgery
Surgery is defined by the World Health
Organization (WHO) as “any procedure
occurring in the operating room involving the
incision, excision, manipulation or suturing of
tissue that usually requires regional or general
anaesthesia or profound sedation to control
pain”.[2] Surgery is rendered across all disease
categories, and is an indispensable component
of health care. Essential surgical care is a
distinct concept, meaning surgery necessary
to prevent imminent death or disability. Without
access to essential surgical care, readily
treatable diseases can pose serious threats to
health.
Safe surgery involves avoiding complications
or adverse events that can arise before,
during and after surgical procedures. Thus,
safety measures are implemented before
anaesthesia, before incision, during surgery
and in the provision of post-operative care.
The WHO estimates that every year almost
7 million surgical patients suffer significant
complications, most commonly including
infection, bleeding and various complications of
anaesthesia. More than half of these adverse
events are preventable. In view of this, the WHO
has implemented Guidelines for Safe Surgery
(2009) to define core safety standards, with 10
essential objectives that can be implemented
in any country and any surgical setting. These
serve to reinforce the standardisation of safe
practices, particularly in developing countries.
Cost of basic surgical care
Access to safe anaesthesia and surgery,
or lack thereof, has a considerable economic
impact on both patients and society.
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