ReSurge’s Visiting Educator trips to Bhutan are making an impact after just over a year working in the country. This week, a VE team is in Thimpu conducting training in hand surgery and hand therapy at Jigme Dorji Wangchuck National Referral Hospital. In January, a winter month when the use of wood-burning stoves spikes, the focus was on burn care.
We recently spoke to Katie Osborn, ReSurge nursing VE, about her Bhutan experiences over the past year.
Improving the Standard of Wound and Burn Care
On her first trip to Bhutan last June, Katie traveled to Thimpu to train nurses in burn and wound care. As she began her first lecture on burn care, she spoke about the importance of the initial skin assessment. The nursing staff responded enthusiastically and pulled her into the ward to show her patients at high risk for skin breakdown and get some tips on preventing it. They spent time at each patient’s bed, with Katie giving advice on how to improve the quality of care—turning patients hourly, positioning them with their heels off the mattress and other tips. According to Katie “I did rounds with the nurses on Monday. By Tuesday, they were able to proudly show me all the changes they had made to implement my suggestions. I was so surprised and impressed. This team really soaks up knowledge!”
Katie was even more impressed when she returned to Jigme Dorji Wangchuck Hospital in January 2018 with a team of visiting educators and found that the nursing staff had made the skin assessment a standard part of the patient’s chart! As Katie says, “Doing a daily skin assessment will go a long way to prevent skin breakdown, shorten patients’ hospital stays, and reduce pain.”
With this practice now part of the patient chart, Katie and ReSurge’s VE teams have improved the standard of wound care in this hospital.
The Need for Training in Medical Specialties
Katie found a talented and caring nursing staff hampered by resource shortages and a lack of specialty training. For example, while a burn unit in the US might have a nurse-to-patient ratio of one to one, in a developing country like Bhutan, it can be as low as one nurse for every 20 patients. The staff at Jigme Dorji Wangchuck Hospital has just one nurse who is trained in wound care.
Because of Bhutan’s small size (the country’s population is approximately 800,000), patient volume for any one specialty is low and there are consequently very few specialists in the country. At present, patients who require specialist treatment are stabilized in Bhutan and flown to India for treatment.
On the ReSurge team’s visit, a patient with severe burns on her lower legs had been in the hospital for a month and had not yet received the necessary skin grafts. The delay increased her risk of the infection that eventually set in, extending her hospital stay to a total of about six months. A patient in similar condition in the US would likely have received skin grafts within approximately 5 days, and been back at home in 10 days.
ReSurge’s visiting educator program offers an opportunity to improve the standard of patient care in this hospital through repeated visits to train the talented local team in the procedures and practices that will have the biggest impact on their patient population.
*This post, by ReSurge International President and CEO, Jeff Whisenant, was originally posted on the InterAction blog.
The challenges facing women interested in a surgical career are daunting anywhere. For women in developing countries, those challenges are far greater. Yet, it is these countries that are in most need of additional surgical expertise.
Today, five billion people worldwide lack access to safe, timely and affordable surgical care. Common maladies treated by reconstructive surgeons, such as injuries, malignancies and congenital conditions are far more readily addressed in countries like the US, where most families — even those without health insurance — have access to immediate medical attention and the kind of surgical intervention that can make a critical difference. In many developing countries, poor families cannot afford such medical help.
Read the full article here.
Lemy is a curious, charming 8-year-old "superhero" we met at Lusaka's Italian Mission Hospital's clinic day.
Every Tuesday Dr. Goran Jovic, ReSurge's Surgical Outreach Partner in Lusaka, holds a clinic to assess patients and set his surgical schedule for the coming weeks and months.
Lemy, who is returning for yet another procedure, was attacked by a dog at age 6. He was badly mauled, leaving his cheek and nose an open wound. As he healed, his skin contracted, leaving him at risk that his nose would close up and prevent him from breathing.
Dr. Jovic provided a stent to prevent this from happening, and has performed grafts to repair the damage to Lemy's cheek and nose.
Lemy now has the confidence to smile for and interact with, ReSurge's film crew. We are so happy to see the change in Lemy--he really is a superhero!
Dr. Jovic is one of just five plastic surgeons in the countries of Zambia and Zimbabwe combined, where there are approximately 33 million people. With well-established programs in Latin America and Asia, ReSurge hopes to expand the scope of its work in Africa, treating more patients like Lemy and supporting the training of more plastic surgeons such as Dr. Jovic.
This is an exciting time to be a provider of surgical care in developing countries. In the last several years, the academic medical community and international bodies such as the World Bank and the World Health Organization (WHO) have begun to study surgical care and promote it as a critical solution for improving health and economic growth in developing countries. Click below to continue reading...
From November 3-5, ReSurge, along with the Cuban Ministry of Health, sponsored a symposium on reconstructive surgery in Havana's Hospital Calixto Garcia, one of the premier hospitals in Cuba. The symposium, a survey course, was attended by 280 surgeons from all over the country. Click below to continue.
In late August, a visiting educator team made ReSurge’s inaugural visit to Mozambique, as part of a joint trip with partner organization Mending Kids. Mozambique, in southeastern Africa, has for a decade been one of the fastest-growing countries in Africa, posting average annual growth rates of 6-8%. Despite this growth, it remains extremely poor, with approximately 52% of the population below the poverty line. (Source: CIA World Factbook) Click below to continue reading.
Bhutan, a constitutional monarchy about the size of Switzerland, borders the Himalayas, and sits between India and China. As a mountainous, land-locked country, Bhutan is geographically isolated. Its isolation is magnified by a historical policy of barring foreign tourists to protect its culture and traditions. Click below to read more...
Jeff Whisenant, CEO of ReSurge International, Dr. Kiran Nakarmi, surgical outreach partner in Nepal, and Eileen Sheldon, ReSurge board member, pause for a moment during Congressional Briefing on Surgical Care and Global Need in Washington, DC.
By Eileen Sheldon
On May 10, 2016 I had the pleasure of attending the second Congressional Briefing on Surgical Care and the Global Need, hosted by ReSurge International and the G4 Alliance. It was my first experience on Capitol Hill and it was a privilege to participate in this informative event. The briefing called on congressional staffers, NGOs and other government representatives to understand the elevated need for surgical care and the impact that access to surgical care can have on the lives of people in low- and middle-income countries. Experts in the field formed a panel that was moderated by Dr. Thomas Novotny, the deputy assistant secretary for health, U.S. Department of Health and Human Services.
The panel’s distinguished speakers included Dr. Ross "Rusty" Segan, Chief Medical Officer, Global Orthopedics & Global Surgery, Johnson & Johnson and Dr. Mark Shrime, research director, Program in Global Surgery & Social Change at Harvard Medical School and member of the Lancet Commission on Global Surgery.
Across the panel, speakers focused on the cost-effectiveness and the cross-cutting impacts of investing in surgical care. For instance, it was reported that 18 million people die each year due to surgically treatable conditions. Simple surgeries can treat a wide range of conditions and diseases, ranging from maternal and child health, trauma, prevention of HIV/AIDS, and even non-communicable conditions like cancer and heart disease. The financial strain of not investing in this gap could result in a $12.3 trillion loss in GDP by 2030 for low-and-middle-income countries.
ReSurge's own Surgical Outreach Director in Nepal, Dr. Kiran Nakarmi, offered a personal and moving description of how the ongoing need for surgical care in his country intensified after the earthquake one year ago. Thanks to prior investments and a commitment to training made by ReSurge, he was able to provide life-saving procedures on earthquake victims who were in dire need of reconstructive surgery. Furthermore, physical and occupational therapists previously trained by ReSurge were available to provide post-surgical care. Dr. Nakarmi and his team continue to treat those whose wounds have not healed properly.
Together, these partners are poised to improve the landscape of global health. ReSurge's history and model for building surgical capacity are certain to play a critical role in in this growth.
Eileen Sheldon currently sits on ReSurge International’s Board of Directors. With a professional background in research and planning, Eileen remains committed to volunteer work. In the past, her dedication to service has led her to Boston, New York City, and Los Angeles, where she trained and guided blind runners through various races. In October 2013, Eileen’s passion brought her to Cox’s Bazaar, Bangladesh. Since that time, Eileen has continued playing an active role in supporting ReSurge’s mission to provide reconstructive surgery for people in the developing world.
Dr. Kiran Nakarmi, ReSurge Nepal's surgical outreach director pictured above, will join speakers from the Lancet Commission on Global Surgery, Johnson & Johnson, U.S. Department of Health and Human Services and others on Capitol Hill to advocate for greater access to safe surgical care in developing countries.
In collaboration with the Congressional Global Health Caucus, ReSurge International and the Global Alliance for Surgical, Obstetric, Trauma and Anesthesia Care (The G4 Alliance) will host a Congressional Briefing on Surgical Care and the Global Need at 2 p.m., Tuesday, May 10, in Washington, DC.
To support our mission to build surgical capacity and provide reconstructive surgical care for those in need, ReSurge works to raise the profile of surgical care as a critical component of global health and advocates to the U.S. government and in the UN system for greater access to care.
Dr. Kiran Nakarmi, ReSurge Nepal's surgical outreach director, will join speakers from the Lancet Commission on Global Surgery, Johnson & Johnson, U.S. Department of Health and Human Services and others on Capitol Hill. They will share the latest findings on the global impact of this public health issue, as well as cost-effective strategies for strengthening health systems and increasing access to surgical care to those in low-income countries.
Around the world, 5 billion people do not have access to safe, affordable surgical and anesthesia care, with only 6% of all procedures benefiting the world’s poorest third. Yet, surgical care, including safe anesthesia, obstetric and trauma care, is a cross-cutting, cost-effective public health intervention to enhance health, productivity and economic development – and is essential to health systems strengthening.
Surgical conditions represent nearly a third of the global burden of disease. The Lancet Commission estimates that in 2010 alone, there were nearly 17 million surgically preventable deaths. The price of closing this global gap is estimated around $350 billion in low-income countries over the next 15 years. However, the cost of not investing in surgical care is projected to result in GDP losses as high as $12.3 trillion dollars in low-income countries. Global surgical care and anesthesia disparities have a far-reaching impact, affecting billions across all socioeconomic and demographic strata.
You can help advocate for safe surgical care for the 5 billion people in the world who lack access to timely, safe and affordable care. Here are a couple of ways to help today:
ReSurge appreciates your advocacy on behalf of those in need of surgical care. If you have any questions or want to get more involved, please contact Sara Anderson, ReSurge’s senior advisor for advocacy and innovation, at sara@resurge.org.
Sample Email to Send to Your Congressional Representative:
Dear Representative ____:
Thank you for representing me and my community in the _(#)_ Congressional District of _(state)___. I am a (medical volunteer/supporter) of ReSurge International, which builds surgical capacity and provides reconstructive surgical care in developing countries. I’ve seen first-hand how access to surgical care saves lives and reduces disabilities.
Increasing access to essential surgical care in low-income countries is important to me. It is a cross-cutting, cost-effective public health intervention to enhance health, productivity and economic development – and is essential to health systems strengthening.
To learn more about this critical issue, I would appreciate it if a member of your staff could attend a Congressional Briefing on Surgical Care and the Global Need at 2pm, May 10, in the Gold Room, RHOB. To RSVP, please click here.
This briefing is in collaboration with the Congressional Global Health Caucus and is hosted by ReSurge International and the Global Alliance for Global Alliance for Surgical, Obstetric, Trauma, and Anesthesia Care (The G4 Alliance). For further information, please click here or contact Sara Anderson at sara@resurge.org.
Thank you for your consideration.
(Your name and address)