When 8 year old Pablo entered a hospital in Peru with a swollen belly and a lump in his groin, he needed a basic surgical procedure to save his life. Instead, Pablo died because there were not enough surgeons trained to do this type of surgery. His death was the moment that Matthijs Botman, at that time a visiting medical student interested in global health, started to realise the importance of safe and effective surgical care in resource- limited settings.
Later, when he worked as a global health doctor in a small rural hospital in Congo, patients languished in hospital beds, waiting for a surgery that might never come. Local doctors received regular training to improve care for patients with HIV, Tuberculosis or Malaria, but they also had to perform essential surgeries, while adequate surgical training was lacking and equipment unavailable. As Matthijs continued his work as a global health doctor in Tanzania, the same scenario played out again: many patients needed surgical care, but the health system was not sufficiently supporting this need. Surgical team members were limited in number, effective training activities unavailable, and equipment scarce. As a result, patients were dying unnecessarily.
His experiences were not unique. Surgical care seemed to be an ignored part of global health in the past decades. Other global health doctors from the Netherlands were facing the same challenges in low and middle income countries (LMICs) around the world. They all found themselves asking the same questions about their peers in LMICs:
“How can we help them to improve surgical care? Why are there insufficient training opportunities? Where is the research?”
These Dutch doctors were at the forefront of a seismic shift in the field of global surgery. Traditional medical missions of short-term surgical trips to low income countries by doctors from a high income country were no longer sufficient. While the visits clearly benefited the patients they saw, they often did nothing to address the system that was unable to provide those surgeries for their own patients in the first place. The way forward had to be sustainable and needed a more comprehensive approach. Global health doctors, surgeons and anaesthetists from the Netherlands could help to play a pivotal role in this new field of global surgery. As a result Global Surgery Amsterdam was created.
Global Surgery Amsterdam has a focus on education, training, research and technology to help close the global gap in access to safe and effective surgical care. We aim for a collaborative model with experts from different fields and different settings to achieve global health equity.