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Global Surgery: A new public health culture

A shift in disease
Globally, two billion people do not have access to basic surgical care. Though historically Public Health focused on infectious diseases, it is increasingly clear that more people worldwide suffer from non-communicable diseases (NCDs) and trauma. Surgical care is not only needed for large traumatic injuries, but also birth defects, maternal health, cancer, and diseases associated with aging that often require surgical intervention. Annually, NCDs are responsible for 63% of global deaths; 80% of these deaths occur in developing countries.

Essential, affordable care
As the “neglected stepchild of public health”, mentioned by Drs. Jim Kim and Paul Farmer, surgical care must be recognized as a cost-effective, basic component of healthcare for all individuals. To put into perspective the critical need, estimates suggest that at least 3 million women in low-income countries have unrepaired vesicovaginal fistulas (VVFs), and approximately 30,000 to 130,000 new cases develop each year in Africa alone. Increased access to affordable surgical care enables patients suffering from VVF and other conditions requiring surgery to return to healthy, productive lives.

In fact, investments in surgical care in many cases have proven to be less costly than traditional public health interventions. One measure used in the analysis of cost related to disability is the DALY, or “disability-adjusted life year”. It projects the total years of life lost due to the burden of disease. One DALY equates to one year of productive, healthy life lost. In Zambia, the estimated cost per DALY averted for caesarian section for obstructed labor is $319. This cost is well within the budget of other public health measures, such as antiretroviral treatment of HIV.

Focused initiative
Successes like the 1970s campaign to eradicate smallpox demonstrate the power of a concerted public health effort. Surgical programs for prevention and treatment of disease could confer similar public health benefits. The demonstrated success of capacity-building programs like IVUmed’s reveals that educational efforts to improve affordable surgical care are possible and effective. Public health professionals, bioengineers and physicians are moving toward a united front on the burden of surgical disease.

In 1968, the U.S. Surgeon General foresaw that, “It might be possible, with interventions such as antimicrobials and vaccines, to close the book on infectious disease and shift public health resources to chronic diseases.” Yet over 40 years later, 28% of the world still has no access to surgical care. The new statistics are changing the focus of public health discourse. From academic centers to social media blogs, professionals are sharing ideas for affordability and availability of surgical care.

Global surgery conferences, such as the 2013 Extreme Affordability Conference hosted by the University of Utah’s Center for Global Surgery, are being held across the country.

Also, social media has recently given global surgery a voice on the internet. Twitter search “#globalsurgery” provides an endless list of conversations, article links, and event streams. The conversation has started and projects are being initiated. However, the public health community needs to ask, is the effort focused?

Strategy in action
As a surgical education organization, IVUmed recognizes the need for efficient, concerted efforts to provide access to surgical care. IVUmed’s services have been requested by many surgical and urological organizations to help increase access to care in resource-limited parts of the world. This global strategy increases the reach of our united efforts.

Establishing greater access to professional training among surgeons worldwide creates a foundation for an improved healthcare system. As IVUmed and its partners develop self-sustaining surgical education programs, greater access to quality care is made available where it is needed most.

According to the World Health Organization (WHO), 11% of the global burden of disease can be treated with surgery. Building the capacity necessary to meet this demand involves developing partnerships, accessibility, and affordability. Following in the footsteps of successful public

health efforts of the last century, IVUmed is joining the world’s leading organizations in creating surgical education models to lay a similar foundation.

 

Join a Global Effort
If you are interested in furthering IVUmed’s mission to make quality urological education and care more widely available, please visit our website at www.ivumed.org or contact our office at 801.524.0201.

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Bringing ideas and countries together with telehealth

IVUmed is invited—and invited back—by host countries that see us as long-term partners. To make the most of the interval between each hands-on surgical training workshop, we have increased our use of telehealth technology.

In partnership with the University of Utah, we have conducted a series of lectures and consultations with our colleagues in Rwanda. This allowed IVUmed volunteers to provide some initial training before hitting the ground in Kigali for their first on-site workshop.

IVUmed is currently working to increase access to this valuable technology among its partner sites and is developing a digital training platform that will combine videoconferencing, distance consultation, and content libraries. This software, developed by IBM and Boston Children’s Hospital, will make an entire digital learning package available to doctors and nurses in low resource—and importantly—low bandwidth areas of the world.

IVUmed partners around the globe wish to participate in this learning format. In fact, 93% of those surveyed stated that they are very interested in telehealth training in their facilities.

Through videoconferencing, online learning libraries, and remote consultation, our volunteers’ efforts have an even greater impact. They provide further education on concepts covered during workshops to maintain continuity and to prepare for further hands-on instruction. The technology also allows our volunteers to provide remote training in multiple countries at the same time.

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Board member, Dr. Francis Schneck and daughter, Meghan recognized by local community for service in Zambia

Board member and Medical Services Committee Chair, Dr. Francis Schneck, recently led our workshop in Lusaka, Zambia. His daughter, Meghan, joined the team to help with logistics and interacting with the patients. Her high school field hockey team recognized her off-the-field time was worth it!

Read more: Mt. Lebanon field hockey player helps African mercy mission 

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American College of Surgeons Present Surgical Humanitarian Award

American College of Surgeons’ Clinical Congress officially presented Dr. Catherine deVries, Founder and President of IVUmed, with the Surgical Humanitarian Award:

Dr. deVries received the Surgical Humanitarian Award for dedicating 20 years of her career to improving urological care around the world. A practicing pediatric urologist, founder and director of the Center for Global Surgery at the University of Utah, Salt Lake City, and professor of surgery at the university, Dr. deVries recognized the unmet needs of children with genitourinary conditions and anomalies, and developed a model of care tailored to the needs of these patients. In 1994, she founded International Volunteers in Urology, the first not-for-profit organization specifically focused on teaching urology in resource-poor settings. Using a comprehensive, sustainable approach, IVU (now IVUmed) oversees highly skilled teams that train physicians and nurses in most areas of urology throughout Asia, Africa, and the Americas. The far-reaching impact of these educational partnerships can be seen in countries like Vietnam, where early IVUmed trainees have established a urology training center in Ho Chi Minh City, which treats more than 1,000 patients annually and trains local physicians. In Honduras, local partners now conduct their own surgical outreach workshops. Similar successes have been achieved in the 30 countries where IVUmed is active and further leveraged by a wide range of international partnerships.”

We are thankful to have a leader among leaders here at IVUmed, Dr. deVries has established an organization that now sits at the table of leaders in global surgery, recruiting some of the most-skilled, humble and dedicated surgeons to teach surgical skills around the world.

For the rest of the article and award announcement, please go here: http://www.facs.org/clincon2012/press/volunteerism.html

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President and Founder, Dr. Catherine deVries’ with Dr. Ray Price are awarded for their efforts.

IVUmed’s President and Founder, Dr. Catherine deVries was awarded the Surgical Humanitarian Award from the American College of Surgeons along side Dr. Ray Price, who was awarded the Surgical Volunteerism Award through the same organization.

Dr. deVries’ efforts in surgical education worldwide does not go unnoticed. With the formation of IVUmed over 20 years ago, Dr. deVries has developed with the help of staff and fellow board members, a surgical urology education platform embraced by physicians around the world.

“It’s my career,” deVries said to KSL 5 News, “It’s what I do. This is my passion.”

This passion has lead to IVUmed’s successes in building relationships with 30 countries since its inception. Building these relationships, local healthcare professionals have learned valuable urological skills to treat their communities.

For the full KSL 5 News Interview: World-traveling surgeons awarded for humanitarian work
American College of Surgeons: Fellows honored for volunteerism

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Haiti, June 2012

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Father’s Day 2012

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IVUmed is committed to making quality urological care available to people worldwide.