By: 21 July 2016
Review of the Fifth Annual Conference on Global  Surgical Frontiers

The Royal College of Surgeons of England, London; 15 April 2016

Practising medical professionals, junior doctors and humanitarian activists gathered to address issues raised in the Lancet Commission on Global Surgery and consider how high-income countries should engage in global surgery over the coming decade

Review by World Orthopaedic Concern

The Lancet Commission published its report on global surgery one year ago, inviting recapitulation on its analysis, conclusions and responses for the future of the world’s under-resourced areas. The Lancet’s graphic cartoon of the globe and its distribution of surgical services was much in evidence, serving as a salutary warning of a nearly scandalous situation under which (neglected) common and simple injury can destroy a working life. The greater part of the world’s poorest communities are tragically deprived.

Of course, those are rough words to use on a situation that is to be pitied rather than criticised, but the Fifth Annual Conference on Global Surgical Frontiers, held at the Royal College of Surgeons in London in April, demonstrated the wide and continuing interest and concern for the subject.

The audience was divided between those already active ‘in the field’, junior hospital doctors fascinated by a subject that is hardly referred to in medical school curricula, and humanitarian activists, both religious and secular.

Professor Chris Lavy, of the Royal College’s department of international affairs, introduced an erudite faculty of experts, from near and far, who are involved with organised trauma service and international surgical needs. These experts are constantly engaged in chairing international bodies on the subject so it was small wonder that their speeches were polished, profound and polysyllabic, conveying the whole world’s opinion.

Laurence Wicks gave a sparkling performance in rhyming verse, on the glorious achievements (and enjoyment) of both the young and old members of World Orthopaedic Concern (WOC) UK, on behalf of the halt and the lame of southern Africa. His infectious enthusiasm lifted the spirit of the packed hall. The energy of the audience was palpable and at the breaks between sections, a queue formed at the WOC desk to enlist in the adventure.

Perhaps the most powerful of the set piece presentations was from Zambia, by Professor Emmanuel Makasa. His wide contact through the College of Surgeons of East, Central and Southern Africa (COSECSA) and WOC has done much to strengthen the educational programmes from sub-Saharan Africa. As Secretary-General of the Zambian Surgical Society and the Zambian Medical Association, Makasa has been instrumental in many recent modifications in the method and emphasis of surgical training through sub-Saharan Africa. He has advisory connections with the World Health Organization (WHO) and United Nations in Geneva.

Presentations in the final sections came from Declan Magee, Mike McKirdy, Robert Lane and Walter Johnson among others. Their communal concerns were addressed in the final question, raised by Louis Deliss, who has connections with Palawan in the Phillippines. Deliss asked ‘what help could and would WHO be able to offer in support of the conference’s constructive requests and suggestions?’ It emerged from every speaker that WHO, with all its apparent influence and publicity, actually has no funds with which to offer assistance, nor any leverage on the international stage. This realistic statement disappointed, but did not surprise anyone in the audience at this excellent meeting.

The Lancet Commission is left with dependence on the generosity of the great philanthropic organisations to stem the tide of desperation in sub-Saharan Africa and the equivalent parts of every other continent. But concern can quite quickly become depression as the magnitude of the global need for relatively inexpensive surgical treatment of everyday accidents is realised.

It is hoped that those bodies responsible for the establishment of WHO might be moved by the energy generated by this 21st century ‘slow motion car crash’. Philanthropy will not cease; but recognition and appreciation would not go amiss.