Responding to Rising Surgical Needs
Harald Veen FRSCEd Chief Surgeon International Committee of the Red Cross
Surgery in the Developing World • only 10% of all major surgery required is actually performed • only 2% of all minor surgery required is actually performed • 10% of surgery requires specialist surgical training •
40% of surgery requires surgical training
•
50% of surgery requires minimal training
“Disasters seek out the poor and ensure they remain poor�
Didier J. Cherpitel Secretary General of the International Federation of Red Cross and Red Crescent
Number of Physicians
ICRC hospital positions
• 2013:
50
• 2014:
130
ICRC 2015 budget
• 1.6 billion CHF • 21% increase
Seven sins of humanitarian medicine. 1. Leaving a mess behind. 2. Failing to match technology to local needs and abilities. 3. Failing of NGO's to cooperate. 4. Failing to have a follow-up plan. 5. Allowing politics, training, or other distracting goals to trump service, while representing the mission as "service". 6. Going where we are not wanted, or needed / being poor guests. 7. Doing the right thing for the wrong reason .
Welling ea Norman M. Rich Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, USA .
World J Surg 2010
Welling DR, Ryan JM, Burris DG, Rich NM World Journal of Surgery 2010 •
Norman M. Rich Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda,, USA
Humanitarian Aid Scene • Concept of ‘experience’ • Up to date? (DC) • Business / Politics / Religion
Responding to Rising Surgical Needs
Harald Veen FRSCEd Chief Surgeon International Committee of the Red Cross
Requirements Humanitarian Surgeon Experience Broad Range of Skills Official Registration Available Language, teamwork, religion, skin color, …………………… • Quality • • • • •
• only 10% of all major surgery required is actually performed
• only 2% of all minor surgery required is actually performed
• 10% of surgery requires specialist surgical training
• 40% of surgery requires surgical training
• 50% of surgery requires minimal training
Primam non nocere • Majority of VVF iatrogenic • O.M. and inadequate # treatment • CS rate 5-15%........
‘just’ a general surgeon?.....
COMEDS
COMBAT SURGEONS CURRICULUM
MOST
UK International Emergency Trauma Register
STAE
6th International MSF Surgery Workshop D端sseldorf
Tel Hashomer
Number of Physicians
RECRUITMENT 2ND half 2014:
• • • •
51 surgeons 28 anaesthetists 44 ward nurses 15 OT nurses
OTHER ORGANISATIONS
1 shared surgical training center ?
To provide Protection and Humanitarian Assistance to the victims of war, armed conflict and disasters