Abstract
Low- and middle-income countries carry a disproportionate share of the global burden of pediatric surgical disease and have limited local healthcare infrastructure and human resources to address this burden. Humanitarian efforts that have improved or provided access to necessary basic or emergency surgery for children in these settings have included humanitarian assistance and disaster relief, short-term surgical missions, and long-term projects such as building pediatric specialty hospitals and provider networks. Each of these efforts may also include educational initiatives designed to increase local capacity. This article will provide an overview of pediatric humanitarian surgical outreach including reference to available evidence-based analyses of these platforms and make recommendations for surgical outreach initiatives for children.
Highlights
Medical and technological advances over the past 100 years have produced vast gains in the prospects for the health and well-being of children worldwide
Surgical humanitarian outreach currently is most often delivered in a short-term application, whether by short-term surgical missions, often 1–3 weeks in length, or by international organizations responding to a crisis, with a plan to deliver emergency services for a limited time period
In any short-term mission, safety and outcome optimization should be prioritized, and mission participants must have expertise in the conditions they will manage. This is a critical consideration in pediatric surgery, where exposure to index cases encountered in low and middle-income countries (LMIC) may be limited after training [43]
Summary
Medical and technological advances over the past 100 years have produced vast gains in the prospects for the health and well-being of children worldwide. Children in many low and middle-income countries (LMIC) still face threats to health and development that high-income countries faced in the previous century, in the area of surgical disease. Recent global health advocacy has focused on surgical systems strengthening as a component of universal health care This has been brought to the forefront with the publication of Global Surgery. This publication reveals that 44 basic surgical interventions and the related anesthesia are cost-effective for all LMICs, at the level of the First Referral Hospital This change will dramatically impact access to basic pediatric surgery if the recommendations are implemented. There is increasingly a realization that achieving these goals in light of this demographic shift will require more policies focused on child survival and support in low-income countries [10], and these policies must include safe surgery. Safe and timely surgical care for children is of particular importance in regions with the most limited access to it
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