× Surgery
A combined team of clinicians and support staff work together to perform surgery to correct an 11-year-old boy’s congenital heart defect. The surgery, among others, is the result of a partnership between PIH, sister organization Zanmi Lasante, and The International Children’s Heart Foundation to pe
Photo by Rebecca E. Rollins / Partners In Health

Diseases that are treatable through surgery—such as some cancers—account for 11 percent of the global burden of disease. Unfortunately much of that burden goes unmet. Two billion people lack access to surgical care and many more struggle to find and pay for it.

In Haiti’s Central Plateau, for example, just two orthopedic surgeons serve 500,000 people. When a passenger truck flips on Route Nationale, as described here, hospital staff scrambles. Elsewhere, a lack of surgical care allows easily treatable conditions to become dangerous. Or worse. Surgeries could prevent up to 90 percent of maternal deaths.

Aside from the powerful moral arguments for expanding surgical care, a growing body of evidence suggests that surgery benefits economies. Repairing a cleft palate, for example, can prevent a speech problem that places a drag, emotional and financial, on an individual and his family. “Essential surgical procedures rank among the most cost-effective of all health interventions,” finds the World Bank.

For these reasons and more, surgery is no longer considered a privilege. Improving surgical care, education, training, and research throughout the world is a key priority in global health.

PIH’s Response

PIH participates in The Lancet Commission on Global Surgery. Launched with an introductory comment in The Lancet in 2013, the commission brings together health and policy experts with the aim of ensuring that all people have access to affordable, high-quality surgery and anesthesia.

At many PIH sites, clinicians offer surgical care, including orthopedics, otolaryngology (ear, nose, and throat), plastics, pediatrics, urology, ob-gyn, and general surgery. University Hospital staff in Mirebalais, Haiti, have recently begun working alongside international teams to perform especially complex surgeries, such as pediatric cardiac surgery and neurosurgery.

PIH also hopes to train the next generation of surgeons. Haiti and other sites offer surgical mentorships, residencies, and special education for local physicians. The Paul Farmer Global Surgery Fellowship and the Global Health Equity Residency teach surgeons how to provide care in resource-poor settings, with the ultimate aim of producing surgical researchers and policy advocates.