Experts from the University of Birmingham-led NIHR Global Health Research Unit on Global Surgery have set the blueprint for change in tackling challenges that cut across health systems and help strengthen global healthcare.
In an article in The Lancet, the authors suggested that surgeons must lead healthcare transformation across the Global South.
It requires integrating surgery into the global health agenda and advocating for simple, cost-effective surgical procedures that strengthen the overall health system.
Establishing ambulance services, strengthening primary care, and improving diagnosis pathways will ensure patients can access early diagnosis and treatment, reducing overall health costs.
Surgeons can become influential system leaders by tackling challenges across health systems. For example, surgeons can deliver change in energy security by supporting on-site renewable energy generation installation.
Fragile energy supplies at hospitals in low- and middle-income countries (LMIC) lead to avoidable patient harm, which means that secure energy initiatives will benefit all patients.
Co-author Dr Dmitri Nepogodiev, from the University of Birmingham, commented: ‘Surgeons can lead positive healthcare change that benefits patients across the Global South. By proactively reaching out to local communities and policymakers, surgeons can shift the common but mistaken perception of surgery as a drain on resources to a vision of surgery as a powerful engine for strengthening both health systems and wider civil society.’
The NIHR Global Health Research Unit on Global Surgery is already taking the first steps toward sustainable healthcare.
Last year, it welcomed surgeons and academics from around the world to the University of Birmingham to discuss research to achieve net zero emissions in operating theatres.
Co-author Mr Aneel Bhangu, Professor of Global Surgery and NIHR Lead Clinician Scientist in the NIHR Global Surgery Unit at the University of Birmingham said: ‘Operating theatres, safe maternity care, vaccine cold chains, and laboratory and radiology diagnostics all depend on a constant electricity supply – not always achievable in the Global South.
‘Secure, on-site energy generation would substantially benefit all patients while installing renewable energy would also accelerate healthcare sector decarbonisation, even as provision is scaled up to meet needs. Surgery is the most energy-intensive activity in the hospital, making surgeons well placed to take the lead in creating energy-secure, low-carbon surgical systems.’
Last year’s ground-breaking ‘green surgery’ event at Birmingham built on earlier research success in this field, including the first documented ‘net zero’ operation in the NHS – a patient discharged safely and recovering well from a keyhole procedure to remove bowel cancer.
Performed at Solihull Hospital in 2022, this operation saw University of Birmingham experts working with a surgical team at University Hospitals Birmingham NHS Foundation Trust to complete the operation.
The operation introduced several changes to standard practice, such as using reusable gowns, drapes and scrub caps; minimising electricity use; and giving medications through the veins for general anaesthesia rather than using anaesthetic gases, which have a strong greenhouse effect.
