THE
KINDEST CUT
The campaign for RCSI has secured philanthropic investment to establish the RCSI Institute of Global Surgery which will develop access to surgery for millions of people around the globe.
O
ver the next century, the developing world will witness the fastest rate of population growth ever, resulting in additional pressure on healthcare systems already unable to meet demand. The health problems experienced in the developing world are many and to date there has been an understandable focus on the diseases contributing to this staggering death toll such as HIV, tuberculosis, and malaria. But here’s something that might surprise you. In 2015, The Lancet Commission on Global Surgery reported that each year more people die from lack of access to surgical care than from HIV, TB and malaria combined. Indeed, a staggering 17 million people die each year because of lack of access to safe, timely surgical care. The Lancet Commission was able to bring new attention and focus to a problem that RCSI has unique experience of and has been working to address since 2007. Surgery is an integral, indivisible component of a properly functioning health system. Without any or too few surgeons, routine illness and accidents which need minor, low-tech surgery often turn into life threatening and life ending episodes. Today, it is estimated that 951 million women are without access to emergency obstetric care should they become pregnant.
THE COSECSA/RCSI COLLABORATION More than a decade on, founder and current Honorary Registrar, COSECSA, Professor Krikor Erzingatsian, a graduate of RCSI, Class of 1968, reflects on the relationship between his alma mater and COSECSA: “The most important aspects demonstrated by our collaborating partnering colleagues [RCSI] have been integrity, generosity towards the underprivileged, and professionalism.” In recognition of his contribution to surgery in Africa, Professor Krikor Erzingatsian was conferred an Honorary Fellowship of RCSI in 2017.
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The Lancet Commission suggested that countries should have a total combined minimum of 20 surgeons, anaesthetists and obstetricians per 100,000 people, equating to approximately ten surgeons. As the first and only institution to continually track and map surgeon numbers across ten African countries, RCSI is able to report that within this region there are 1,690 surgeons for a combined population of 320 million – in Malawi and Mozambique, for instance, there are 0.25 surgeons per 100,000, with Kenya at the top of the table with just 1.2 surgeons per 100,000 (Ireland has 13.1). RCSI, with a network of alumni in 97 countries and a reputation as instigators of betterment and change, is implementing programmes that make a significant and immediate impact on the ground in these countries.
Addressing longterm demand
Since 2007, with funding from Irish Aid, RCSI has partnered with COSECSA (The College of Surgeons of East, Central and Southern Africa) to provide surgical specialist education and training to medical practitioners in Africa. The largest single contributor to the workforce in the area, COSECSA, with RCSI support, has trained 15 per cent of all surgeons in the region and more than half of all current surgeons in training in the region are in COSECSA programmes. And there are bigger ambitions afoot.
From top left: The mobile training unit; Professor Krikor Erzingatsian, Honorary Registrar, COSECSA; RCSI and COSECSA colleagues.
