Surgical Delivery in Under-resourced Settings: Building Systems and Capacity Around the Corner and Far Away

摘要: Service to patient and community has always been the sacred vow of every physician. Certainly for those marginalized in society—by poverty, plague, isolation, or disaster—our obligationtakesonrenewedimportance.As thephysicianFrancis Weld Peabody wrote his classic essay “The Care Patient,” “One essential qualities clinician is interest humanity, secret care caring patient.”1 During past decade, this focus oncommunities inneedhasbeenreinforced thesurgicaldisciplines by growing global surgery. Global surgery practice surgery—and development systems surgical care—in resource-limited settings. We now seeanewgenerationof traineespursuingcareers inglobal surgeryandanexplosionof fellowships, training tracks, andclerkship opportunities focused on surgery.2 Additionally, there have a number collaborative,multi-institution, multinational efforts incorporate into public health discourse. Some recent examples include publication volume third edition Disease Control Priorities3 as well Lancet commission surgery.4 discipline has, date, provision settings— largely impoverished countries around theworld—by trainees practicing surgeons from United States other resource-rich It equally important, though, recognize that settingsdonot exist solely lowandmiddle-incomecountries; they are also abundant “deserts care” high-income such States.5 As field further develops, key issues crucial consider emphasize, including need capacity building, locally driven care, challenges solutions, ethics work.