Tim Crocker-Buqué5th Year – University of Nottingham
Professor Harold Ellis Medical Student Prize for Surgery
9th October 2009
What Effect can Surgeons have on World Health?
GAPMINDER
Disability Adjusted Life Year - DALY
1 DALY = 1 year of ‘healthy’ life lost to disability or death
Quantifying the global burden of disease:
Murray and Acharya, 1997
The World Proportional to Total Population
United Nations Development Programme’s 2004 Human Development ReportFrom: www.worldmapper.org
The World Proportional to Absolute Poverty (<$2 per day)
United Nations Development Programme’s 2004 Human Development ReportFrom: www.worldmapper.org
Low income countries: LIC
The World Proportional to Number of Deaths from Injuries per Year
United Nations Development Programme’s 2004 Human Development ReportFrom: www.worldmapper.org and Ozgediz & Rivello, 2008)
90% Injury Deaths in LIC
African children >5yo – more deaths from injuries than HIV, Malaria and TB combined 63,000,000
DALYs
Only 33% injured patients in Africa reach a health facility
The World Proportional to Number of Deaths from Congenital Birth Defects per Year
United Nations Development Programme’s 2004 Human Development ReportFrom: www.worldmapper.org
The World Proportional to Number of Deaths from Congenital Birth Defects per Year
United Nations Development Programme’s 2004 Human Development ReportFrom: www.worldmapper.org
14,000,000 DALYs
The World Proportional Maternal Mortality
United Nations Development Programme’s 2004 Human Development ReportFrom: www.worldmapper.org and Ozgediz & Riviello, 2008)
500,000 surgically preventable deaths PA
99% maternal deaths in LICs
10,000,000 DALYs
Contribution of surgically treatable diseases:
164,000,000 Disability Adjusted Life Years
=
11 - 15% Global Disease Burden
Debas at al., 2006
What Effect can Surgeons have on World Health?
Almost nothing.
The World Proportional to Number of Working Doctors
World Health Organisation’s 2006 World Health ReportFrom: www.worldmapper.org
1 Doctor:15,000 population
1 Surgeon:30,000 population UgandaOzgediz et al., 2008
Education
Education
Education
Questions?
Thank you
Recruitment and Retention of Doctors in LICs
Remuneration and incentives
Resources: equipment and drugs
Safe working environment
Training and mentoring
Cost of of treating surgical disease:
Measles Vaccine
HIV Antiretroviral Therapy
Basic Surgical Care
$5
$300 - $500
$11 - $33
Estimated cost (USD) per DALY averted
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