Global Initiative for Childrens Surgery

​

• Gaps: Global Surgery and Child Health

​

​

• Joining efforts in children’s surgery

​

​

• Philosophy:
• “Northern voices dominate global health discussions”

(Shaikh et al. 2017 Health Pol Plan)

​

​

​

Surgical Access for Children

3.3 billion

0.5 billion

5 billion

Mullapudi et al. Bull WHO 2019

Childrens Surgical Conditions

• Abdominal emergencies: Sevenfold higher mortality in LICs
• Congenital Anomalies: 94% in LMICS, share of neonatal and infant mortality rising
• Injuries: More deaths ages 5-14 than HIV/TB/malaria
• Cancer: 43% of cancer cases in children undiagnosed globally
• Southeast Asia and Subsaharan Africa

​

Last Meeting: GICS IV Johannesburg, South Africa

January 2020

• Formed as Non- Profit Organization 2016
• Meetings 2016, 2017, 2018
• Leadership half LMIC / HIC
• Global Representation

​

​

� Optimal Resources for �Children’s Surgery Guidelines

National children’s hospital

�http://escholarship.org/uc/item/7hc8w9s5

FREE DOWNLOAD

250. Members

​

13 specialties

​

44 countries

ORECS – Use and Implementation

• Gaps: Global Surgery + Child Health
• Specialty based working groups
• Anesthesia / Orthopedics / Neurosurgery / Plastic / Nursing

​

• Thematic Work Groups
• Trauma / Oncology / Congenital
• Training / Research
• NGO - Academic partners

​

Past Chair Kokila Lakhoo

Emmanuel Ameh, Chair

Anesthesia – Perioperative Care

• 100 x higher mortality in children in Kenya than HIC
• Newton et al. 2020 Anesthesiology
• ASOS Peds (Alex Torborg)
• Limited anesthesia workforce
• PATA – New Pediatric Anesthesia fellowship Training for Africa
• Nurse Anesthesia
• CANECSA and Fellowships
• SAFE course (WFSA)
• Much more work necessary in tandem (surgery/anesthesia)

Zipporah Gathuya

Faye Evans

Pediatric Surgical Nursing

• Central role of the nurse
• Wound care manual
• Family counseling for surgical conditions
• Pediatric Surgical Nursing curriculum
• Need to integrate nursing training

​

​

​

Olubunmi Lawal

Orthopedics

• Global Clubfoot Initiative
• Fracture Care
• Bone infections

Vrisha Madhuri

“ETALO”

Fracture Simulation Drill

CORSU Hospital, Uganda

Moses Fisha Muhumuza (CORSU)

Coleen Sabatini (UCSF)

Neurosurgery

• Led by William Harkness
• Created InterSurgeon – Network for Surgeons

​

​

​

• “Ohana One” Partnership for remote training

and communication

• Scaling therapeutics for hydrocephalus
• Endoscopic third ventriculostomy (CURE Hospital Mbale, Uganda)

​

William Harkness

James Johnston

Oncology

• WHO Childhood Cancer Initiative
• Cancer control programs
• Increasing access to childrens cancer care
• Pediatric Surgical Oncology Training Courses
• Wilms as a target solid tumor
• 60% target survival

​

Hafeez Abdelhafeez

Trauma

• Trauma Management Guidelines
• Integration of Pediatric Trauma Training into PTC
• Injury Prevention Materials on GICS website
• Falls
• Burns
• Bike injuries
• Battery ingestion
• Pedestrian Safety

​

Abdelbasit Ali

Congenital Anomalies

• Community Identification of Birth Anomalies
• Common anomalies GICS Survey
• Structural Birth Defects Registries / Spot surveys
• Parent Support Groups
• WHO Birth Defects Program

Tahmina Banu

Disease Control Priorities 4

• The “First 8000 Days of Life” (Bundy et al)
• Overemphasis on first 1000 days
• 99% of Google scholar publications under 5
• 210 billion investment on education; 4 billion on health
• Health needs of children continue beyond 1-5
• Outlining the expansive childrens surgical role
• Emphasis on Platforms, and costs, benefits

Justina Seyi-Olajide

- Human capital contributes to 70% of the wealth in HIC; <40% in LMIC

• “More investment needed for LMIC to develop

their most vulnerable populations to attain their full potential as adults”

​

Neema Kaseje

- Modules for Childrens

Surgery Emergencies

at the District Hospital

​

- WHO Learning Academy

- “ECO” Care

​

Phyllis Kisa

Uganda: Pediatric Surgical Emergencies Workshops

for Rural Providers

Martin Situma

Incorporating Childrens Surgery �into National Surgical Plans

• Emmanuel Ameh / Tina Seyi-Olajide
• National Surgical Plan for Nigeria
• Already partially funded, leading with childrens surgery implementation
• Lubna Samad - National Plan for Pakistan
• Use of ORECs document for needs assessment / gap analysis

NGO Partnerships

• KIDS OR Africa 2030 Initiative
• 120 centers of excellence
• Nearly 60 ORs installed by end 2022
• Including Kakuma Refugee Camp
• Training partnership with Smile Train
• E learning platform
• COSECSA / WACS
• Data collection support
• Advocacy initiative

Garreth Wood

Founder

David Cunningham

CEO

Rosemary Mugwe

Africa Director

GICS Surveys

• Economic Impact on Families of Childrens Surgery
• Wilms Tumor Practices
• Burn Survey
• COVID Impact
• Vaccine equity and uptake
• Prenatal Evaluation
• Wound care survey

Growth Opportunities

• Dialogues on Equity in Global Health Programs
• Integration with Child Health Initiatives
• Impact on Global Goals beyond Health
• Poverty, Development, Gender, Inequality
• Expanded Flow of Knowledge
• LMIC 🡨🡪 HIC
• LMIC 🡨 🡪 LMIC across regions
• Amplifying Children’s / Family’s Voices
• “Making the invisible visible”
• Sustainability
• Managing systemic failures in global health

​

globalchildrenssurgery.org

Marilyn Butler

Join GICS!

Can join as individual or institutional member

Last GICS Webinar Feb 19-20 2022

Next Meeting Philippines Early 2024