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Global Scalpels: A Global Surgery Podcast
62 minutes | Jun 5, 2022
Ep 43: Steven Orr
In commemoration of Pride month this month, we wanted to highlight a population within society, but particularly in the field of global surgery, that is often left behind. The LGBTQ+ community has experienced high rates of discrimination and ostracization resulting in higher rates of mental illness, suicide, and even drug use. Further, LGBTQ+ patients encounter a very unique set of barriers within healthcare globally. For example, in many countries, significant others/partners of LGBTQ+ are not recognized as legal unions. This lack of legally legitimate status can pose issues when healthcare proxy decisions need to be made. Further, LGBTQ+ may have decreased number of children due to society and logistical pressures not experienced by heterosexual counterparts. This leads to a lack of access to needed elder care in regions where children and offspring predominantly handle elder care. Lastly, access to “luxury treatments” such as hormone therapy and gender-affirming surgery is extremely limited around the world leaving many transgender patients without access to potentially life-saving medications and surgeries. It is the job of clinicians to treat all patients fairly and with respect. Fair, does not necessarily mean the same, however. Recognizing how to interact with, respect, and support people of all backgrounds is essential as human beings. Putting ourselves in the shoes of other people brings new perspectives and insights. Join us in this special episode with Dr. Steven Orr as we highlight implicit bias within the surgical realm, the promotion of diversity and inclusion in surgery, and how to encourage the health and safety of all patients - regardless of sexual orientation or gender.
50 minutes | May 5, 2022
Ep 42: Joel Bervell
Lights, camera, ACTION! With the continued evolution of social media and technology, content creators can share their talent widely throughout the world without the need of a stage crew, make-up artist, costume designer, scriptwriter, director, etc. etc. etc.; in fact, you can do it from your very own living room with your iPhone! While it doesn’t take an army to create the content, it can be just as powerful and impactful as anything on the big screen. Many of these posts can reach tens of millions of people in a matter of hours and have the power to create movements (think the ice bucket challenge), shape culture, influence fashion, and even affect finance. All from the press of a button. Our guest today is doing just that. With more than 40,000,000+ impressions across TikTok and his other social media platforms, Joel Bervell has become an “influencer turned medical educator” who is tackling health disparities, racial bias in medicine, and global youth empowerment like no one else. Join us on one of our most interesting episodes to date as Joel shows us the man behind the screen, his views on how anyone can become a content creator for a cause, and how to challenge what we think we know. You won’t be disappointed!
59 minutes | Apr 5, 2022
Ep 41: Marci Bowers
The beautiful thing about surgery is that it has the power to change lives in ways that no other field can. Surgery is often used to correct physical deformation. Whether that is a fractured femur from a motorcycle accident, a craniotomy to relieve pressure on the brain, or an appendectomy to remove a ruptured appendix, each of these procedures helps to restore a person back to “whole”. What we don’t often talk about is when these procedures are needed to help bring a person back to whole when many places in the world do not acknowledge that this person has a deficit or even needs to be fixed. They fail to recognize the dissonance between the person’s soul and body. As one of the most vulnerable citizens in society, transgender individuals have staggering rates of harassment, discrimination, and violence. Although their fight is not seen as a medical issue by some, our guest today is helping to tackle this issue to provide safe access to gender-affirming surgery. Join us as explore these sensitive and important issues including the personal, legal, medical, and surgical process of gender affirmation surgery, female genital mutilation, and clitoral restoration surgery. This is an episode you won’t want to miss!
53 minutes | Mar 5, 2022
Ep 40: Priyanka Naidu and Zach Collier
Asking questions is at the very core of education. Surgical education specifically is a unique circumstance in which “learning” directly affects the lives of others - sometimes in very negative and real ways. Thus, tackling training of new surgeons around the world has very real consequences that can help increase access to needed care around the globe but in safe and competent ways. The goal of surgery is to be effective, safe, and have the desired outcome. Learning how to ask questions and learn essential procedural skills through accessible materials is the goal of Drs. Priyanka Naidu and Zach Collier. Join us as we talk about how they are using hackathons, self-assessments, apps, language translation, and dynamic education materials to learn and/or refresh surgical skills to be able to address the current gap in surgical knowledge and open doors to safe and affordable surgery globally.
63 minutes | Feb 5, 2022
Ep 39: George Dyer
Imagine if you arrived at your house and there were dozens of Amazon boxes at your door. None of which you had ordered. You open them only to find random items – a hairbrush, t-shirts that are way too big for anyone in your household, a toaster, and ice cream that is now all melted since you didn’t know it was there and should be refrigerated. Further, this doesn’t happen just once. It happens over and over again. Each time with a new set of items, all of which you didn’t order and may or may not even need. The items start piling up and boxes are everywhere. Despite your best efforts to keep up, stuff just accumulates and clutters your house. The items are unusable to you and impeding your access to your own space and effectively just becoming trash. Now imagine if you got a knock at your door. It’s a random person unknown to you, claiming to be a contractor. They let themselves in and start accessing your home and telling you they need to tear down this wall, re-route a pipe, change light fixtures, etc. They may even start doing these things without consulting you first or getting your permission. They never present any type of license or ask your opinion “because they are the expert and know best”. This is how it can feel in some global health situations. While people are trying to help, external aid can often be misdirected and create new, additional problems. The sending of supplies to resource-poor settings is often ill-informed and becomes like the Amazon analogy – trash. Incredible resources that are donated but unusable in their setting, incomplete material sets, not sorted, or frankly, not needed. The receiving institution may not be equipped to deal with the influx of these donations, and they become a burden rather than a help. This is compounded by physicians and surgeons offering their services regardless of the stated needs of the area, often leaving the local physicians to clean up the aftermath of post-operative checks, new medication management, and physical therapy needs. Join us as we talk with Dr. George Dyer, an orthopedic surgeon/professor at Harvard Medical School and orthopaedic advisor for Partners in health, about trash (disguised as donations) and the need for need-directed donations, education, and effective surgical support. You won’t want to miss this!
68 minutes | Jan 5, 2022
Ep 38: Fabio Botelho
4 hours? 7 hours? 10 hours? Look around you. Chances are you have a cell phone, tablet, or computer within reach (you are reading this after all). The number of hours an individual spends on their electronic devices each day continues to rise every year. With mobile devices reaching almost every corner of the earth, access to technology has never been easier. So how can we use this technology to do good? And how can we harness it specifically for surgery? The term “virtual reality” is often used but it’s not something I know a lot about. Simulating an experience in which the user can interact with a created world around them is the very heart of virtual reality. This is what Dr Fabio Botelho is trying to tackle - using virtual reality to teach paediatric trauma care. Using virtual scenarios where a clinician can talk with nurses, order tests, and work with patients, this simulated world enables just about anyone to gain knowledge and training in a real but standardized and measurable way. Surprisingly, it is actually cheaper than many other forms of training and the power to be able to disseminate the course is diverse and scalable. Join us as we explore a range of topics including virtual reality, pediatric trauma training, and burnout in this exciting new episode!
54 minutes | Dec 5, 2021
Ep 37: Bukola Oluyide and Charity Kamau
Our episode today covers a debilitating and life-threatening condition that disproportionately affects those in developing countries around the world. Affecting more than 150,000 people annually, Noma is a fatal infection of the face and mouth with the mortality rate approaching more than 90 percent and the morbidity/sequelae are permanently debilitating. Noma is a result of acute necrotizing ulcerative gingivitis (infection of the gums) which can rapidly spread and destroy other facial tissues. This can lead to struggles with eating, talking, and even breathing for affected individuals - if they even survive. Not only does this affect their activities of daily living, but it also affects their social interactions; often becoming shunned or excluded from societies and families due to the severely disfiguring and unpleasant aftermath. Further, the social and economic deprivation and political insecurity are staggering. A simple internet search before this episode will put the condition in context. Despite the high fatality rate and crippling aftermath, noma is a sorely neglected disease that can be prevented with multidisciplinary treatment. Join us in this episode as we speak with Dr. Bukola Oluyide and Charity Kamau as we discuss Noma as a condition, efforts that are being done to tackle it, and the sociological/anthropological aspects that remain following disease in its many forms.
51 minutes | Nov 5, 2021
Ep 36: Kokila Lakhoo
Children are one of the world’s protected populations. Indeed, they are the very make up of our future as a race. They bring new life, ideas, and opportunities we can only dream of. Unfortunately, not all children around the world have equal opportunities to contribute to this future. In 2019 alone, more than 5 million children under 5 years died from preventable and treatable causes - many of which are due to lack of surgical access. While there are many initiatives to help combat these alarming findings, many projects are condition specific (e.g. clubfoot, cleft palate, etc.) or have teams that work in silos from other parties that may benefit. They lack a “we” or “us” mentality and rather an “I” phenomenon. To help address this issue, the Lancet Commission on Global Surgery developed The Global Initiative for Children’s Surgery (GICS) in 2016. Join us today as we talk with Professor Kokila Lakhoo, a paediatric surgeon at Oxford, as she shares with us her insights into global collaboration as past president of GICS. We also explore the importance of trainee programs, advocacy, and training true doctors that have no borders.
51 minutes | Oct 5, 2021
Ep 35: Paola Fata
Findings from studies published in The Journal of the American Medical Association (JAMA) report that more than 45% of resident physicians experience burnout and the numbers are continuing to climb. If that number didn’t surprise you, then you are well aware of the psychological stress and struggles that doctors and other healthcare workers experience on a daily basis - particularly during this recent pandemic. As a result, more than 1 in 10 physicians said they had suicidal thoughts. Unfortunately these thoughts often become action with suicide deaths among physicians is 250-400% higher than similar counterparts in other occupations. These suicides lead to more than 1 million patients losing their medical expert in the US alone - leaving a substantial number of underserved and vulnerable populations without healthcare services. As these statistics show, mental health is a major issue among physicians and our speaker today is attempting to help alleviate that. Join us as we talk with Dr Paola Fata about protected spaces (including protected nap spaces!), increasing positive feedback and value, community ties, and helping to bring ourselves back to center in safe environments.
53 minutes | Aug 5, 2021
Ep 34: Drew Reynolds and Alison Fussell
Undergoing surgery is an extremely multifaceted process that includes physical, mental, and social aspects to make it successful. Often when we talk about surgery, we focus on the physical and neglect these other important parts. This is where social work can bring all the pieces together to include the biopsychosocial approach to surgical care - an inter-disciplinary model that connects these three important patient factors. Join us as we talk in this episode about how Drew and Alison are helping to tackle this issue for pediatric populations around the globe!
49 minutes | Jul 5, 2021
Ep 33: James Johnston (w/ Guest Host Daniel Lowe)
Humans are inherently social creatures. For centuries we’ve learnt to survive, adapt and overcome through collaboration and unity. Medicine, in particular, highlights the value of taking input from multiple specialities and healthcare professionals to optimise patient care. However, with the power of modern technology, does this collaboration need to be confined to a single hospital? Why shouldn’t we collaborate with experts from around the world? Intersurgeon.org aims to establish a new paradigm to ensure the standard of clinical care is high no matter the setting. By harnessing the knowledge of over 600 specialities worldwide, this free service drives the pursuit of equitable and safe surgery. Join us as we dive deeper into the work of Paediatric Neurosurgeon Dr James “Jim” Johnston, co-founder of Intersurgeon with Guest Host Daniel Lowe a passionate Medical Student from Australia as we discuss how to facilitate regional LMIC collaboration and the value of ‘coral reef’ networking.
36 minutes | Jun 5, 2021
Ep 32: Christina Dejean Soray
Healing takes time. To heal means to regenerate, to align and to gain strength. Wound healing, in particular, highlights the power of the human body in times of crisis – manipulating its resources and cells to restore homeostasis. But what happens when that fails? What happens if it’s a traumatic wound that gets infected, fails debridement? In high-income settings, the simple answer is negative pressure wound therapy – which costs thousands of dollars a device. But that’s not sustainable in every environment around the world. Here creativity and innovation rise from the ashes as Hattian and International surgeons and engineers were able to push the boundaries of function and cost for low-resource settings. Join us in this incredible episode as we talk with Haitian orthopaedic surgeon Dr Christina Dejean Soray on her low-coast “Turtle VAC”, finding solutions based on what you see clinically, and advice on being female and navigating a heavily male-dominated speciality!
41 minutes | May 5, 2021
Ep 31: Adrianna Serna
Checklists have been instituted in many sectors to help streamline processes. They are there to make things easier and bring peace of mind by eliminating forgotten aspects of a procedures. Surgery is no different. The surgical checklist is vital to the delivery of safe surgery around the world, however, checklist implementation involves changing minds, operating room culture, and the dreaded word - paperwork. However, “leadership is more important than resources. If you change your mind you can change every environment. The difference is inside of the head of the people.” Surgical checklists save lives. One doesn’t want to be having an emergency in the midst of an emergency due to lack of planning or a skipped step. Everything needs to be ready exactly as is needed at its time of utilization. Join us in this incredible episode as we talk with Dr. Adriana Serna about initiatives to institute surgical checklists in Colombia and other Latin American countries and how to empower members of the surgical team to speak up and participate in making this life saving practice a routinely used item!
42 minutes | Apr 5, 2021
Ep 30: Chidiebere Ibe
Medical textbooks are a staple for education for medical trainees worldwide. These textbooks teach through words but they also teach through picture portrayals of conditions students will see in the future. Topics include basic anatomy, skin conditions, injury patterns, and even necessary medical equipment. Unfortunately, many of these textbooks are currently dominated by picture portrayals of patients with caucasian skin. This lack of diversity not only misrepresents the overall patient population, but can also be misleading - for example, certain skin conditions can look extremely different based on skin color and students may miss critical diagnoses due to inadequate education for this patient population. Our host today is working to change that. Meet Chidiebere Ibe; a Nigerian medical illustrator working to increase visibility of patients with non-caucasian skin in the medical literature and textbooks. Join us as we talk about how he hopes to use medical illustration to make neurosurgery more attainable for African medical students, how mentorship helps to overcome barriers, and how equitable illustrations can help both patients and trainees understand conditions better!
52 minutes | Mar 5, 2021
Ep 29: Garreth Wood
Vaccination efforts around the world have been extremely successful - saving millions. They have been particularly helpful in pediatric populations. While vaccinations for children are important, if they are not followed by adequate access to surgical care, many of these children will still die premature. Currently part of the bottleneck of decreased access for pediatric populations is the lack of operating rooms as well as lack of surgeons trained to care for this vulnerable population. This is where Garreth Wood and KidsOR are trying to help, by not only building additional pediatric operating rooms but also helping to train additional local pediatric surgeons to expand access in many countries around the world. It is an investment but one that certainly has immense benefits - both economically and for people’s lives. “Investing in children surgery is one of the best returns on investment that one could get. The impact is immense [through] all of the lives saved and disability prevented by children who need surgery. We have calculated that in one year of activity, in just one operating room, it generates 11.7 million dollars for the local economy. Then if you scale that up to multiple operating theaters over multiple years, we are talking about billions of dollars being generated in GDP across low- and middle-income countries… [thus] investing in surgery is unrivaled in performance.” Join us in this fascinating episode as we discuss the need for pediatric surgical efforts and some of the strategies that are currently being used to tackle this important issue!
55 minutes | Feb 5, 2021
Ep 28: Lotta Velin and Lina Roa
“Climate change is the single greatest threat to planetary and human health of our time. It is not a distant future concern, but a process that is occurring here and now.” - Roa L, Velin L, et al. Climate change is a huge idea. It stems from the accumulation of greenhouse gases due to human consumptive practices that results in environmental changes. Some of these changes have drastic changes not only on our planet but also on health. Increasing global temperature have “resulted in approximately 125 million more people who have health issues related to heat, such as dehydration, heatstroke, and cardiovascular disease, in 2016 compared with in 2000.” Rising sea levels has led to increased flooding and other natural disasters thus leading to heightened need for trauma care and economic ruin and resulting poverty. Further, pollution plagues the air of many cities globally that may cause respiratory effects that rival that of smoking. While increasing access to surgical services worldwide is vital to human life, doing so in a environmentally friendly manner is essential to sustainable scaling and longitudinal growth. Join us in this earth shattering episode as we discuss with Dr Roa and Dr Velin about their recent paper in the Lancet and how to use solutions from all six building blocks to be advocates for a two-way relationship between surgery and climate change. You won’t want to miss this!
34 minutes | Dec 12, 2020
Ep 27: Cecilia Chitayi
Performing surgery requires many different parties. Each needs to come to the operating room prepared to excel in their field but also work collaboratively with the other parties. Unfortunately, the field of surgery has the potential to be surgeon-centric and important collaborators like anesthesia fail to be discussed. In this episode, we seek to better highlight the field of anesthesia through the lens of Cecilia Chitayi - a nurse anesthetist practicing in Kenya. In a country where more than 70% of the population lives in rural areas, training healthcare providers at all levels is vital to expanding care capacities. Join us in this fulfilling episode as we discuss the differences between different anesthetic providers, anesthesia supply chain issues in a country like Kenya, and the ImPACT Africa program!
63 minutes | Dec 6, 2020
Ep 26: Salome Maswime (w/ Guest Host Daniel Lowe)
Health systems are sick. Around the world gaining access to necessary surgical treatment can be difficult due to inadequate healthcare infrastructures but also due to imbalanced care across demographics. Women across the globe often struggle to gain equal access to healthcare and maternity services - and not just access, but high quality care. The issue extends far past the surgeon in the operating room. It is the break in health systems, the procedures being performed, and the surgical outcomes. This is where Dr Salome Maswime and her team are trying to chart a new course for maternal health. Join us as we talk about the importance of playing a role in healthcare access, regardless of how big or small that may be. We can all play a role in helping to provide safe, comprehensive quality care for everyone around the world. In a period plagued by a pandemic, this requires innovative and out-of-the-box thinking to tackle key issues like providing gynecological services when it isn’t really practical to do vital health services such as virtual maternal check ups. The question is, will you be the next innovator to expand care?
73 minutes | Nov 27, 2020
Ep 25: Katayoun Madani & Joffre Guzman
The power of students can be immense. In a team, each person brings something to the table and has different strengths to offer. Students offer the benefit of time, passion, and drive. Mentors offer the benefits of experience, teaching, and context. The combination of student and mentor can bring both to new heights. In the world of global surgery, students have banded together to push the movement forward. One such initiative has been the InciSioN Global Surgery Symposium (IGSS) - an annual student-led global surgery conference, and the largest of its kind in the world! Join us in this powerful episode as we explore the inner-workings of IGSS2020, all that it took to make this virtual conference a reality, and the topics of teamwork, inequity, organizational behavior, and overcoming language as a barrier with two of the convenors of IGSS2020 - Dr. Katayoun Madani and Dr. Joffre Guzman!
64 minutes | Nov 21, 2020
Ep 24: Andres Rubiano
Trauma injury kills more people every year than HIV/AIDS, malaria, tuberculosis (TB) combined. Despite this, it often takes a backseat when receiving research support, clinical funding, and policy change. Trauma disproportionally affects low- and middle-income countries with its far reaching effects beyond the walls of the hospital. In fact, in some countries like Colombia, severe traumatic injuries are sustained from many mechanisms including landmines, guerrilla and paramilitary warfare, homicide, and vehicular accidents. As a member of the Global Initiative for Essential and Emergency Surgical Care at the World Health Organization, our guest today has worked extensively with partners from around the world to tackle multiple goals for trauma care system building such as addressing shortage of staff, lack of clinical management, and insufficient funding. His passion for neurotrauma has led him to work with both local and international supporters to promote advocacy and good communication through avenues such as social media. Join us as we talk with Dr Andres Rubiano, about his home country of Colombia, the intersection between politics and health, as well as the MEDITECH foundation which is working to create a coordinated and proactive network of responders to enact integral trauma care across the country.
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