A note from Neema Kaseje, a Pediatric Surgeon committed to improving access to care in resource limited settings:

A year after the World Health Assembly passed a resolution to support access to essential surgical care - the struggle to reach universal access to surgical care continues. An estimated 5 billion individuals, including children, lack access to essential surgical care. In many lower and middle income countries (LMICs) infants and children make up a significant proportion of the population: in Haiti and Kenya, more than 40% of the population is made of individuals less than 18 years old. Unfortunately, it is specifically in these regions where the infrastructure and human resources needed to support optimal pediatric surgical care are lacking. The absence of these resources results in devastating mortality and morbidity rates.

In Kisumu, Western Kenya, a baby girl named Akinyi was born with her intestines outside her abdomen. Akinyi, which means” born in the morning”, died 4 days later due to exposure and infection because of lack of a simple plastic silo bag that would prevent infection, hypothermia, and allow gradual return of her intestines into the abdomen until closure by a surgeon. Close to 100% of babies born with gastroschisis in Western Kenya die. Had Akinyi been born in a high income country, she would have survived almost 100% of the time and led a normal and productive life.

There is therefore an urgent need for a concerted effort to build infrastructure and train the human resources necessary to meet the need for essential pediatric surgical care globally in partnership with all stakeholders.

In May 2016, a group of concerned and committed providers from high income countries and lower and middle income countries met in London to define the state of global pediatric surgical care and develop solutions. The Global Initiative for Children’s Surgery came into being with a vision of every child having access to surgical care.  A second meeting involving all stakeholders was held in conjunction with WOFAPS in October 2016 in Washington DC. At this meeting, results of assessments of the current situation in multiple lower and middle income countries was reviewed in order for priorities to be set and context specific solutions developed. Subsequently a third meeting was held in Vellore, India in January 2018, where new priorities were set to enable progress toward our goal of assuring safe surgical care for children throughout the world.



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