EQUIPMENT SUPPLY
Delivering much-needed safe surgery for children
Dave Tipping, a qualified architect, and director of Global Operations at Kids Operating Room (KidsOR), describes the charity’s work to try to ‘close the gap’ in children’s healthcare globally, but especially in low and middle-income countries in Africa, South East Asia, and Latin America, with the supply of a range of modern operating theatre equipment to hospitals in these regions that, to date, it says, has ‘saved children’s lives, averted needless pain, and prevented an estimated 509,238 years of disability’.
When you think of the most significant scientific breakthroughs of the past century, these five words are probably not what springs to mind: ‘Children are not little adults’.1
They certainly don’t have
the same attraction as antibody puzzles, human trials, or vaccine recipes. Yet, what they represent in terms of the shift in medical thinking and surgical practice has saved countless lives, and continues to prevent untold misery. That’s because when it comes to surgical care, children are different, and indeed, are not simply little adults. They develop distinct conditions, present unique anaesthetic challenges, and have special perioperative needs. Moreover, given that children – by definition – are at a critical stage of development (whether that be physical, cognitive, mental, or social), the consequences of surgical conditions may be lifelong, and the effects, good or bad, have compounded and magnified potential.
Exceptional improvements in care The recognition that the surgical needs differ for children has led to exceptional improvements in care. Many children with congenital anomalies that were once thought incompatible with life are now flourishing, seriously injured children are returned to normal function, failed organs are replaced, and neonatal surgery is commonplace.
These advances, however, are not shared equally. In fact, to write that the huge advances in paediatric care are not shared equally would be too great an understatement. Around the world 1.7 billion children lack access to safe surgical care. Globally, that means that 10 out of 11 children live in a country lacking the dedicated facilities they need. More children die children from surgically curable conditions than HIV, Malaria, and TB, combined. It’s hard to believe, but there are still 11 countries across the continent of Africa that don’t have a single paediatric surgeon. Simply put, hundreds of thousands of children
The operating theatre door at the Muhimbili National Hospital in Dar es Salaam.
are dying every year from surgically curable conditions.
Perhaps, like me, when I first grasped the scale of the problem, you’re shocked by this. Maybe you’re asking how you’ve not heard of this issue or, at the very least, why those in high-income countries or the international community aren’t doing more to rectify it?
A focus on isolated healthcare issues Part of the problem is that for the past 50 years donor nations and philanthropists have been consumed with primary
healthcare and vertical interventions. Instead of looking to build capacity and strengthen healthcare systems in a sustainable way from the ground up, international development, overall, has looked at isolated healthcare issues. In many ways, this approach has been successful: in 1990, 12.6 million children under five died every year; by 2018 that number had dropped to 5.3 million. Yet those numbers are still colossal, and we have a situation whereby mortality and morbidity from common conditions needing surgery have grown in the world’s poorest regions, both in real terms, and relative to other health gains. This glaring gap in global health is exactly what Kids Operating Room was created to fill.
Surgeon, Bip Nandi, at Kamuzu Hospital in Malawi.
We are a global health charity focused entirely on the provision of high quality, safe surgical services for children in low- and middle-income countries. From our warehouse in Scotland, we provide surgeons and their teams with the infrastructure needed to transform the care available for their nation’s children. Sustainability is at the heart of our model, and we only invest in local people; building real capacity and promoting self- reliance in the long-term. Importantly, we never send surgeons from high-income
September 2021 Health Estate Journal 53
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