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ADVANCING HEALTH EQUITY THROUGH SURGERY

Carine Visagie

New centre focuses on access to safe, affordable care

Prof Kathryn Chu, recently appointed as professor of global surgery at the newly formed Department of Global Health of the Faculty of Medicine and Health Sciences (FMHS), has a heart for improving surgical care.

Chu was raised in the United States of America, where she studied and worked at some of the country’s top universities and academic hospitals. Yet she chose to relocate to the tip of Africa, creating innovative healthcare solutions for a country and continent that doesn’t always offer attractive work conditions.

Even more fascinating is that this highly skilled surgeon is working in a field that many healthcare practitioners have never heard of. The concept of “global surgery” only gained public recognition in 2015, when The Lancet published its study on the inequity in access to surgical care worldwide, “Commission on Global Surgery”, to advocate for equitable, quality surgical access as a global health priority.

Global surgery is still an emerging field and one that has only recently been incorporated into Stellenbosch University’s curriculum.

From public sector surgeon to expert in global surgery

Chu first became interested in the field in 2015, when she was working at Somerset Hospital in Cape Town.

“I could see the inequity,” she recalls. “Patients would become very sick from delays to treatment for surgical conditions such as a perforated appendix. These conditions could be effectively treated through surgery. Why weren’t they reaching care earlier?

“I read the article in The Lancet, which mentioned that five billion people across the globe didn’t have access to surgical care when they needed it,” she continues. “And so I wanted to make changes to the entire surgical system rather than just treat the patients in front of me.” 

When FMHS Dean Prof Jimmy Volmink called Chu and said he wanted to create a Centre for Global Surgery, she jumped at the chance to join the team. Their visions were aligned and this was an opportunity to make a difference on a continent that desperately needed the help.

Worldwide, it’s now well recognised that a third of the global burden of disease can be cured or alleviated through surgical care. Despite this knowledge, there are currently gross disparities in access to safe surgical care.

“Ninety-five percent of people living in Sub-Saharan Africa don’t have access to safe and affordable surgery,” Chu says. “And, in South Africa, there are great disparities between those with and without medical aid. Those without medical aid, simply don’t always get the surgical care they need in time.”

Overcoming four barriers to surgical care

A strong focus of the work of Chu and her colleagues is to understand the four barriers to surgical care:

1.)  Why don’t people seek surgical care?

2.)  Why do so many not reach care?

3.)  At the hospital, what are the delays to receiving care?

4.)  What are the barriers to retention in care? 

“Much of our research in the next few years will focus on understanding these barriers,” says Chu. “Many surgical conditions such as traumatic injuries require timely access to prevent loss of life and disability. Strengthening the entire surgical ecosystem – including all levels of care from the community health centre to the district hospital and the tertiary hospitals – is essential.”

When asked what excites her most about her work, Chu doesn’t hesitate in answering: “The ability for surgeons to join the discourse on the strengthening of our public-health systems. We’re finally getting a chance to talk to economic and social scientists, emergency healthcare specialists, as well as healthcare professionals from several other fields.”

And when asked why she’s working in South Africa instead of the USA or even China, where her family comes from, she talks about her love for the continent. “I’ve always regarded the fact that I grew up in the States as a bit of an accident of birth and I never really thought of going back to China. From the first time I started working here, I’ve been in love with Africa.”


FOR MORE INFORMATION, VISIT THE DEPARTMENT OF GLOBAL HEALTH’S SECTION ON THE FMHS WEBSITE: www.sun.ac.za/english/faculty/healthsciences/global-health

‘I could see the inequity. Patients would become very sick from delays to treatment for surgical conditions such as a perforated appendix. These conditions could be effectively treated through surgery. Why weren’t they reaching care earlier?’  – Prof Kathryn Chu

 

Photo credit: Stefan Els