Safe Surgical Access

Solidarity Bridge in Synergy with A Global Platform

Written by: Dr. Richard Moser, Neurosurgeon

Responding to the Needs of Neurosurgical Patients in Bolivia

I write this as we complete our second week of mission in Bolivia. This week our team of three neurosurgeons and an ENT specialist performed six surgeries in the cities of Sucre and Santa Cruz. The surgeries were complex and diverse in nature. Our Bolivian neurosurgical colleagues had invited us to join them in providing surgical treatment for patients with pituitary macroadenomas, clival chordoma, cervical spine tumor, and traumatic injury to the spine. 

Our youngest patient also proved to be our most complex case, requiring multiple days of surgery. 

Though each case was unique, they shared a common thread: our patients and their families live below the international poverty line of US $1.90 per day per person. These individuals face enormous obstacles in covering the costs of basic laboratory tests and radiological imaging necessary for a diagnosis and have no means whatever to access surgical care even if it were available. 

Our mission helped provide the needed neurosurgical care in close collaboration with and mentoring of our Bolivian neurosurgeon, offering our patients the potential opportunity to again lead a normal life. This was particularly evident in the cases of 13 and 15-year-old children who showed inspiring courage in the face of great adversity. We are deeply appreciative of the contributions made by our medical supply donors, Atlas, Inc., which generously provided quality Globus instrumentation for the spine surgeries, and Globus Medical whose generosity supported our travel. Our partner organization in Bolivia, Puente de Solidaridad, superbly coordinated logistics, provided additional medical supplies, and arranged for qualified medical translators.

Responding to the Needs of Surgical Patients Worldwide

Nonetheless, every day around the world countless men, women and children with a vast array of medical and surgical needs literally have nowhere to go for help. The enormous volume of patients in the public hospitals where we operate, illustrate what I have observed on twenty previous Solidarity Bridge mission trips: doctors and nurses work hard locally to heal individual patients but systemic changes in national health policy are required to advance safe surgical access in low and middle income countries like Bolivia. And that is precisely why Solidarity Bridge joined the G4 Alliance.

The critical interface between these two organizations provides Solidarity Bridge missioners and supporters a platform to enhance and expand our role as teachers and healers in Bolivia while also promoting safe surgical access worldwide.

Dr. Richard Moser at the G4 Alliance conference in November 2016

The G4 Alliance is comprised of 85 member organizations, including hospitals, academic institutions, foundations, industry and nonprofit service organizations. The Alliance advocates for the neglected surgical patient, encompassing all subspecialties, trauma, obstetrics and anesthesia care. Moreover, it catalyzes our collective voice for implementation of the World Health Assembly’s resolution that created the Global Initiative for Emergent and Essential Surgical Care and offers a forum for developing policies, goals and indicators specific to the needs of each country.

The Permanent Council of the G4 consists of several Standing Committees and is interwoven with task-oriented working groups. I am excited to be part of the Communications and External Relations Committee and the Surgical Tracking Map working group.

As an advocacy and convening group, the G4 Alliance works to improve the surgical ecosystem and access to safe surgery in 140 countries. To move this agenda forward, we use both our own knowledge of and experiences in the countries we work and the compelling evidence at the global level documented in:

  • the UN’s Sustainable Development Goals (SDGs),
  • the World Health Assembly’s resolution 68:15 establishing the Global Initiative on Emergent and Essential Surgical Service,
  • the World Bank’s Disease Control Priorities 3rd Edition (DCP3) Volume on Essential Surgery and
  • the Lancet Commission on Global Surgery (LCoGS).

The steps are clear:

  1. convene interested parties in each country to gain influence so that health ministries will adopt standards for safe surgical care at the 70th World Health Assembly in May 2017;
  2. scale our message to regional, national or global audiences; and
  3. influence policies, disseminate programs, and establish achievable goals and indicators through member organizations working at the local level.

Solidarity Bridge and its Bolivian partner organization Puente de Solidaridad are doers. Mentored surgeries, local health campaigns, courses and medical resource distribution strengthen health work locally. Our continued work on the ground is in synergy with the advocacy role of the G4 Alliance on a global platform. The critical interface between these two organizations provides Solidarity Bridge missioners and supporters a platform to enhance and expand our role as teachers and healers in Bolivia while also promoting safe surgical access worldwide.

Dr. Richard Moser is Chair of the Department of Neurosurgery at the University of Massachusetts Medical School. He serves as a member of the Board of Directors at Solidarity Bridge, and as the Medical Director of our Program for the Development of Neurosurgery.