Although global health has come a long way over the past 25 years, access to surgical care remains very uneven across the world. Five billion people lack access to basic surgical care; this translates into unnecessary death and disability. More than one-third of all global deaths are from conditions requiring surgical care—more than the number of deaths from HIV/AIDs, tuberculosis and malaria combined. In addition, one-quarter of the world’s disability has been attributed to surgically treatable conditions.
In January 2014, an international team of 25 surgeons and public health experts launched The Lancet Commission on Global Surgery to address the widespread need for surgical care around the world. After 14 months of global consultation and four international meetings, the commission published a 32,000- word report today in TheLancet that provides a strategy for governments, policy makers, non-profits, funding agencies, academic institutions, professional associations, health care providers and local communities to engage in concrete action in low- and middle-income countries.
On May 6, the commission hosts its North American launch in Boston to present its key findings and priority action items. John G. Meara, MD, DMD, MBA, Plastic Surgeon-in Chief at Boston Children’s Hospital and the Kletjian Professor of Global Surgery at Harvard Medical School, is one of three chairs of the commission. We sat down with Meara to learn more about the commission’s work, which he describes as one of the “most impactful things he has done in his career to date.” …
What’s IBM’s Watson been up to since winning Jeopardy? Among other things, it’s been trying to help doctors make decisions. “We live in an age of information overload,” says Mike Rhodin, Senior Vice President of the IBM Watson Group. “The challenge is to now turn that information into knowledge.”
Interestingly, most of the inquiries Rhodin received post-Jeopardy were from doctors, who were interested in the way Watson sorted and ranked possible answers. Here, Rhodin and Dan Cerutti, VP of Watson Commercialization, outline IBM’s vision to improve global health care through a technology platform called CarePlex:
It was an offer I couldn’t refuse. Student leaders from MIT Hacking Medicine had invited me to join a weekend health care hackathon in Doha, Qatar. We had taken our show on the international road before, to Uganda and India, but this hack (November 20–22, 2014) would be our first in the Middle East and the first focused on sports medicine. In partnership with Qatar Science & Technology Park (QSTP), a member of the Qatar Foundation, this hack brought together students, athletes and health care professionals to solve sports medicine’s most pressing challenges. …
Paul Farmer, president and co-founder of Partners in Health, has dedicated his life to the idea that the problems of the world’s poorest people are humanity’s problems writ large. Having recently returned from West Africa, Farmer spoke at Harvard Medical School and appeared on the Colbert Report last week, calling for a stronger response to the Ebola outbreak.
“We want to have a radical inclusiveness,” Farmer told the Harvard Medical School audience. “We readily acknowledge that we are overwhelmed by this.” …
TEDMED2014 focused on a powerful theme: unlocking imagination in service of health and medicine. Speaker after speaker shared tales of imagination, inspiration and innovation. Here are a few of our favorites:
$100 plastic car stands in for $25,000 power wheelchair
In the first (and likely only) National Institutes of Health-funded shopping spree at Toys R’ Us, Cole Galloway, director of the Pediatric Mobility Lab at the University of Delaware, and crew stocked up on pint-sized riding toys.
Galloway’s quest was to facilitate independence and mobility among disabled children from the age of six months and older and offer a low-tech solution during the five-year wait in the United States for a $25,000 power pediatric wheelchair.
The hackers jerry-rigged the toys with pool noodles, PVC pipe and switches, reconfiguring them as mobile rehabilitation devices to promote functional skills among kids with special needs. …
My father had a favorite bit of advice as we embarked on our adult lives: “Go big or go home.” Going big is exactly what OPENPediatrics is doing, empowering physicians and nurses to care for children across the globe.
The Web-based digital learning platform was conceived 10 years ago by Jeffrey Burns, MD, MPH, chief of critical care at Boston Children’s Hospital, and Traci Wolbrink, MD, MPH, an associate in critical care. It concluded a year-long beta test in April 2014, and version 1 has now been launched.
Developed to impart critical care skills, OPENPediatrics uses lectures, simulators and protocols to deliver training. In the process, it has helped save lives. …
The world paused for a moment when the news broke last week that two Ebola-infected American missionaries working in Liberia had received an experimental therapy called ZMapp. As I write this, both patients are back on U.S. soil, and seem to be responding well to the treatment.
But was it ethical?
That difficult question can be divided into two. First is the question of whether it was ethical to give the two patients a drug that, up to that point, had never been tested in people. The second—in some ways thornier—question is: Was it ethical to give the treatment to two Americans but not the nearly 1,850 West Africans infected in the outbreak (as of August 11)? …
Diarrhea is a bigger global killer than HIV and malaria combined. It accounts for more than 800,000 deaths each year among children 0-5 years. And how tragic this is when the simple intervention of hand washing can prevent some of these deaths. Results of a trial, published in the March edition of The Lancet Global Health, indicate that teaching families in under-resourced areas of the world about hand washing is not only possible but also scalable, sustainable and successful—if it’s done the right way.
Hand washing is a simple intervention, but the prevalence of the behavior is as low as 1 to 2 percent in some under-resourced global settings. A London School of Hygiene and Tropical Medicine group, led by Adam Biran, PhD, decided to try to improve these statistics by devising an effective intervention.
However, the route to simple solutions is often complex. The researchers used very sophisticated methodology to identify the levers of behavioral change. They realized that health messages about hand washing have not worked. The idea that what I do today may prevent diarrhea down the road just did not have enough oomph to motivate people to adopt a new routine.
The researchers hypothesized that emotional drivers (including nurture, status, disgust and belonging) would be strong pushes to get families to wash their hands. And they were right. …
Maitreyi Mazumdar, MD, MPH, practices pediatric neurology at Boston Children’s Hospital. She leads a research program in Bangladesh that studies the effects of the epidemic of arsenic poisoning on neurological outcomes in children.
Neurodevelopmental disorders, including autism and attention deficit/hyperactivity disorder (ADHD), affect many millions of children and appear to be increasing in frequency worldwide. Improved diagnosis and changes in diagnostic criteria explain a portion of the rise, but not all. In other words, the increase in neurodevelopmental disorders seems to be “real.”
To date, research has mainly invested in finding genetic causes, implicating biological pathways that affect, for example, the formation of synapses and the production of neurotransmitters. Such discoveries improve our understanding of the basic biology of neurodevelopmental disorders and may ultimately lead to new therapies. But genetic variants alone cannot explain the recent rise; if they did, population rates of neurodevelopmental disorders would be expected to stay the same, or even decrease over a 30- to 40-year period, due to affected people likely having fewer children. Instead, reported rates have steadily increased over the past several decades. Something else is going on. …
Beginnings—whether a new year or a new century—offer an optimal time for evaluating goals. Quality improvement literature reminds us that goals should be specific, measurable and timely, and that progress checks are crucial. With one year left to achieve the ambitious Millennium Development Goals (MDGs), global child health stakeholders are assessing gains and gaps.
In 2000, the United Nations set the MDGs, and homed its sights on child mortality in MDG 4, aiming to cut mortality among children younger than age 5 by two-thirds by 2015, from the 1990 base figure of 12 million.
By 2012, the figure was nearly halved to 6.6 million.
“There’s a hopeful sense,” says Judith Palfrey, MD, director of Boston Children’s Hospital’s Global Pediatrics Program in the Department of Medicine. At the same time, the goal remains “seriously off target for many countries,” wrote Zulfiqar Bhutta, MB, BS, PhD, from the Hospital for Sick Children in Toronto, and Robert Black, MD, from Johns Hopkins University in Baltimore, in The New England Journal of Medicine in December.
Palfrey agrees, noting that while some countries are on track to meet the goal, some have stagnated and some have regressed. “It may be that there are some intractable issues,” she says. The countries that have failed to make progress are marked by corrupt governments, armed conflict or both. …