Transcriber: Jennifer Nathalie Reviewer: Esra Çakmak
So I'm going to start off with my own personal story.
When I was 11 years old,
I was involved in a car accident,
and I was one of the few people who had to have a very complex surgery
and know that even adults haven’t gone through.
In this accident, my kidney was injured,
and the only thing that they could do to save my life was to take out my kidney.
Many people wouldn't survive,
not because it’s impossible to have nephrectomy,
but many of us live in places and come from places
where there isn’t even a surgeon or a team
that can do these operations.
I was taken to two hospitals.
At first, the paramedics didn't even notice what was going on.
They took me to a hospital where they only noticed the fracture on my arm.
But when they referred me for that fracture in the hospital,
then I ended up with --
They realized that I had internal bleeding
and that I was going to die if I don’t go to theater.
And afterwards I went to ICU,
spent a few days in hospital,
and I ended up with a normal childhood.
You know, many people would have been robbed of their childhood going through
such an experience, but I've had a normal childhood and upbringing.
So what does this really mean for many of us?
Every one of us at some point might find ourselves
in a position where you are sick, when you are in hospital,
when important decisions need to be made.
Whether you need to be admitted, you need to go to ICU,
you need to have a surgical operation.
And the truth is, not everyone has got access to safe surgical care,
even when they really need it.
In fact, in Africa, many women are not even able to have a caesarean section,
even when they really need it.
So we are quite familiar with having medical treatment.
You get sick, you are given medication,
you might be admitted and observed for a few days.
But what happens when you need to be operated?
How much work goes into making sure that there's a team?
It's not just about the operation,
it's about ensuring that you've got this surgeons, you've got the nurses,
you’ve got the equipment, you’ve got the resources
that if you end up in an accident,
there are paramedics who will arrive before you die
because not everyone who dies from an accident dies
because they had severe injuries.
Sometimes people don’t make it
because the systems were not functional enough to save their lives.
And you don't want to be one of those people.
So this matters to you and me because we live in a world and
a place where any one of us can find ourselves not having access to
the care that we need.
So the situation in the world is that
five billion people don’t have access to safe and timely surgery.
Five billion.
That means the majority of us,
if we end up in a situation where we need to have surgery may not have it.
And the majority of these people are in Africa,
and in low and middle income countries.
But even in situations where there is access to surgery,
people still die from complications to surgery
because even our systems are not functional enough to ensure that those
who then have access survive the complications that happen.
So an adult has got it in Africa
is two times more likely to die from complications of surgery.
A child is also two times more likely to die from complications of surgery.
But a pregnant woman is 50 times more likely to die
from complications of caesarean section in Africa
than women in high income country.
So what is global surgery?
Global surgery is all about ensuring that people across different parts of the world
different geographical areas have got access to safe
and timely surgery to high quality,
comprehensive surgical care that it shouldn't matter where you come from.
It shouldn’t matter whether you live in an informal settlement
or whether you live in an established place.
Everyone who deserves care needs to have access to care.
No one should be dying just because they could not get the care that they needed.
So global surgery is all about that, and it's all about ensuring this.
So what do we need?
Why I spend half of my life developing to become a surgeon,
to become an obstetrician and gynaecologist,
doing caesarean sections.
And as I started trying to find out where the problem is,
I realized the problems were not in theater.
They were not inside the hospital.
They had to do with health systems.
They had to do with infrastructure.
They had to do with IT systems.
It was things that everyone could get involved in,
and not just ourselves as clinicians.
So global surgeries about strengthening service delivery,
it's about strengthening surgical care.
It's about ensuring that there are policies in place nationally,
provincially, locally that ensure that
everyone has got access to time and safely surgery.
It’s about ensuring that people also invest in surgery.
Those who run foundations, high income earners,
those who are able to give to such causes,
it’s about ensuring that they donate.
They give and make an investment in surgical care.
It's also about ensuring that our governments put more money.
It's not only about primary health care and ensuring that you enter
the health system, it’s about if you need surgical care,
if you need ICU, if you need oxygen,
you need ventilators that you will survive.
So it's not just about entering the health system.
It's about ensuring that once you enter
there are systems in place to ensure that you’ll be treated up till you go back,
you are rehabilitated and you are able to continue with your work
and continue with your daily activities of life,
healthy cities play an important role.
Have you ever looked at the roads around you where there are very narrow roads,
where there are no footpaths? There are more accidents.
That means that we’ve got more patients coming in with injuries in places
where there’s gender based violence,
and also means that we've got more women coming in who need to be operated.
So how we live, where we live,
the culture that we have also determines how many of us are going to end up in
hospital, how many of us are going to be sick.
So it's not just about ensuring that our systems inside are functional,
it's about ensuring that the communities that we live in promote health care
and prevent certain diseases and injuries
so that people can live longer and experience better lives.
So I challenge you all to imagine a world
in which everyone has got access to safe and timely surgery.
Thank you.