Global Surgical Inequality: 5 Billion Without Access to Safe Surgery


Five billion people in the world lack access to safe and timely surgery. This article details why the problem exists and what we can do about it to ensure that no one dies from not being able to receive basic surgical care.

There is an unspoken truth: every 5 in 8 people on the globe do not have access to necessary surgical care for easily treatable conditions. Compare this with nearly universal surgical coverage in the United States and Canada where most people can receive safe and timely surgery. As a result of the global lack of surgical coverage, millions of people die each year. There is much we can do to make proper surgical care a reality for most people, but we focus on medical technology access and education.

Starting with medical technology access, we look at the most common tool used before and during surgery – the pulse oximeter. “Worldwide, it is estimated that there are 77 700 operating theaters that similarly lack a pulse oximeter,” says one study. The pulse oximeter is used to monitor the patient’s level of oxygen in blood. It is a critical tool and is the only medical device that is part of the World Health Organization’s Surgical Safety Checklist.

While in the United States or Canada, you can find a functioning pulse oximeter in almost every operating room, this is not the case for most of the world. Since the realization of the global pulse oximeter shortage, efforts have been made to distribute pulse oximeters worldwide, notably by Lifebox, a global nonprofit dedicated to making surgery and anesthesia safer.

Photo by Mockup Graphics on Unsplash

For $250 donated, they send a kit that includes a high-quality, durable, easy-to-use pulse oximeter with training materials on pulse oximetry. Through these efforts, they have delivered over 32000 pulse oximeters to operating rooms in need. This has impacted over 35 million patients worldwide, and it’s easy to support via individual donations. We can do our part and send a pulse oximeter to make surgery safer for all.

Following medical technology, we focus on education. There is a global shortage of the surgical workforce. In Afghanistan and Bangladesh, for example, there are nearly no surgeons, with surgical coverage measured at 0 and 3 surgeons per 100000 population respectively. Compare this with high indicators in Belarus and Cuba, at 125 and 101 respectively. Whether an outcome of national policy, financial deficits, or historical inequalities, this shortage must end fast.

This issue would require major institutional or public investments to solve. The Lancet medical journal’s commission estimates that around $420 billion are needed to solve the issue of global surgical coverage, and education is surely a major part of that investment. However, they say, the cost of not making these investments would be much higher, currently valued at over $12 trillion. Together, we can implement pressure on our elected officials and representatives to commit to these necessary investments.

The issue of global lack of surgical coverage is a major roadblock to an equitable and healthy world where basic surgical care is guaranteed to every patient, no matter where they come from, who they are, or whether they can afford to pay. But there is much we can do to help change the tide. Whether you decide to make a donation this month, volunteer next month, or spread the message, it is in our power to put this issue front and center for our society to take the steps to fix the situation. We can do it.

Featured Photo by JAFAR AHMED on Unsplash


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Andrey Romanov

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