The Center for Global Surgery aims to improve access to essential surgical care by addressing the barriers to care, with multidisciplinary and bidirectional partnerships, through innovation, research, education, policy, advocacy, by training the next generation of global health leaders and building sustainable capacity in regions with health inequities.
Approximately 5 billion of the world’s 7 billion people have no access to safe, affordable surgical and anesthesia care, resulting in more deaths and disability than HIV/AIDS, tuberculosis and malaria combined. Misconceptions as to the cost, required supplies, expert knowledge and scope often serve as obstacles to offering surgical relief to many patients in low-resource areas in low-, middle- and high-income countries. Addressing surgical disparities and issues surrounding access to care is of paramount importance, as untreated disability caused by degeneration, non-communicable diseases or trauma is often a death sentence in these environments.
The Center for Global Surgery houses and strengthens the multidisciplinary initiatives that are ongoing in global surgery at Northwestern, funded through grants, donations and NGOs.
Global Surgery Fellowship
The Global Surgery Fellowship cultivates physicians with not only experience in research, programmatic development, policy and advocacy, but also the ambition and compassion needed to reduce the burden of untreated surgical disease in resource-limited areas. Our fellows are encouraged to seek diverse collaborations, in both low- and high-resource settings, to facilitate the understanding and elimination of socioeconomic, cultural and environmental barriers to surgical access.
Since 2010, medical students, residents, fellows and young faculty have joined the NTSI, a global surgery lab started by Swaroop, to build sustainable access to surgical care through education and research in low-resource settings. The NTSI creates an academic pathway for those interested in becoming Academic Global Surgeons.
Due to obstructed labor, or attempts to relieve this labor via cesarean section, fistulas cause devastating injuries for women, like total urinary and/or fecal incontinence. Women are often ostracized from their families and communities and unable to access safe, affordable surgical care.
Since 2012, Kielb has worked twice a year in Kigali, Rwanda, at Kibagabaga Hospital to repair obstetric fistulas for women with the International Organization for Women and Development. Her team works closely with the Rwandan Ministry of Health, local staff at the Kibagabaga Hospital and Rwandan surgeons. They keep detailed records and charts with regular reporting of outcomes to the Ministry of Health and quality improvement metrics in place for optimal patient care.
The team trains Rwandan medical students and residents and includes educational programs intended to prevent fistula formation. Kielb also conducts IRB-approved research in Rwanda, evaluating the regional variation in fistula formation, the change in trends as to the cause of fistula and the importance of intra-operative cystoscopy during fistula repair. These projects involve Rwandan medical students, residents and physicians, as well as Northwestern students and residents.
Kielb also serves as a board member and mission leader for the International Organization for Women and Development.
PROMIS Bolivia, founded by Steven Schuetz, MD, is a charitable foundation whose mission is to adapt, disseminate and implement state-of-the-art science and international healthcare interventions throughout Bolivia to maximize the health outcomes of patients and their families. A delegation from the National Comprehensive Cancer Network, including oncology leaders from the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, recently met with health leaders in the Plurinational State of Bolivia to begin generating cancer treatment recommendations to fit the country’s unique needs.
Murphy's team, in collaboration with the chief of surgery and fellow urologist Dr. Edet Ikpi, implemented basic infrastructure to integrate urology education into the surgical residency curriculum at the John F. Kennedy Hospital in Monrovia, Liberia, to embark on bidirectional educational exchange and future research endeavors. The hospital has been sent biomedical equipment, surgical instruments and educational materials.
The collaboration is funded in part by the World Bank to expand urologic surgical training. Ikpi, who trained at the University of Calabar Teaching Hospital in Nigeria, collaborated with Murphy on an evaluation of prostate cancer in Nigeria by looking at autopsies, funded by the Northwestern Global Health Catalyzer Grant.
Through the collaboration and guidance of the Northwestern team, Ikpi was responsible for the department achieving regional accreditation by the West African College of Surgeons for their surgical residency training program.
As a part of the RISE Initiative, the Gender Pathway Program takes a multidisciplinary approach to provide self-empowering and self-affirming psychological, medical and complex reconstructive care to the transgender, gender-expansive and victims of female genital cutting community.
Female genital cutting, a traditional, non-religious or cultural practice harmful to young girls and women, comprises all procedures that involve partial, or total, removal of the external female genitalia or other injuries to the female genital organs for non-medical reasons. This practice is currently increasing in high-income countries while it is decreasing in low-income countries.
Jordan's team strives to create a secure, safe atmosphere for patients and aims to advocate for gender and sexual minorities and victims of female genital cutting.
Founded in 2005 with Victoria Brander, MD, Operation Walk Chicago is a humanitarian medical mission that provides free hip and knee replacement surgeries. The group works to improve the quality of life of disadvantaged patients around the world by reducing disability from advanced joint disease while building capacity in countries by teaching surgeons and residents in the country.
Stulberg's is currently working on an innovative approach to data collection via an IRB-approved project in Vietnam. Each trip includes educational opportunities for Northwestern medical students, residents and fellows and always incorporates programmatic development for partnering countries.
Building surgical capacity and evaluating the quality of care in Sub-Saharan Africa are the two focuses of Abdullah’s team in partnership with Dr. Hope Addy of Korle Bu Teaching Hospital in Accra, Ghana. On a recent trip to Accra, the team taught the Fundamentals of Laparoscopic Surgery over two days to a group of surgeons from three different countries with standing room only.
The team then traveled to Liberia to conduct a two-day course on inguinal hernia repair, a common pediatric surgical problem easily corrected with appropriate surgical training. These efforts to train local surgeons have the potential to expand access to surgical care multifold in under-resourced areas.
Research fellows at Ann & Robert H. Lurie Children’s Hospital of Chicago have active lines of inquiry examining children’s access to surgical care, the quality of existing surgical care and the ease of implementation of novel database registries. These registries allow scientists to understand longitudinal patient outcomes and assess baseline characteristics of developing surgical systems around the world. Discussions about implementing a novel database registry are underway in Zambia.
The Global Surgery Steering Committee, Inaugural Meeting: March 31, 2016
The Global Surgery Steering Committee’s inaugural meeting was held on March 31, 2016. Brought together by David Stulberg, MD, and Vicky Brander, MD, eight surgeons and physicians met to learn about surgical initiatives at Northwestern Medicine and to determine constructive ways to support individual and collective efforts. The Steering Committee also served as the initial advisory committee for the Center for Global Surgery.
Fizan Abdullah, MD
Sam Attar, MD
Victoria Brander, MD
Roxanna Garcia, MD
Wilson Hartz, MD
Eric Hungness, MD
Stephanie Kielb, MD
Magdy Milad, MD
Adam Murphy, MD
Steven Schuetz, MD
Nathaniel Soper, MD
Sam South, MD
Samuel Stulberg, MD
Mamta Swaroop, MD
Jonathan Vacek, MD
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