I attended the one-day symposium along with at least 100 other people Friday at the Harvard Club in Boston. Here’s my brief summary from the morning. It would be great for others to share their takeaways in this GHDonline discussion or start a new one.

Paul Farmer started the day by emphasizing the critical need to improve surgical care globally. Recognizing the enormity of the challenge, he said, no hospital anywhere can function sufficiently without an operating room, but first you have to make sure there is also water and electricity. Farmer cautioned against creating competition for the allocation of scare resources and then suggested the audience bring together research, training, and service. “Don’t forget to scrub in,” he said.

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Many patients in rural areas and in the developing world are not able to receive life-saving surgeries because of the lack of surgeons, anesthesiologists, or medical officers with basic surgical and anesthesiology training.

Initiatives like the WHO Safe Surgery Saves Lives Checklist are proving very useful. The 19-item checklist, an effort led by Dr. Atul Gawande, has thus far demonstrated efficacy in reducing the complications and mortality associated with a variety of surgical procedures by more than 30% by facilitating essential communication among all members of the operative team. But some suggest that in health facilities where leaders and supervisors pushed the use of the checklist without getting first buy-in, “even a year into implementation, providers (doctors, nurses, and techs) do not use it in the manner intended and it has become just another burdensome form to be completed.” There are many efforts like these, but once again better coordination and open collaboration between actors is sorely needed.

A home in the rain forest in Costa Rica, where Dr. Hau had a first glimpse of medicine in underserved areas visiting rural health facilities with a medical Spanish program.

I recently met with Ann Hau, MD, an anesthesiology resident at Beth Israel Deaconess Medical Center in Boston, U.S. (BIDMC) and a co-moderator of the Global Surgery & Anesthesia community on GHDonline with Robert Riviello, MD, MPH, Brigham And Women’s Hospital also in Boston; Lubna Samad, MD, Indus Hospital, Pakistan; and Nadine Semer, MD, American College of Surgeons.

During our discussion, Ann talked about her inspiration and work, future projects, and her hopes that the community will connect people and help answer questions, and bring a better understanding of the issues that members face on the ground.

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