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Summary

This is your chance to hear directly from Dr. Salome Mass, full professor and the head of the Global Surgery Division at the University of Cape Town, who has been recognized countless times and awarded with prestigious honors. In this session, she will address the challenges of access to healthcare, the three delays and strategies for health system strengthening. Dr. Mass will take you through her stepwise approach for identifying and implementing sustainable strategies for global surgery. She will also discuss various intervention techniques, including increasing the number of surgeons, increasing the number of surgeries, improving surgical outcomes, and reducing the need for surgery. Don't miss this opportunity to be part of the discussion and learn from one of the most influential and impactful medical professionals in South Africa.

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Description

Welcome to the GASOC International Conference 2022, we are delighted to have you join us either in person or virtually.

Join the conversation online by using #GASOC2022

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📮 Contact support@MedAll.org with any questions about the platform

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Links from Chat:

Twitter is @GASOC_2015. The facebook is GASOC UK. The conference hashtag is #gasoc2022

https://youtu.be/Hl7c3oDxIU8

Prof Mahmood Bhutta - 'The Real Cost of Healthcare': https://www.youtube.com/watch?v=Hl7c3oDxIU8

Dr Hixson's twitter: @ICUdocX / Twitter: @oceansandus

https://www.incisionuk.com/about-4

https://www.fmlm.ac.uk/clinical-fellow-schemes/chief-sustainability-officer%E2%80%99s-clinical-fellow-scheme

Miss Hunt - https://bjssjournals.onlinelibrary.wiley.com/doi/10.1002/bjs5.50122

References from Michelle Joseph: References:

https://gh.bmj.com/content/4/5/e001853

https://gh.bmj.com/content/5/7/e003164

https://gh.bmj.com/content/6/2/e002921

GASOC Mailing list - https://www.gasocuk.co.uk/join-now

https://www.gasocuk.co.uk/ Is our website for the Keith Thomson travel grant info

Phil - You can set up your own teaching organisation and get going straight away at https://MedAll.org/host

Or feel free to find at time that works for you to jump on a call after the conference and if we can help, we always will: https://calendly.com/phil-medall

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HOUSE KEEPING - once you have entered the event, on the left of the screen you will find the following icons:

🎤 Main stage - this will be where all our talks will happen - you can use the chat on the right to ask any questions

💬 Breakout session - this is where you will see our coffee rooms where you can network throughout the conference and also sessions

ℹ️ Event Info - you will find our schedule - we will try our best to keep to the times listed

👀 Sponsors - we have a few some incredible sponsors here - please do take a look

📃 Poster hall - this will open in a new window for you, you can browse these and click on them to read them - click on them a second time and this will enlarge it for you. Please do 'like' the posters as well as ask our poster presenters any questions

SCHEDULE

(subject to change | 'Skills Sessions' 1, 3 & 4 can be found in the sessions tab on the left of your screen, Skills Session 2 is on the main stage )

08:00-09:00 | Poster Hall and Sponsors

✳️ Welcome

09:00-09:10 | President's Address | William Bolton

09:10-10:00 | Keynote Speech: "Global Surgery: The State of Play" | Kee Park

✳️ Sustainable Global Surgery

10:00-10:25 | Human Healthcare and the Oceans| Richard Hixson

10:25-10:50 | Sustainability in surgery: A circular economy for medical products | Mahmood Bhutta

10:50-11:15 | Sustainable surgery, Making each day count| Katie Hurst

11:20-11:30 | Break | Sponsors and Posters or chat to others in our coffee break session

✳️ Sustainable Global Training

11:30-12:05 | Sustainable Mesh Hernia Surgery – Can Dreams Come True? | Mark Szymankiewicz & Mugisha Nkoronko

12:05-12:30 | What can the Sierra Leone surgical training program teach UK surgeons? | Lesley Hunt

12:30-12:55 | HEE’s Global Health Partnership Team: Global Learning Opportunities | Fleur Kitsell

13:00-13:45 Lunch | Sponsors and Posters or chat to others in our Lunch break session

13:15-13:45 | Sponsor Breakout Session

✳️ Sustainable Policy and Advocacy

13:45-14:10 | Health Partnerships: for sustainable and mutually beneficial health systems strengthening | Kit Chalmers

14:10-14:35 | Sustainable surgical solutions in LMICs, how do we achieve this? | Tim Beacon

14:35-15:00 | Climate Change and Global Surgery Policy | Lina Roa

15:00-15:15 | Break | Sponsors and Posters or chat to others in our coffee break session

SESSIONS **(use tab called 'session' on the left of screen)**

15:15-16:15 | Skills Session 1 - Trainee perceptions of Global Surgery and our role as advocates| Catherine O’Brien

15:15-16:15 | Skills Session 2 **Main Stage** - Research skills in Global Surgery | Michelle Joseph & Kokila Lakhoo

✳️ GASOC Projects updates

16:20 - 16:40 | The Future Surgical Training - Sustainability and Challenges | Moiad Alazzam

16:40 - 17:00 | Uganda VRiMS and Events Update | Helen Please

Sunday 23rd October

✳️ Welcome

09:00-09:10 | Secretary and Conference Organiser Address | Pei Jean Ong

✳️ GASOC Trainee Prize Presentations

09:10 - 09:20 | Ethical challenges in the implementation of global surgery: The Non-Maleficence Principle | Ana Toguchi

09:20 - 09:30 | A case report of multiple urogenital abnormalities detected during the post-surgery in a 20 year old primipara in Uganda | Paul Stephen Ayella-Ataro

09:30 - 09:40 | Designing low-cost simulation model for laparoscopic appendectomy and its application for surgical training in lower and middle-income countries | Bishow Karki

09:40 - 09:50 | Prize presentation including announcement of Keith Thomson grant recipients

09:50 - 10:00 | What are the challenges facing the development of pre-hospital care service in a low resource setting? | Elizabeth Westwood

10:00 - 10:10 | Speech from President of FoNAS | Michael Kamdar

✳️ Sustainable Global Development

10:15 - 10:30 | Why Global Healthcare Education Matters | Phil McElnay

10:30 - 10:55 | Patient-Centered Impact Evaluation in Global Surgery | Mark Shrime

10:55 - 11:15 | Sustainable Strategies for Global Surgery | Salome Maswime

11:15-11:45 | Break | Sponsors and Posters or chat to others in our coffee break session

11:25-11:45 | Mentoring in Global Surgery (EADP) | Omar Ahmed

✳️ Sustainable Global Innovation

11:45-12:10 | Design Challenges for Affordable and Reusable Surgical Devices for Low-Resource Settings | Jenny Dankelman

12:10-12:35 | Environmentally Sustainable Change in Theatre - Our Experience and How-to Guide | Katie Boag

12:35-13:00 | Frugal Innovation in Healthcare: How to Do More and Better with Less | Jaideep Prabhu

13:00-13:15 | Conference Close and Prize Giving | William Bolton

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A Global Conference

The GASOC International Conference 2022 will be hosted in Sheffield City Hall, UK, on the 22-23rd of October. Everyone is welcome, including medical students, trainees and allied health professionals from all surgical specialties, anaesthesia, obstetrics and gynaecology with a passion for global health. There will be something for everyone, with a range of keynote speeches from inspiring leaders in global health, breakout skills sessions, and opportunities to present your research through our e-poster hall. Finally, delegates will have a chance to meet our sponsors and exhibitors both online and in-person.

Sustainable Global Surgery

The theme of this year's conference is Sustainable Global Surgery. This is an exceptionally important topic as sustainability impacts every aspect of healthcare training and service delivery. Through this conference, we hope to not only tackle areas concerning environmental sustainability but also take on a broader approach and explore sustainability in other aspects, including sustainable training programmes, sustainable global partnerships, and sustainable innovation.

Click here to view our conference programme.

Posterhall

We thank all poster presenters for your enthusiastic participation. Please upload your posters by 17th October.

*Important information regarding registration*

Delegates from the UK can only register for in-person attendance, until our venue capacity is reached.

  • UK: in-person tickets only, virtual option will only be made available when venue capacity is reached
  • LMICs: free in-person and virtual tickets available, subject to a strict vetting process. Please note this does not include accommodation or travel expenses etc, these must be covered by yourself
  • Any other countries: in-person and virtual (fee-paying) tickets available, please save the date for now and we will open this option at a later date

LMIC is defined as per World Bank LMIC country classification, please do not pick the Fair Medical Education ticket if you live/work/study in any other country.

All delegate registrations will be reviewed to ensure that the correct tier of payment is selected. We take probity issues seriously and reserve the right to refuse admission to delegates who may have been dishonest in their application.

Please do not hesitate to get in touch via gasocuk@gmail.com if there are any queries about payment.

Refund Policy

GASOC is a trainee organisation and will have to shoulder the burden of the costs when people cancel their tickets. We seek your understanding in this matter. Should you require an urgent refund, this will be considered on a case-by-case basis. No refunds will be considered after 6th October. Please get in touch via via gasocuk@gmail.com in the earliest instance to discuss.

We look forward to seeing you soon!

Please visit our GASOC website for more information on the conference programme, food and accommodation. You can also follow us on Twitter @GASOC_2015 for the latest news updates!

Learning objectives

Learning Objectives:

  1. At the end of this session, participants will be able to identify the key barriers to healthcare and strategies to address them.

  2. Participants will be able to describe how global surgery works through a "surgical ecosystem" and interventions that can be employed to improve access to surgical care.

  3. Participants will be able to identify the Lancet 2030 targets for global surgery, and the four key areas for improving surgical care.

  4. Participants will be able to devise a stepwise approach for strategizing global surgical care, including increasing the number of surgeons, increasing the number of surgeries, and improving the quality of care.

  5. Participants will be able to explain the importance of health system strengthening, legal determinants of health, and reducing the need for surgery to promote sustainable strategies for global surgery.

Generated by MedBot

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Computer generated transcript

Warning!
The following transcript was generated automatically from the content and has not been checked or corrected manually.

Good morning, everyone. Great to see you all again. Everyone is looking very fresh for a second day of conference. I'm very impressed. Um, so it's my great pleasure to introduce Salome Mass. We may, um, reading through her bio. I thought I'll just pull out a few key bits I'm reading. I'm like, Oh, my goodness, This woman has done so many amazing things. Um, just flicking through her twitter as well. She seems to do it all in style. Um, so she is a full professor and the head of the global surgery division at the University of Cape Town. And she's an obstetrician gynecologist, a World Economic Forum, young scientists, member of the Academy of Science, South Africa and the next Einstein fellow. What a great fellowship. She's the vice president, vice president of the women in global health, South Africa, President of the South African Clinical Scientist Society and Board member and research chair of the Health Systems Trust in South Africa. She's also global council member of Life box, which I'm sure you all know very well. And board member of F a l f and S h a w see a after specializing, she completed her med and PhD in obstetrics and gynecology. She did a Postdoc Research Fellowship at Massachusetts General Hospital and Harvard Medical School. And she has a diploma in project management and a certificate in leading organizations and change from M. O. T. I think my first question to you is going to be When do you sleep? She's a section editor of the PAS Global Public Health Journal. She's received numerous awards for her research contribution to maternal health, including the Trailblazers Young Achiever Award by the president, South Africa in 2017 and in 2020 she listed Mail and Guardian, 50 most powerful women in South Africa. And in 2021 she was named among 20 young shapers of the Future in Health and Medicine by Encyclopedia Britannica. So without further ado, I'll hand over to her and we'll find out why she has one So many awards. Thank you so much. And greetings, everyone from South Africa. I'm talking today about the sustainable strategies for for global surgery, and this is something that I'm quite passionate about, and thank you to the organizers for inviting me to to speak on this, uh, topic next slide so our view of global surgeries that is really about looking at the solution is inside of theater and outside of theater. And so that's why it's important for us not only to look at, you know, to to look beyond and start thinking about strategies, and and and and not assume that we've got all the answers to how we can do what we want to do but to be strategic and how we plan to improve surgical outcomes and lower little income countries next slide. So what we know about barriers to healthcare, and I'm just gonna dive straight into it because I know the last two days have been incredible and a lot of speakers would have given the background to all of this. But I'm going to because I'm speaking about strategies. I'll lay the foundation for what I want to say. So the barriers to healthcare include poor infrastructure, shortage of resources, lack of facil, lack of human resources and specialists, poor leadership, inequity and discrimination, failure to implement policies on healthcare, and so as the bedrock of how we try to improve access to care. We need to think about these problems that we face in our health systems, and particularly how they affect access to surgical care next side. So the three delays, as we know, is the delay in seeking appropriate medical care for patients, particularly the second delay delay in reaching appropriate health facilities. And the third delays delay in receiving an appropriate care. So even once you're in a medical facility, you may not always get access to surgical care, even if you've made it on time and you've been referred appropriately. And so that's where the planning and the strategy comes in, because these are the key issues that we try to approach right community level in the car on the way to the hospital and facilities and what happens right inside of the hospitals next slide. So this all speaks about health system strengthening, and that is why your global surgery is really about strengthening the healthcare system. And so these ties up very nicely with the problems that I laid out at the beginning. Because health systems health system consists of all the organizations, people actions, who's prob intent is to promote, restore and maintain health. And so, as a global surgery community, we are looking at How can we improve issues of of, of service, delivery, infrastructure, leadership, governance, human resources, financing and information? And so as we strategized and come up with plans for countries, these are the things that we have to have in mind next slide. So we also don't work on our own. We've got a surgical ecosystem. We work with governments who work with community leaders NGO, uh, sub national governments, clinicians, academics, professional societies and religious and traditional leaders, and so important that as we think about what to do, that we include all the important stakeholders. Next slide. So health system strengthening. I've divided it into three key areas that you know, it's about the interventions that we want to do. And so, as a global surgery community, I think we're very clear on the problem on what we want to see, particularly by 2030. And but this can only be done through interventions. Some of these interventions will be regional. Where it's it's perhaps in sporadic. It's it's it's it's it's in Africa Continental. It may be national where you're looking at your country. It may be a region within your country where you go sub national and it may be right in a facility so all of us can do something. But at the end of the day, it's if it's it's about coming up with interventions that are going to improve. X to care. There are two things. Two ways I look at how we how we intervene as the global surgery cysts, uh, community supporting the health system, which may include activities to improve services or strengthening the health system. And many of us are not necessarily trained in the surgeons. But this is when it's it's comprehensive changes, too. Performance drivers, including using policies, regulations, organizational structures and the relationships across across the health system. So health system strengthening is a bit more complex. Uh, but many of us play a supportive role in in in helping, uh, governments are facilities to improve the the service delivery next slide. And so I also just want to touch on the legal determinant of health and particularly to say that the laws and the policies actually affect, uh, global surgery access to care because they can either perpetuate or mediate, uh, social determinant of health. So it's also important to to see that the policy's laws. Uh, and And I have an important role in improving access to care because these can help us address, uh, the concerns, or and and putting in place, uh, laws that will protect communities and prevent, uh, certain conditions and and certain emergencies that that patients may face, thereby improving outcomes. Next. Right, So we all are clear on the Lancet 2030 targets. And so I'm not going to go into that. But the basis of my talk is to say, Now that we know what to see, we have to plan the how we're gonna do it, the what we are going to do, and then who is going to do it? Uh, next slide and again just to emphasize I mean, there were recommendations for government, for international partners, for organizations, for finding agencies. But particularly what I'm focusing on is how governments and how nations and how groups can strengthen surgical services and and the health system next slide. So what? The basis of strategies? Understanding that change requires more than righteous anger, were all passionate about wanting to see change. But it's not our passion alone that's going to count. It requires us to to organize ourselves to develop programs and and strategies to improve outcomes next slide. And so I'm presenting this step wise approach. Doing that right at the top. Yes, we need surgical plans. We need governments to come up with policies that will better improve our surgical outcomes, but it cannot end there. It has to move on to strategies which are the road maps on how we are going to do this. It moves on to implementation and designing programs that are actually going to do this work. And in the end, it's about the actual services and the impact on the services that we provide at facility level. So my focus is really going to be on strategies and some suggestions that I have next slide. So first you have to define the strategy for your particular population of the population that you're working with. And I think for many of us there are four key areas that we would work towards overall, that that are overlying everything that we want to do. One. We can approach it from increasing the number of surgeons, which is what has been been advocated for for many years, that let's increase the number of surgeons or in increasing the number of surgeries and then improving surgical outcomes. Because quality of care is obviously very important. You don't want to increase access to surgery and still have to lose patients at the end of the day, and the last one is reducing the need for surgery and going into prevention. If we reduce the need to surgery, then you don't need to increase the number of surgeons by as much as you would have. If everything stays the same. Next slide. So increasing the number of surgeons. There are various ways of doing this. And as I talk through the next four slides, it's really to give you ideas on what type of strategies you can look, too for your particular population so you can creating surgical fellowship pro programs. These can be exchange programs nationally internationally, sending fellows to other countries or bringing insurgents to your country to come and teach. But we need to create more programs so that more surgeons are created task shifting task sharing, so we're not necessarily creating more specialists, surgeons and subspecialists. But we are teaching people the skills that will do the operations properly. as time goes on and creating capacity building programs so that the surgeons that we have are equipped and and have the correct skills. Next slide, then it's looking at How do we increase the number of surgeries? And this could be going into places doing surgical missions, creating extra surgical list, specific global surgery. So list the way it's about catching up with backlogs. It's providing equipment, resources and and all the things that you may need to increase the number of surgeries and also providing the right leadership so that sometimes it's really a leadership issue and not so much about resources and equipment Next slide. And then it's improving surgical outcomes where we do quality improvement programs again emphasizing on leadership and again doing capacity building and surgical training to better improve the skills of those who are operating in that area. Next slide and then the last one is about reducing the need for surgery. And again, your strategies will be different here because you'll target mainly the communities health promotion, prevention, using policies, working with governments, increasing screening programs, pap smears, etcetera so that you you you catch the disease is before they they need surgery and next slide. And so my, my, my, my summary on all of this is just to highlight how you develop the strategy. It's important that you target a population and identify the beneficiaries of this program that that you do too often we come up with a strategy and look for a population. But we should be finding a population and then coming up with the context, specific strategy for that particular population to be clear on the intended outcomes. The problem is quality of care. Then the strategy needs to be around the quality of care. If its capacity, building and skills, then your program should be around capacity building. Decide on what interventions are suitable for the population and that will meet the intended outcomes. You need to understand the population you're dealing with so and make the right assumptions so that you don't go with. If you go with wrong assumption, then you get wrong. Then you won't get the answers you want. You need to you know what input, what resources you need to carry out these interventions successfully the activities that are required and the outputs. And I put this because many of us. There's been a lot of plans but failed intervention, implementation. And that's often because there isn't a clear strategy because we know what we want. But we're not going the extra mile of mapping it out properly specifically for the communities we're looking at and last life. So in summary, the Lancet Commission for Global Surgery has provided the targets and goals for the global surgery communities. So we're all on the same page with our vision. Uh, indicators what we want to see by 2030. But for change to happen, we need more than a plan. We need a strategy. We need programs. This can be regional national Subhash community level of facility level strategies are a road map for what you want to do, where you want to do it and how you want to do it. And successful strategies need to be contact specific, uh, feasible and and and impactful. So thank you very much again for inviting me and for giving me this time. And I hope this contribution will help those of you that are looking at developing, uh, strategies for various populations. Thank you so much salary for your very interesting talk. I think I can say that. I think we've had a really interesting session with three very different speakers. Fill spoken to us about metal and the amazing work that they've done And that inspires us to think about creative ways, um, to engage people in, um, medical indication. And that's been really important for us with our global audience. We've had marks speak to us with some really interesting points about how you know just being here. We feel that we are doing good, but that's not enough and are good ideas and not enough. So we need to think about the context of which these ideas applying, um, and actually evaluate the impact properly. So I think that's challenged me personally, but I hope it's also challenged. You, um, sometimes just spoken to us about health systems, strengthening what we're going to do and how our passion alone, um, will not count. We need a step wise approach to how we manage things. So starting with our plan, our strategy programs and then the development of services. Um, so of course, we have now got time for questions. Um, please do right in the middle of chat if you have any questions? I've seen one come in so far for you swallowing. Um, there's a question by So, um, that says thank you, Professor. Uh, swimming. What is the role that colleagues in other countries can play in helping you drive forward these policy changes? Okay, thank you so much for for that question. And I think this goes to two partnerships as well. So I mean, you you always have to work with the people in that local community. It must be driven by the local community coming up with the solutions and strategies. But we can't do everything on our own. And I think that's where the partnerships come in. That is where we design, you know, programs together. You know, say, for example, it's a capacity building program. Say we identify, find that you know the problem is surgical training, and we want to send our fellows to other countries to go and train. So I think it's it's coming up with solutions together and people identifying the unique role and and skills that they have that they can then use to to to to provide. And so it's It's what we always say that It's about support and and supporting the idea's that have have come from from the from the population at at hand. So definitely there's a space for all of us who work together collaboratively. But it's important that those who understand there are challenges the most are the ones who are driving the strategies and and the ideas. And those who got experience with working with this at multinational level are also able to provide the guidance and and wisdom that that is required and resources were needed. Thanks. Thank you so much. That's really helpful. Just in the middle chat, Um, Catherine House made a comment for global surgery in surgery planning. I think it's important that countries do more for preparedness, training for refugee health and meeting there. Surgical needs. We know that with climate change will come mass migration. That's obviously something we've talked about a lot yesterday and displacement on a massive scale. This should come from medical school education upwards into training. So I just thought that was a really interesting point. A final question for you. Um, sorry, it's just leading. Um, Joanna, Hilda has said, I just wondered of the four strategies that you mentioned increasing surgeon surgeries, improved outcomes and then prevention. Is there one that you feel is most important or needed in your context at present? Thank you very much for that question, and I think it's very community specific. I think the reality. Many low and middle income countries, especially low income countries, as the surgeons are just not. You know, there isn't enough money to do the training, enough resources to do the training. And so you've been in in in such places, it may be issues around. Let's start off with capacity development. Let's start off with improving the quality of care. And and and it might not be feasible for us to aim to have, you know, x number of surgeons within the next five years. You know, the resources are probably not there, so I think it's it's all very country specific in my area and setting. There's been a lot of capacity development that we have been engaged, and there's there's We were also doing a bit of health promotion because in where I where I live in in in South Africa, we have a higher identity of of surgeons. But we also have a lot of adverse outcomes. And I'm sure you would have read through the African surgical outcome. Studies that, you know, quality improvement is is a key focus and and areas where there may be more surgeons. So But if you go to a county where there is no pediatric surgeon, just know that no one is getting the operations that are required at that level. So I think it always really has to be context a specific, and it cannot apply to an entire continent. We have to break it down to to the region's that we work in. Thank you. Thank you so much. And we were just going to actually give the opportunity to you guys who were here as well. Um, does anyone in the room have any any particular questions? They want to ask someone as well. We have a mike that we can pass around. So just in case someone had a burning question that they didn't want to put on the chat? No, I don't see any hands. I'll give you, like, 10 seconds. Mhm. No. Okay. All right. Thank you so much. Thank you so much. And, um, it's been a really lovely time having you here. And we really appreciate you speaking to us this morning. I hope you have a lovely day. Thank you.