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Off The Table: A Global Surgery Podcast

Off The Table: A Global Surgery Podcast, on behalf of the Global Surgery Lab

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We are a diverse group of people who deeply care about improving access to surgical care worldwide and believe that those solutions come from the ground up. Our mission is to create an environment to have safe conversations about equitable surgical care globally. To give a voice to surgical providers on the ground to express the challenges of delivering surgical care in their contexts. To highlight equitable global surgical partnerships, free from neocolonialism. To offer evidence-based appr ...
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Each surgical subspecialty has unique sets of challenges when performing their specific procedures. In plastic surgery, procedures for complex burns, hand injuries, and congenital deformities can require tissue/skin graft preparation and microscopic reapproximation. These challenges are only exacerbated when resources are limited - both in terms of…
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​​The dawn of a new year brings new resolutions, new perspectives, and new hope. And what better way to kick off 2024 than with our latest episode – one that explores global surgical topics as well as life lessons. We are proud to present our guest, Dr Myron Rolle, a former American football (NFL) player turned neurosurgeon. In this episode, we wil…
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Leaving behind everything to escape war, persecution, or even natural disaster poses its own unique challenges. Forced relocation is difficult, creating a unique set of problems including housing, food, finances, and importantly, healthcare. Accessing these resources as a refugee is extremely difficult and uniquely convoluted. Refugee camps seek to…
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As professionals working on a global scale, even the simplest of things must be challenged. Surgeons, lawyers, administrators, and many others, must adapt to become multifaceted individuals in this space. Surgery doesn’t just start and stop with the drapes. It involves supply chain, personnel management, legislation, advocacy, and so much more. In …
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Delivery of surgical services in low-resource settings is extremely difficult. Supply chain issues, funding, shortages of supplies, and even lack of healthcare professionals are each enormous hurdles in and of themselves. What about when civil conflict arises and a war begins? Increases in different types of injuries start to plague the already fra…
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Global climate change directly affects every person on the earth today. Whether this is a simple temperature rise or abnormal weather patterns to complete displacement of one's living situation due to rising ocean waters, climate change is happening all around us. Many industries have sought to do their part to slow the progression including the mi…
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When we discuss global surgery, we often focus on the physical workforce that it takes to support a patient through their surgical needs. The other side of this process is the digital or mechanical support that makes surgery all possible. It is easy to take for granted the countless computers, x-ray machines, ventilators, and more. We often don’t r…
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New year, new episode! After a brief pause, we are excited to be back to share with you more about the amazing initiatives happening around the world and major concepts within the field of global surgery. The episode today is focused on a topic relevant to every listener because we all have one - mothers! Women’s health is at the very core of medic…
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In commemoration of Pride month this month, we wanted to highlight a population within society, but particularly in the field of global surgery, that is often left behind. The LGBTQ+ community has experienced high rates of discrimination and ostracization resulting in higher rates of mental illness, suicide, and even drug use. Further, LGBTQ+ patie…
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Welcome to our seventh episode, featuring the inspiring husband and wife duo, Dr. Nandakumar Menon and Dr. Shylaja (Shyla) Devi. In this episode we welcome two extraordinary individuals who have made an enormous impact on improving healthcare accessibility and delivery for indigenous populations in rural India. Shyla, a gynecologist, and Nandakumar…
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Lights, camera, ACTION! With the continued evolution of social media and technology, content creators can share their talent widely throughout the world without the need of a stage crew, make-up artist, costume designer, scriptwriter, director, etc. etc. etc.; in fact, you can do it from your very own living room with your iPhone! While it doesn’t …
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The beautiful thing about surgery is that it has the power to change lives in ways that no other field can. Surgery is often used to correct physical deformation. Whether that is a fractured femur from a motorcycle accident, a craniotomy to relieve pressure on the brain, or an appendectomy to remove a ruptured appendix, each of these procedures hel…
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Asking questions is at the very core of education. Surgical education specifically is a unique circumstance in which “learning” directly affects the lives of others - sometimes in very negative and real ways. Thus, tackling training of new surgeons around the world has very real consequences that can help increase access to needed care around the g…
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This episode we welcome the man who wears many hats; Dr. Abebe Bekele, founding Dean of the School of Medicine and Deputy Vice Chancellor at the University of Global Health and Equity (UGHE) in Rwanda. Dr. Bekele is a renowned thoracic Surgeon and a Professor of Surgery at Addis Ababa University, School of Medicine in Ethiopia. He is a fellow of th…
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Imagine if you arrived at your house and there were dozens of Amazon boxes at your door. None of which you had ordered. You open them only to find random items – a hairbrush, t-shirts that are way too big for anyone in your household, a toaster, and ice cream that is now all melted since you didn’t know it was there and should be refrigerated. Furt…
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We are delighted to be joined by the incredible Dr. Brian Madison, president of South Sudan Orthopaedics and Trauma Society. Dr. Madison is an orthopaedic surgeon with a passion for global surgery. He is a dedicated advocate for the improvement of surgical systems in Africa. Born in Eastern Equatoria, before South Sudan was even recognized as an in…
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4 hours? 7 hours? 10 hours? Look around you. Chances are you have a cell phone, tablet, or computer within reach (you are reading this after all). The number of hours an individual spends on their electronic devices each day continues to rise every year. With mobile devices reaching almost every corner of the earth, access to technology has never b…
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Welcome to our fourth episode, featuring special guest Dr. Bret Batchelor. Dr. Batchelor is a renowned Family Practitioner and Chief of Surgery at Queen Victoria Hospital in Revelstoke, B.C. He completed his medical degree at the University of Calgary before undertaking Rural Family Medicine training at the University of British Columbia and an Enh…
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Our episode today covers a debilitating and life-threatening condition that disproportionately affects those in developing countries around the world. Affecting more than 150,000 people annually, Noma is a fatal infection of the face and mouth with the mortality rate approaching more than 90 percent and the morbidity/sequelae are permanently debili…
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This week we are ecstatic to be joined by the renowned Dr. Dieudonne Lemfuka, a general surgeon from the Democratic Republic of the Congo. Dr. Lemfuka is passionately involved in surgery, surgical education, global surgery advocacy, and Christian SIM missionary work. Dieudonne received his medical training from the Pan-African Academy of Christian …
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Children are one of the world’s protected populations. Indeed, they are the very make up of our future as a race. They bring new life, ideas, and opportunities we can only dream of. Unfortunately, not all children around the world have equal opportunities to contribute to this future. In 2019 alone, more than 5 million children under 5 years died f…
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Introducing the awe-inspiring doctor and feminist extraodinaire, Dr. Marcella Ryan-Coker. Born, raised, and currently practicing in Sierra Leone, Dr. Ryan-Coker is an esteemed physician and global surgery advocate at the forefront of the inspirative humanitarian movement to improve surgical care in West Africa. She completed her MSc in Global Healt…
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Findings from studies published in The Journal of the American Medical Association (JAMA) report that more than 45% of resident physicians experience burnout and the numbers are continuing to climb. If that number didn’t surprise you, then you are well aware of the psychological stress and struggles that doctors and other healthcare workers experie…
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Dr. Emmanuel Makasa does not require an introduction, and he tells his story and career path better than anyone else. In short, he is an orthopaedics and trauma surgeon turned global health diplomat with senior management experience at the Zambian Ministry of Health as Deputy Director responsible for Emergency Health Services. He was Secretary Gene…
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Undergoing surgery is an extremely multifaceted process that includes physical, mental, and social aspects to make it successful. Often when we talk about surgery, we focus on the physical and neglect these other important parts. This is where social work can bring all the pieces together to include the biopsychosocial approach to surgical care - a…
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Humans are inherently social creatures. For centuries we’ve learnt to survive, adapt and overcome through collaboration and unity. Medicine, in particular, highlights the value of taking input from multiple specialities and healthcare professionals to optimise patient care. However, with the power of modern technology, does this collaboration need …
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Healing takes time. To heal means to regenerate, to align and to gain strength. Wound healing, in particular, highlights the power of the human body in times of crisis – manipulating its resources and cells to restore homeostasis. But what happens when that fails? What happens if it’s a traumatic wound that gets infected, fails debridement? In high…
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Checklists have been instituted in many sectors to help streamline processes. They are there to make things easier and bring peace of mind by eliminating forgotten aspects of a procedures. Surgery is no different. The surgical checklist is vital to the delivery of safe surgery around the world, however, checklist implementation involves changing mi…
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Medical textbooks are a staple for education for medical trainees worldwide. These textbooks teach through words but they also teach through picture portrayals of conditions students will see in the future. Topics include basic anatomy, skin conditions, injury patterns, and even necessary medical equipment. Unfortunately, many of these textbooks ar…
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Vaccination efforts around the world have been extremely successful - saving millions. They have been particularly helpful in pediatric populations. While vaccinations for children are important, if they are not followed by adequate access to surgical care, many of these children will still die premature. Currently part of the bottleneck of decreas…
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“Climate change is the single greatest threat to planetary and human health of our time. It is not a distant future concern, but a process that is occurring here and now.” - Roa L, Velin L, et al. Climate change is a huge idea. It stems from the accumulation of greenhouse gases due to human consumptive practices that results in environmental change…
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Performing surgery requires many different parties. Each needs to come to the operating room prepared to excel in their field but also work collaboratively with the other parties. Unfortunately, the field of surgery has the potential to be surgeon-centric and important collaborators like anesthesia fail to be discussed. In this episode, we seek to …
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Health systems are sick. Around the world gaining access to necessary surgical treatment can be difficult due to inadequate healthcare infrastructures but also due to imbalanced care across demographics. Women across the globe often struggle to gain equal access to healthcare and maternity services - and not just access, but high quality care. The …
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The power of students can be immense. In a team, each person brings something to the table and has different strengths to offer. Students offer the benefit of time, passion, and drive. Mentors offer the benefits of experience, teaching, and context. The combination of student and mentor can bring both to new heights. In the world of global surgery,…
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Trauma injury kills more people every year than HIV/AIDS, malaria, tuberculosis (TB) combined. Despite this, it often takes a backseat when receiving research support, clinical funding, and policy change. Trauma disproportionally affects low- and middle-income countries with its far reaching effects beyond the walls of the hospital. In fact, in som…
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The term “global surgery” is extremely broad and elusive. “Academic global surgery” even more so. It can be hard to feel like one is making a difference, particularly when there are so many injustices all around us. However, global surgery is everywhere! It is anywhere that there is health inequity. Join us in this inspirational episode as we talk …
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Lean methodology is a core principle that focuses on minimizing waste in order to maximize value. In other words, when an organization is lean, they have created the most value possible for both the producer which can then be passed onto the consumer. In order to do this, there needs to be a shift from optimizing individual processes to optimizing …
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Colonialism has affected almost every major indigenous population around the globe. Some civilizations have been affected by settler colonialism with large-scale immigration of foreign individuals to overtake land and property that did not belong to them. Other civilizations have experienced more exploitative colonialism where natural resources and…
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Home to 25 million people, North Korea is a world of its own. Insights into the country’s healthcare system are scarce at best, let alone surgical care. This is not the case, however, for Dr Kee Park, a neurosurgeon working with Harvard’s Program in Global Surgery and Social Change and the World Health Organization to support local surgeons in thei…
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In a matter of seconds, your world can change. When a 7.0 magnitude earthquake ripped through Haiti in 2010, no one was prepared for the aftermath that would occur. Over a quarter-million people dead, and with 52 aftershocks, the country continued to be hit over and over. As the poorest country in the Western Hemisphere at the time, the country’s i…
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hu·man·i·tar·i·an: (h)yo͞oˌmanəˈterēən/ = concerned with or seeking to promote human welfare. We often put humanitarian aid as an ideal – but what does it truly mean to be a humanitarian? Is it volunteering one’s time or financial resources to another? Is it only during times of crisis or disaster, or is it at any time? What are the ethics behind t…
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There are many ways to make a difference in people’s lives. Some people do that through medicine. Others through technology. And even others through public health. For our speaker this week, he started as a clinician and has transitioned to a public health specialist. Global surgery requires an army - people from every discipline to come together t…
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Delivering care in rural areas is one of the hardest challenges of global surgery. Access to necessary medications is difficult and limited, but access to surgery is even harder, forcing many to travel hours on muddy roads through public transport to seek care. Even still, these are the lucky ones. Many never even make it out. Today about 15% of pe…
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Laparoscopy is a major breakthrough in surgery. By using gas to inflate the abdomen, surgeons are able to drastically increase their visibility and thus can work through very small incisions to do major abdominal surgeries. The benefits are numerous including smaller scars, quicker recovery, and shorter time to return to work (which decreases lost …
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Imagine you are sitting in a medical tent in a combat zone. You are the military surgeon and a solder is brought to you with injuries from a bomb blast that you have no idea how to treat. This wasn’t in your training. You have no idea what to do. How do you save this soldier’s limb - or even more importantly - this soldier’s life? Now imagine you a…
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You are sitting at your desk with a paper and pencil. You draw a rectangle on the paper and start looking at it from different angles. It represents the layout of an operating room. You draw a larger box around the inner one. This represents the whole perioperative area. What do you put inside these boxes? How many water stations do you need? Hand …
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As a country, creating a national long-term strategy to address barriers in your health system is a daunting task. Where do you start? What do you do if you fail? And how to you ensure long-term longevity. It is your responsibility to bring together key stake holders with different backgrounds including: health economics, surgery, business, advocac…
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In many regions of the world, clean water, electricity, medical facilities, and medical personnel are limited or nonexistent. Healthcare infrastructure is lacking and access to needed supplies can be highly variable. But what if you could have a state-of-the-art hospital and a whole crew of medical professionals delivered directly to the areas that…
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250 degrees Fahrenheit. 121 degrees Celsius. This is the temperature at which surgical equipment is sterilized. Pressured steam envelops each and every instrument cleansing them of impurities and killing microbes. This whole process is vital to the practice of safe surgery and is done in the confines of an autoclave. In order to create these temper…
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Every day 830 women die from pregnancy or childbirth related causes - that is over 330,000 per year. That is 830 mothers. 830 sisters. 830 wives. Lives lost, and families shattered. Sometimes these deaths come as a result of surgical complications, other times due to unsanitary conditions or infection, and still more due to severe bleeding that cou…
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