Journal Review in Burn Surgery: Global Engagement and Sustainable Participation

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 5 May 2025

⏱️ 32 minutes

🔗️ Recording | iTunes | RSS

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Summary

In our recent episode on global burn surgery with Dr. Barclay Stewart and Dr. Manish Yadav, we discussed several cases at Kirtipur Hospital in Nepal to illustrate the global burden of burns and similarities and differences in treating burns at Harborview Medical Center, a level 1 trauma and ABA verified burn center in Seattle, WA and Kirtipur Hospital (Nepal Cleft and Burn Center) in Kathmandu, Nepal. In this episode Dr. Stewart and Dr. Yadav return for an interview by UW Surgery Resident, Paul Herman, sharing insights on how to get involved in global surgery with an emphasis on sustainable participation.

Hosts:
Manish Yadav, Kirtipur Hospital, Nepal
Barclay Stewart, UW/Harborview Medical Center
Paul Herman, UW/Harborview General Surgery Resident, @paul_herm
Tam Pham, UW/Harborview Medical Center (Editor)

Learning Objectives
1. Approaches to global surgery
a. Describe historical perspectives on global health and global surgery reviewing biases global surgery inherits from global health due to the history of colonialism, neo-colonialism and systemic inequalities
b. Review a recently published framework and evaluation metrics for sustainable global surgery partnerships (GSPs) as described by Binda et al., in Annals of Surgery in March 2024.
c. Provide examples of this framework from a successful global surgery partnership
d. Define vertical, horizontal and diagonal global surgery approaches
e. Share tips for initial engagement for individuals interested in getting involved in global surgery

References
1. Gosselin, R., Charles, A., Joshipura, M., Mkandawire, N., Mock, C. N. , et. al. 2015. “Surgery and Trauma Care”. In: Disease Control Priorities (third edition): Volume 1, Essential Surgery, edited by H. Debas, P. Donkor, A. Gawande, D. T. Jamison, M. Kruk, C. N. Mock. Washington, DC: World Bank.

2. Qin R, Alayande B, Okolo I, Khanyola J, Jumbam DT, Koea J, Boatin AA, Lugobe HM, Bump J. Colonisation and its aftermath: reimagining global surgery. BMJ Glob Health. 2024 Jan 4;9(1):e014173. doi: 10.1136/bmjgh-2023-014173. PMID: 38176746; PMCID: PMC10773343.
https://pubmed.ncbi.nlm.nih.gov/38176746/

3. Binda CJ, Adams J, Livergant R, Lam S, Panchendrabose K, Joharifard S, Haji F, Joos E. Defining a Framework and Evaluation Metrics for Sustainable Global Surgical Partnerships: A Modified Delphi Study. Ann Surg. 2024 Mar 1;279(3):549-553. doi: 10.1097/SLA.0000000000006058. Epub 2023 Aug 4. PMID: 37539584; PMCID: PMC10829902.
https://pubmed.ncbi.nlm.nih.gov/37539584/

4. Jedrzejko N, Margolick J, Nguyen JH, Ding M, Kisa P, Ball-Banting E, Hameed M, Joos E. A systematic review of global surgery partnerships and a proposed framework for sustainability. Can J Surg. 2021 Apr 28;64(3):E280-E288. doi: 10.1503/cjs.010719. PMID: 33908733; PMCID: PMC8327986.
https://pubmed.ncbi.nlm.nih.gov/33908733/

5. Frenk J, Gómez-Dantés O, Knaul FM: The health systems agenda: prospects for the diagonal approach. The handbook of global health policy. 2014 Apr 24; pp. 425–439

6. Davé DR, Nagarjan N, Canner JK, Kushner AL, Stewart BT; SOSAS4 Research Group. Rethinking burns for low & middle-income countries: Differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries. Burns. 2018 Aug;44(5):1228-1234. doi: 10.1016/j.burns.2018.01.015. Epub 2018 Feb 21. PMID: 29475744.
https://pubmed.ncbi.nlm.nih.gov/29475744/

7. Strain, S., Adjei, E., Edelman, D. et al. The current landscape of global international surgical rotations for general surgery residents in the United States: a survey by the Association for Program Directors in Surgery’s (APDS) global surgery taskforce. Global Surg Educ 3, 77 (2024). https://doi.org/10.1007/s44186-024-00273-2
8. Francalancia S, Mehta K, Shrestha R, Phuyal D, Bikash D, Yadav M, Nakarmi K, Rai S, Sharar S, Stewart BT, Fudem G. Consumer focus group testing with stakeholders to generate an enteral resuscitation training flipbook for primary health center and first-level hospital providers in Nepal. Burns. 2024 Jun;50(5):1160-1173. doi: 10.1016/j.burns.2024.02.008. Epub 2024 Feb 15. PMID: 38472005; PMCID: PMC11116054.
https://pubmed.ncbi.nlm.nih.gov/38472005/

9. Shrestha R, Mehta K, Mesic A, Dahanayake D, Yadav M, Rai S, Nakarmi K, Bista P, Pham T, Stewart BT. Barriers and facilitators to implementing enteral resuscitation for major burn injuries: Reflections from Nepalese care providers. Burns. 2024 Oct 28;51(1):107302. doi: 10.1016/j.burns.2024.107302. Epub ahead of print. PMID: 39577105.
https://pubmed.ncbi.nlm.nih.gov/39577105/

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Transcript

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0:00.0	Behind the Night, the Surgery Podcast, relevant and engaging content designed to help you dominate the day. 5 billion people in the world do not have access to basic emergency surgical care.
0:27.5	9 out of 10 people cannot access basic surgical care in low and middle-income countries.
0:32.7	143 million additional operations are needed every year to meet this need.
0:37.2	I'm Paul Herman, a UW
0:38.6	general surgery resident, here to discuss approaches to sustainable engagement in global surgery.
0:45.1	In our recent episode on global burn surgery with Dr. Barclay Stewart and Dr. Manish Yadav,
0:49.9	we discussed several cases at Kirtipur Hospital in Nepal to illustrate the global burden of burns
0:55.4	and similarities and differences in treating burns at Harborview Medical Center,
0:59.5	a level one trauma and ABA verified burn center in Seattle, Washington,
1:04.0	and Kirtipur Hospital, Nepal-Kleft and Burn Center in Kathmandu, Nepal.
1:08.9	In this episode, Dr. Stewart and Dr. Yadav again join us to share
1:13.0	insights on how to get involved in global surgery with an emphasis on sustainable participation.
1:18.3	Dr. Yadav and Dr. Stewart, thank you for being here. Thanks, Paul. Yeah, thanks, Paul.
1:23.2	We'll be back. Well, abhorance is definitely a very critical topic, and we are glad to be able
1:29.2	to share what we have learned from our partnership with the aim of developing stations
1:33.7	entrusted in health equity, reducing disparities, and to engage in global work in the most
1:39.8	productive way. As discussed in several prior episodes by the global Surgery Team, the focus of global surgery
1:46.8	has shifted from episodic, mission-based care to a multidisciplinary field of research, study,
1:52.5	and practice focused on delivering surgery in a way that improves health equity regardless
1:57.0	of location, with a special focus on underserved, marginalized populations and populations
2:02.6	in crisis. Trauma is particularly important in the field of global surgery, given the high burden
2:08.3	disease. Burns in particular are an important focus, as burns tend to affect individuals
	...

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