Correctable surgical disease is ubiquitous in the developing world and is now recognized as accounting for at least 11 percent of the world’s global health burden. The Global Health Advocacy Program in Surgery (GHAPS) was initially conceived in 2008 as a program under the OHSU Department of Surgery and is in a unique position to not only contribute to the care of patients across the globe but advance OHSU's strategic plan to become an international leader in health and science.
Global Surgery Director
Karen Kwong, M.D., is a Professor in the Department of Surgery, an Associate Program Director of the General Surgery Residency Program and Global Surgery Director. She maintains a clinical appointment and is Chief of General Surgery at the Portland VA Medical Center (PVAMC). She is a faculty advisor and Chair of the Clinical Competency Committee which enacts the General Surgery Milestones. Dr. Kwong also teaches the Ethics and Professionalism Skills Lab and supports Clerkship Director Mackenzie Cook M.D. in the advisement of students desiring to train in general surgery. Dr. Kwong is very interested in global health initiatives and travels to Haiti twice each year with residents and students to provide medical and surgical care, as well as promoting other educational and communication health activities. She is faculty for the Medical Student Elective Surgery and Inequalities course.
Surgery and Inequalities Course
Where Surgery, Global Health and Public Intersect
Inequalities in healthcare dramatically impact individuals and populations. On a global scale, over two billion people have limited access to even the most basic surgical care. This is very troubling in light of the fact that over 10% of the global burden of disease is surgical and the poorest third of humanity receive less than 3.5% of the surgical care.
Health disparities are not limited to international settings – here in the United States, surgical diseases such as obesity, cancer and trauma are significant public health issues. These challenges disproportionately affect our most vulnerable populations and access to care is similarly limited. This triad of high disease burden, poor access and disparity has spurred an evolving interest among surgeons, educators and health delivery researchers to integrate concepts of population health with surgical care.
OHSU surgeons have an active interest in community health, both globally and locally. Faculty have traveled to Haiti and Uganda, as well as developed educational experiences for OHSU surgery residents in Tanzania and Haiti. In addition, faculty surgeons are actively working to improve rural surgical care right here in Oregon.
The Surgery and Inequalities course will introduce 1st and 2nd year medical students to the critical role that surgery can play in reducing health inequalities. Discussion will include the ethics of global volunteerism, social determinants of health, governmental policy, and the World Health Organization’s Emergency and Essential Surgery program. Several case studies of war time, the developing world, and disaster surgical care will be examined. Sessions will be led by guest speakers, speaker panels, and student-facilitated journal clubs with an online response component.
- Expose students to a non-traditional context of surgical care
- Discuss the impact of health inequalities on the surgical burden of disease
- Discuss the global burden of disease and the critical importance of surgical care in ameliorating it
- Encourage critical analysis of medical volunteerism through discussions of ethical considerations
- Encourage and highlight the importance of academic and multi-disciplinary collaboration
- Understand the logistical challenges of international health work