RT Journal Article
SR Electronic
T1 Towards resilient health systems: opportunities to align surgical and disaster planning
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e001493
DO 10.1136/bmjgh-2019-001493
VO 4
IS 3
A1 Jordan Pyda
A1 Rolvix H Patterson
A1 Luke Caddell
A1 Taylor Wurdeman
A1 Rachel Koch
A1 David Polatty
A1 Brittany Card
A1 John G Meara
A1 Daniel Scott Corlew
YR 2019
UL http://gh.bmj.com/content/4/3/e001493.abstract
AB Natural disasters significantly contribute to human death and suffering. Moreover, they exacerbate pre-existing health inequalities by imposing an additional burden on the most vulnerable populations. Robust local health systems can greatly mitigate this burden by absorbing the extraordinary patient volume and case complexity immediately after a disaster. This resilience is largely determined by the predisaster local surgical capacity, with trauma, neurosurgical, obstetrical and anaesthesia care of particular importance. Nevertheless, the disaster management and global surgery communities have not coordinated the development of surgical systems in low/middle-income countries (LMIC) with disaster resilience in mind. Herein, we argue that an appropriate peridisaster response requires coordinated surgical and disaster policy, as only local surgical systems can provide adequate disaster care in LMICs.We highlight three opportunities to help guide this policy collaboration. First, the Lancet Commission on Global Surgery and the Sendai Framework for Disaster Risk Reduction set forth independent roadmaps for global surgical care and disaster risk reduction; however, ultimately both advocate for health system strengthening in LMICs. Second, the integration of surgical and disaster planning is necessary. Disaster risk reduction plans could recognise the role of surgical systems in disaster preparedness more explicitly and pre-emptively identify deficiencies in surgical systems. Based on these insights, National Surgical, Obstetric, and Anesthesia Plans, in turn, can better address deficiencies in systems and ensure increased disaster resilience. Lastly, the recent momentum for national surgical planning in LMICs represents a political window for the integration of surgical policy and disaster risk reduction strategies.