Celebrating 50 years of service!

An Article from FIENS Board Member Dr. Jose Piquer

First of all, I would like to thank all the NED volunteers who have worked with us in Zanzibar and have helped us to achieve our goals.

With this short report, I intend to focus specifically on the Foundation and demonstrate to you how surgery can also effectively fight poverty and disease.

The accessibility to safe and affordable surgery is a main priority in Global Health and this should be recognized and plans implemented by every West world government. 18.6 million people do not have access to life-saving surgical procedures. The lack of an essential surgical procedure kills 3 times more than HIV/AIDS, tuberculosis, and malaria. Nevertheless, 70% of Global Health funds were committed to these communicable diseases. Surgery is the neglected stepchild of Global Health.

In order to address and invert this issue, the World Bank, the World Health Organization, and the global commission for surgery from Lancet, formed by 25 experts and collaborators from more than 110 countries, published in 2015 a consensus statement entitled Global Surgery 2030.

Global Surgery, by definition, is focused on the prevention of disease and promotion of health, aiming to improve and equalize surgical availability for those in need. It explores in detail how surgery and anesthesia promote health and how this can trigger the economic development of developing countries. It presents solutions and initiatives and sets a timeline to make it happen: 2030.

The evidence is shocking. Five billion people do not have access to safe, affordable, and timely surgery and anesthesia. 143 million additional surgical procedures per year and more than 2.2 million surgeons, anesthesiologists and gynecologists are needed.

However, it also emphasizes this important concept: safe surgery and anesthesia are not only cost-effective and save lives but also trigger the economic development of the developing countries. It looks like this the time for a “Surgical Spring”! (How Surgery Can Fight Global Poverty, Shrime and Meara, New York Times 2015).

Surgery is essential to achieve the goals of sustainable development and might be globally funded. To achieve this goal by 2030, funds approaching 420 million dollars are needed or the poorest countries in the world will have to pay 12.3 trillions of dollars and face a 2% decrease in the annual GDP, which would be devastating.

In this context, which role does neurosurgery have? Is it a luxury to think about global neurosurgery? Or are neurosurgical procedures so complex that do not even play a role in a developing country? Does it make any sense that a foundation like FIENS or NED promotes neurosurgery in sub-Saharan Africa?

The answers to these pertinent questions are found in Global Surgery 2030. Essential surgery is defined as a surgical procedure that has a high global impact and it is cost-effective. It lists the 44 procedures considered essential, most of them basic procedures of general surgery, traumatology, ophthalmology and gynecology. Nevertheless, surprisingly, craniotomies and ventriculo-peritoneal shunt placements - 2 common neurosurgical procedures - are part of the list.

Neurosurgery is not a luxury subspecialty; rather, it is an essential need and global neurosurgery is an unavoidable reality. We could not feel prouder of having founded FIENS or NED more than ten years before the publication of the Lancet report. We could not feel prouder for having spent the last 10 years trying to develop global neurosurgery in sub-Saharan Africa. Our volunteers have been challengers, innovators, and visionaries. Thank you all for making this dream to come true.

The NED Institute in Zanzibar has performed over 500 neurosurgeries in less than 2 years. It is the Foundation’s “Alma mater”, housing more than 20 missions, one hundred volunteers and two thousand patients per year. It is a model of Global Surgery Hospital that should be followed and who’s the focus is overcoming three major challenges (Three Delay Framework):  Seeking Care, Reaching Care, Receiving Care. 

NED institute has not only a clinical mission: we have research and teaching activities too. An internal audit of the surgical activity provided is being performed and our data has been shared with Neurosciences Master students and Professors from NISA CEU. Our data has also been presented in conferences and published in order to contribute and increase cooperation internationally.

Currently, our projects are not only neurosurgical but we have expanded our spectrum to traumatology, gynecology, and anesthesiology/intensive care (all of them as part and a priority in Global Surgery).

I hope that after reading this short summary, you feel excited enough to compel the politicians of your countries to provide international help. Also, feel free to make an individual donation. Any donation will help to promote health through surgery.

My dear friends, solidarity can change the world! Our efforts are focused to carry on this commitment through the Project “FIENS-NED/Global Surgery 2030”, a project that could be neither more challenging nor more rewarding. (The world calls, Papa Francisco).

NED building inside the Mnazi Mmoja Hospital campus, 2016.

NED building inside the Mnazi Mmoja Hospital campus, 2016.

Dr. Jose Piquer (NED Foundation President) and Dr. Maria Santos (Weill Cornell Global Neurosurgery fellow) performing a complex neurosurgical procedure with a last generation neurosurgical microscope.

Dr. Jose Piquer (NED Foundation President) and Dr. Maria Santos (Weill Cornell Global Neurosurgery fellow) performing a complex neurosurgical procedure with a last generation neurosurgical microscope.