Keppel Health Review

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Surgical organisation reinforcement: collaboration is the solution

In 2015, the United Nations (UN) published the Sustainable Development Goals (SDGs). These are a set of 17 goals to be achieved by the year 2030 and which are proven to be interconnected with various major stakeholders. Diving deep into these common goals illustrated, goal number 17  is the most important because the rest of the goals ultimately depend on it. It highlights the importance of partnerships for the goals as it states: “Strengthen the means of implementation and revitalise the global partnership for sustainable development.” Strengthening the means of implementation and revitalisation of global partnership can only be realised with a strong commitment to global partnership and cooperation. However, such strategies are difficult to implement as they are more likely to fail than they are to succeed if a proper collaborative effort does not take place.

A proper collaboration will reflect both outcomes and will expedite the process of achieving the common goals between the collaborating organisations. For instance, a good partnering chain was strongly reflected in the global health meetings organised by the WHO to coordinate and delegate job scopes. This is an effective method in job delegation for various organisations to achieve a common goal. In critical times such as during the COVID-19 pandemic, organisations and companies have cooperated in many ways, with an impact that superseded their vision.

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Due to lockdowns, conferences and meetings were cancelled globally. Nonetheless, the race for vaccines never stopped, which required a large amount of coordination and a collaborative effort. It is therefore crucial for organisations—globally and locally—to collaborate in any capacity to achieve a noble cause of generating energy and promoting engagement.  

From a surgical organisation perspective, collaborations and partnerships in research between both high-income countries (HICs) and low-to middle-income countries (LMICs), have produced landmark papers in global health research. Global surgery research networks such as GlobalSurg, CovidSurg, and Global NeuroSurg are some of the few notable collaborative groups that have changed the practices of surgery worldwide. Some of these collaborative efforts have involved physicians across 120 countries. These partnerships have provided big datasets to further understand disease patterns and have paved a sustainable international collaborative model for the scientific community. These international networks have also provided an important platform for medical students and young doctors to further improve and develop their research skills. 

In the year of the COVID-19 pandemic, education in the broader context was put on hold. Conferences moved to online platforms, advancing accessibility to knowledge. This has increased the attendance of international conferences that would normally be too expensive for curious early-career physicians to attend. The execution of an online conference such as the InciSioN Global Surgery Symposium, or University of Utah Centre for Global Surgery Symposium, require different pools of organisational skills; many of which are dependent on the knowledge and availability of online tools. In the wake of the need to organise such conferences, we have seen collaborations between a multitude of organisations. 

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The COVID-19 pandemic has also disrupted surgical services, resulting in a large backlog of bellwether procedures. Recently published data from COVIDSurg show that an estimated 28 million surgical operations and procedures will be cancelled, and disturbingly LMICs will bear the brunt of these cancellations. Therefore, collaboration and partnership in mobilising surgical services to the areas and countries with a high need of varied clinical requirements is an essential instalment to clear the backlogs.

For instance, the public-private healthcare sector collaboration concept became an important metric in clearing the backlog surgical operations as adapted by National Health Service (NHS) in the United Kingdom and also in many LMICs around the globe. 

The Lancet Commission on Global Surgery (LCoGS) group reported that approximately 70% of the global population are lacking access to surgical care. In response to this unmet need, a National Surgical Obstetrics and Anaesthesia Planning (NSOAP) has been formed. This is an attempt to provide the key components needed for a country to plan for surgical care in terms of policy implementation. Countries in the Western Pacific have started this planning process, garnering buy-in from major stakeholders including frontline providers, governmental and non-governmental bodies, academic institutions, and the private sector. The Ministry of Health coordinates the NSOAP by working closely with local stakeholders to gain consensus. This has yet again been the result of the willingness of stakeholders to collaborate and reach further. The impact of these multi-layer collaborations generates enormous adjustments which will benefit millions of people. This is in hope to reach the audacious dream of the “Health for all” that was declared by the WHO in 1978.  

To sum up, collaboration can sometimes be seen as a weakness in the inability to perform a certain task from one party. The authors would argue it is a strength and virtue to recognise one’s weakness as it requires great humility to ask for help. The resultant synergistic product through collaboration is essential for the continuation of innovation and drives humankind forward. “If you want to go fast, go alone. If you want to go far, go together”—African Proverb