Global Surgery & Anesthesia

Thanks Nadine and Anat for those resources. Task shifting in HIV/AIDS care will most certainly provide important lessons for task shifting in global surgery. Critical issues for successful task shifting are adequate training/supervision and implementation of simplified protocols/guidelines.

Here is another article from Médecins Sans Frontières/Doctors Without Borders regarding surgical task shifting in sub-Saharan Africa. Please feel free to share your personal experiences if you have been involved with such initiatives.

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000078

Nice article. There are good examples of surgical task shifting in the US as well. PA's and nurse practitioners now do most of the work previously done by surgical residents and even attendings: placement of chest tubes, central lines, Ultrasound (FAST exam), trauma leader, management of patients in the ICU, etc. I really liked the "lessons learned" in this article as they form a great framework.

Ray Price

Ray - thanks for your comments! Great point about task shifting in the US. I agree, the "lessons learned" section highlights fundamental principles that will make it successful in surgery and anesthesia -- we already see "developing adapted guidelines" and "simplification" through the implementation in some areas of the global surgery safety checklist. It will be interesting to see how "Exploring potential for community support" develops and if it becomes as successful for surgery as it has for HIV care.

Ann