Talks

SNF Discussions: Global Health Inequality

Friday June 24, 12:30, Lobby NLG

Martin Mueli (ETH Zurich), Surgeon-in-Chief at the Surgical Clinic at the University Children's Hospital Zurich; Full Professor for Pediatric Surgery at the University of Zurich
Amanda McClelland, Senior Vice President of Prevent Epidemics, Resolve to Save Lives.
Irene Wulff, Chief Executive Officer - FOCOS Orthopedic Hospital

Moderated by:
Claire Muñoz Parry, Assistant Director, Global Health Programme, Chatham House

The need for political and social change was highlighted by the conversation about global inequalities in access to health. The four speakers, who have experience in both developed and developing countries, presented problems related to the lack of equitable access to health services for children and adults and suggested solutions that can improve people’s quality of life.

Dr. Tihitena Negussie Mammo, pediatric surgeon and Global Clinical Director of Lifebox, a nonprofit that seeks to improve the safety of surgery, anesthesia, and the postoperative course for patients in developing countries, kickstarted the conversation.

Speaking via a video link, Dr. Negussie Mammo addressed the unequal access to health services in Ethiopia. When there is a lack of equitable access to the health system, she said, safe care is not provided. Drawing on her experience in pediatric surgery, she explained how most problems arise from inadequate care delivery, untrained workers, and lack of infrastructure.

Dr. Martin Mueli, Surgeon-in-Chief at the Surgical Clinic at the University Children's Hospital Zurich and Professor of Pediatric Surgery at the University of Zurich (ETH), then took the floor. He referred to the positive example of Switzerland, a country where there is a balance between demand and supply of high quality health services.

He stressed that the health system works even in the most mountainous villages there. "It is not possible for someone to suffer from a myocardial infarction anywhere in Switzerland, even high in the Alps, and not be rescued within half an hour," Dr. Mueli said, adding that “‘flying intensive care unit’ helicopters will transport intensive care specialists to resuscitate patients, who are then flown to the most appropriate hospital.”
He also mentioned fetal surgery in Switzerland, i.e. prenatal surgery in utero, and the operation he himself performed on the back of a fetus with spina bifida. The operation ensured that child a life of mild disability, as opposed to a life of incurable, severe disability, had the surgery not been performed.

But this is not the reality for most children in the world, he concluded. That's why he and his team are training medical and nursing staff from under-resourced countries like Afghanistan in Switzerland in such a way that, when the latter return, they can improve the health services in their home countries. In Kabul, he said, his team also set up a burn center with the assistance of the Swiss government.

Next, Irene Wulff, CEO at FOCOS Orthopedic Hospital in Ghana—a 70-bed nonprofit hospital—detailed the social exclusion experienced by children with spinal deformities.
"When children are born with deformed spines, they don't go to school. Those that do manage to attend, are stigmatized," she said. They are in pain and deal with a variety of health problems. "They cannot become productive citizens," she continued. "They have low self-esteem, which leads to mental health issues."

She described how, between 1998 and 2011, some 500 volunteer orthopedic surgeons, anesthetists, intensive care specialists, and nurses from around the world would volunteer up to four times a year, working pro bono in Ghana. In 2012, thanks to various donations—including one from the Stavros Niarchos Foundation (SNF)—the FOCOS Orthopedic Hospital was created. In its 10 years of operation, 3,500 children have received surgical care and 70,000 have been admitted to the clinic. "The children [who have gotten surgery] have managed to go to university and three of them are now working for us," she said.

Finally, Amanda McClelland, Senior Vice President of Resolve To Save Lives’ Prevent Epidemics program, talked about mitigating social inequalities following natural disasters.

"Disasters seek out the poor and keep them poor," she said.

Using the example of the COVID-19 pandemic in the United States, she illustrated the impact that social policies beyond health have on people's access to it.

"In New York, we saw how the lack of paid sick leave resulted in workers not being able to isolate when we asked them to," she said. While a pandemic could have acted as an equalizer for everyone, we saw that some people were exposed to more risk than others,” she added.

"We must not forget the lessons we have learned from previous crises," Amanda McClelland concluded. "We need to acknowledge the inequities we have ignored in the past, she said. “The challenge is to act on those lessons.”