A minority of respondent surgery programs host formal, organized surgical global health programs with a structured leadership based at academic medical centers. Although most institutions have individuals leading international humanitarian missions to LMICs, these leaders do not function in an integrated fashion with their departments, institutions, or other academic medical programs. The majority of respondents were interested in coordinating their surgical trips with other groups. Respondents suggested the creation of a central database that would allow trip organizers to share information about upcoming trips, site logistics, and personnel or supply needs.
HighlightsA patient presented with sepsis and a necrotizing infection of the abdominal wall.Upon operative exploration he was found to have perforated appendicitis.Maintain a high index of suspicion as diagnosis is often delayed.Necrotizing fasciitis results in significant mortality; immediate intervention is paramount.
The health of a country's population is directly correlated with increased life expectancy and productivity, as well as with its economic progress and ever-expanding wealth. The citizens of high-income "developed" countries, as defined below, depend on an advanced healthcare system as the foundation of the well-being of its citizens. Whether health care is provided by the public and/or by the private sector, delivery of care and managing disease are largely dependent upon public health resources that can identify and quantify disease threats at population levels. One may ask if a country's public health system, even in highincome countries, is sufficiently equipped and prepared to address novel disease threats such as posed by infectious disease pandemics. The ability of a country to support public health management services depends on coordination of multiple components including government health agencies at the central and local levels, donor organizations, civil society groups, and directly with affected communities. These relationships are meant to provide the services necessary for successful healthcare, but must also be responsible for planning for future needs and for executing programs to recognize and deal with emergencies. The coronavirus pandemic highlights the latter function as a determinant of which nations are adequately resourced and which have yet to achieve that status.
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