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Cited by 7 publications
References 4 publications
Approximately one year ago we wrote that there was no current or impending physician glut and that the entire alleged problem of physician overabundance or underabundance was simply one of massive maldistribution on a neighborhood, city, state, regional, national, or continental basis.1 We documented that there was a giant imbalance in the doctor import-export ratios and that our country's 50:1 positive balance of trade of doctors was embarrassing. We suggested that an appropriate role for a developed country to play in 1984 was to export physicians to a world in need.2 The response was overwhelming. We obviously struck a very responsive cord among many physicians whose zest for doing interesting and exciting things or whose penchant for altruism was ripe. Many of you wrote us and asked what you could do and where you could go. But we didn't know, except in very general ways. So we set about to answer your questions and to plan another JAMA international theme issue. This is it.A wide vista of international health circumstances, models, and opportunities is here for you. One of the most outstanding accomplishments in international medicine in history was the global irradication of smallpox. In this issue, Behbehani' provides a very interesting historical summation of the original classic Arabic monograph on smallpox, with insightful com¬ ments about the ancient Persian physician Rhazes. From China we have a commentary on the traditional Chinese concepts of mental health provided by editor Li' of the Chinese Medical Association. More clearly stated concepts I have never read. We are told in writing classes that good prose should be like a clear pane of glass. This is. Also on China, Grey Dimond' offers his most recent observations and deductions of what actually happened to the medical profession during the rise, continuation, and transition from power of Mao. From a highly developed country in Europe, Forman and co-workers'' contrib¬ ute original information on the increased risks for the delivery of low-birth weight newborns with increasing age of the mother.'' From the Centers for Disease Control and Nepal, Kane and colleagues' report on a study of epidemic non-A, non-B hepatitis from Kathmandu. Among other interesting findings, they demonstrate viruslike particles from the stool of an acutely ill patient and an experimentally infected marmoset, lending support to the concept that this form of hepatitis may be caused by a transmissible viruslike agent.7What should be done internationally? Bessinger and McNeeley" provide us with a model for the provision of regional health services in a developing nation, that of Haiti. Mullan and Bryant' discuss many aspects of global primary medical care. Samuels and associates'" describe an ongoing successful model for anesthesia and plastic surgery in develop¬ ing countries currently run out of Stanford University Medical Center. Ralph Crawshaw" tells every physician that he or she can make a difference and proposes a doctor-to-doctor international medical education exchange...
Approximately one year ago we wrote that there was no current or impending physician glut and that the entire alleged problem of physician overabundance or underabundance was simply one of massive maldistribution on a neighborhood, city, state, regional, national, or continental basis.1 We documented that there was a giant imbalance in the doctor import-export ratios and that our country's 50:1 positive balance of trade of doctors was embarrassing. We suggested that an appropriate role for a developed country to play in 1984 was to export physicians to a world in need.2 The response was overwhelming. We obviously struck a very responsive cord among many physicians whose zest for doing interesting and exciting things or whose penchant for altruism was ripe. Many of you wrote us and asked what you could do and where you could go. But we didn't know, except in very general ways. So we set about to answer your questions and to plan another JAMA international theme issue. This is it.A wide vista of international health circumstances, models, and opportunities is here for you. One of the most outstanding accomplishments in international medicine in history was the global irradication of smallpox. In this issue, Behbehani' provides a very interesting historical summation of the original classic Arabic monograph on smallpox, with insightful com¬ ments about the ancient Persian physician Rhazes. From China we have a commentary on the traditional Chinese concepts of mental health provided by editor Li' of the Chinese Medical Association. More clearly stated concepts I have never read. We are told in writing classes that good prose should be like a clear pane of glass. This is. Also on China, Grey Dimond' offers his most recent observations and deductions of what actually happened to the medical profession during the rise, continuation, and transition from power of Mao. From a highly developed country in Europe, Forman and co-workers'' contrib¬ ute original information on the increased risks for the delivery of low-birth weight newborns with increasing age of the mother.'' From the Centers for Disease Control and Nepal, Kane and colleagues' report on a study of epidemic non-A, non-B hepatitis from Kathmandu. Among other interesting findings, they demonstrate viruslike particles from the stool of an acutely ill patient and an experimentally infected marmoset, lending support to the concept that this form of hepatitis may be caused by a transmissible viruslike agent.7What should be done internationally? Bessinger and McNeeley" provide us with a model for the provision of regional health services in a developing nation, that of Haiti. Mullan and Bryant' discuss many aspects of global primary medical care. Samuels and associates'" describe an ongoing successful model for anesthesia and plastic surgery in develop¬ ing countries currently run out of Stanford University Medical Center. Ralph Crawshaw" tells every physician that he or she can make a difference and proposes a doctor-to-doctor international medical education exchange...
Background Billions of people lack access to quality surgical care. Short-term missions are used to supplement the delivery of surgical care in regions with poor access to care. Traditionally known for using international teams, Operation Smile has transitioned to using a local mission model, where surgical service is delivered to areas of need by teams originating within that country. This study investigates the proportion and location of Operation Smile missions that use the local mission model. Methods A retrospective review was performed of the Operation Smile mission database for fiscal years 2014 to 2019. Missions were classified into local or international missions. Countries were also classified by their income levels as well as their specialist surgical workforce (SAO) density. As no individual patient or provider data was recorded, ethics board approval was not warranted. Results Between 2014 and 2019, Operation Smile held an average of 144.8 (range 135–154) surgical missions per year. Local missions accounted for 97 ± 5.6 (67%) of the missions. Of the 34 program countries, 26 (76%) used local missions. Of the countries that had only international missions, six (75%) were low-income countries and the average SAO density was 1.54 (range 0.19–5.88) providers per 100,000 people. Of the countries with local missions, 24 (92%) were middle-income, and the average SAO density was 30.9 (range 3.4–142.4). Conclusion International investments may assist in the creation of local surgical teams. Once teams are established, local missions are a valuable way to provide specialized surgical care within a country’s own borders.
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