The landscape of global urologic surgery missions after COVID-19 lockdown: are we ready for their return?

Abstract

Concerns have been raised that the lack of progress regarding limited surgical resources in low-and middle-income countries (LMICs) would lead to a new crisis. In 2015, it was estimated that there was a shortage of 1.1 million surgical staff disproportionately affecting LMICs. 1 Conditions for smaller surgical subspecialties like urology are even more discouraging: Nigeria, the most populous country in Africa, has one urologist per 3.2 million people. 2 These discrepancies are expected to worsen following the COVID-19 pandemic, which not only halted local medical and surgical care due to preferential management of patients infected with SARS-CoV-2, but also directly affected the personal health and already stretched resources of medical providers. The pandemic also limited international aid that may have been typically provided if it were not for the global shutdown.Global surgical mission groups serve a much-needed purpose in these under-resourced locations. Prior to the COVID-19 pandemic, over 250 000 surgeries were performed by surgical volunteer organizations (SVOs) in LMICs. 3 These organizations play an even more important role in helping expose and train local providers.International Volunteers in Urology (IVUmed) is a surgical mission group conducting surgical workshops in LMICs, while also focusing on creating a sustainable training pipeline. Its aim is to eventually hand over the entire surgical workshop and the training program to local physicians in LMICs so that they can independently expand and support themselves. Before the pandemic, IVUmed was performing 25 missions in 13 countries per year. On average, it provided care for 812 patients, performing 564 cases and training 296 local surgeons at an estimated service value of US$4 204 217.60 annually. As the COVID-19 virus spread around the globe, domestic and international travel came to a halt, as did surgical missions. 4 It has been over two years since the onset of the COVID-19 pandemic and since IVUmed's last workshop. As vaccines were developed and are being deployed, and as LMICs are adjusting to a postpandemic landscape, the question remains of how and when to restart surgical missions in these regions.