Thoracic surgery in Palestine

Idkedek, Mayar Ishaq; Al-Qtishat, Bayan Fathi; Shaqqura, Bisanne; Akar, Firas Abu

doi:10.21037/jtd-21-1139

Cited by 1 publication

(1 citation statement)

References 5 publications

(4 reference statements)

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“…Additionally, the political environment surrounding the population in Hospital B is of critical consideration. Cost is a major prohibitive factor for many patients as private hospitals are not directly covered by governmental insurance, however, the option to transfer is also a limitation [ 33 , 34 ]. Access to healthcare for children is constrained due to the requirement for special permits and visas to travel to specialist hospitals, adding another burden for many children and their families given their restricted mobility [ 34 , 35 ].…”

Section: Ethical Dilemma In Global Health Initiativesmentioning

confidence: 99%

Global Health Challenges: Why the Four S’s Are Not Enough

et al. 2022

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A well-known tenant of global health is the need for the four-S’s to be successful in providing care in any context; Staff, Stuff, Space and Systems. Advanced thoracoscopy is slow to gain traction in low- and middle-income countries (LMICs). To our knowledge, no pediatric advanced thoracoscopy had been attempted previously in either LMIC. Therefore, we report the challenges associated with the adoption of the first advanced thoracoscopic procedures in two LMIC hospitals by a visiting surgeon. To further identify aspects of care in promoting the introduction of advanced thoracoscopy, we added a fifth S as an additional category—Socialization. A key to accomplishing goals for the patients as a visiting surgeon, particularly when introducing an advanced procedure, is acceptance into the culture of a hospital. Despite facing significant obstacles in caring for complex thoracic pathology with heavy reliance on disposable and reusable instrumentation provided through donation and limitations in staff such as access to neonatologists and pediatric surgeons, many obstacles have been overcome. In this perspective article, we show that a “fifth S” is also integral—having local surgeons and anesthesiologists eager to learn with acceptance of the visiting surgeon’s expertise opens a path towards attempting advanced procedures in limited-resource settings.

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