Global Surgery Episode 2: Trauma Care in Resource-Limited Settings

Behind The Knife: The Surgery Podcast

Join us for another episode of our Global Surgery series, where we have a special focus on trauma care in resource-limited settings.
Traumatic injury remains one of the largest burdens of disease and causes of mortality internationally. The WHO estimates that 4.4 million lives are lost to traumatic injuries per year, accounting for approximately 8% of all deaths. Notably, traumatic injuries are the top killer of children, adolescents, and young adults, compounding the patient-years lost. Trauma is ubiquitous–accidents and injuries happen all over the globe, and thus differences in trauma incidence and mortality is often a function of health systems and infrastructure.
Jon Williams is joined by Dr. Anthony Charles. Dr. Charles is a trauma surgeon at University of North Carolina, Chapel Hill. Additionally, he holds professorships in the medical school and school of public health at UNC, as well as serving as the director of the adult ECMO program and the director of global surgery at the UNC Institute of Global Health and Infectious Diseases. He leads the Malawian Surgical Initiative, designed to train and support local surgeons in the country of Malawi where he has established a longstanding partnership with UNC. Having been raised in Nigeria, Dr. Charles completed medical school at the University of Lagos, and subsequently underwent general surgery residency training in London at North Middlesex University Hospital and subsequently at Charles Drew University in Los Angeles. Upon completion of trauma and critical care fellowship at University of Michigan, he took a faculty position at UNC where he has remained since and grown the global surgery presence to what it is today.
Key Points:

1. Often, the pivotal first step in developing global surgery trauma initiatives is increasing trained personnel, and so training initiatives are very meaningful and provide sustainability to the effort.
2. Growing a health system’s ability to provide trauma care helps develop improved care for all aspects of disease. The resources, training, and infrastructure required benefits healthcare at large.
3. Improvement of trauma care extends well beyond in-hospital care–injury prevention and pre-hospital care/triage/transport are even more impactful.
4. It takes more than surgeons to improve trauma care globally. Thus, clinician and non-clinician training and oversight is critical, and foundational concepts of care of the trauma patient must be familiar to all.
5. Local governing bodies need to understand the importance of trauma care to invest in it. Traumatic injuries and mortality are a health burden, but even more so an economic burden to a country. This is what is compelling to investment in trauma care.

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