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A Stitch in Time Saves Lives: Cancer Surgery in Africa
I’ve always pictured myself as a surgeon operating in a modern and efficient surgical suite using the most advanced surgical equipment and supplies. That was before I went to Zambia as a volunteer with the Bush Institute’s Global Health program to combat cervical cancer.
If I were Zambian, my image of surgery would be vastly different, as I recently learned from Dr. Groesbeck Parham, an American cancer surgeon in Zambia who’s worked in Africa since 1986. African surgeons know how to adapt the ideal way of performing surgery to their own reality in order to save patients’ lives. They often lack complete sets of surgical instruments, medical supplies and proper lighting. They may also not have adequate amounts of anesthesia gases, blood products or oxygen tanks.
Despite these barriers, according to Dr. Parham, “African surgeons find innovative ways and get the job done each day” and have taught him to do the same. This “can-do” attitude is essential for the new challenge that many of these African surgeons are beginning to face: a large number of cases of early stage invasive cervical cancer.
The 45 gynecologic surgeons in Zambia, including Dr. Parham who is the only formally-trained gynecologic cancer surgeon in the country, cope with the current demands, however, only 5 percent of Zambian women have ever been screened for cervical cancer. As this number increases due to improving access to cervical cancer screening, those needing surgery will increase. The lack of cancer surgeons in Zambia will create a bottleneck. Women will become aware that they have cervical cancer but will be unable to access treatment. Without innovative solutions to provide surgical care, many of them will die.
Unlike cryotherapy in which precancerous lesions are frozen off, cancer surgery for invasive cancers requires good surgical skills. Gynecologists, surgeons and surgical clinical officers can be trained to perform cancer surgeries, as they already possess the basic surgical skillset. Zambia could exponentially increase its cancer surgery capacity within a year or two through new approaches to training.
This urgent need was highlighted by Zambian First Lady Dr. Christine Kaseba at the recent African First Ladies Summit, sponsored by the Bush Institute in Dar es Salaam, Tanzania.
I thought that my future career as a surgeon would revolve around a modern and efficient surgical suite, but I found that such an operating room is just the final step in a well-run and resourced health care system. Together, we can ensure that patients who reach this final stage can be adequately cared for in a system that can handle their needs—and I know that I’ll be there, working towards this goal.
Prithvi Rudrappa is an SMU student (Biochemisry, Finance, Spanish '15) and was part of a small volunteer delegation renovating a cervical cancer clinic in Livingston, Zambia, supported by the George W. Bush Institute as part of Pink Ribbon Red Ribbon.
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President and Mrs. Bush's Visit to Namibia and Botswana in Photos
They delivered a message to Congress and all Americans: lives in Africa matter.
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The new administration should stay the course as a strong leader in global health. This is a bipartisan effort, as both sides of the aisle have agreed on the importance of health care investments through successive Congresses and administrations, reflecting the priorities of the American people.
7 Things to Know about PEPFAR on World AIDS Day
Today marks World AIDS Day: a day to honor those lost, celebrate the global progress made in the fight against AIDS, and commit to put an end to the disease. In 2003, at the signing ceremony for the legislation that enacted the President’s Emergency Plan for AIDS Relief (PEPFAR), President George W. Bush said, “We believe in the value and dignity of every human life. In the face of preventable death and suffering, we have a moral duty to act, and we are acting.” Since then, PEPFAR has delivered life-saving antiretroviral treatment (ART) to 11.5 million people, and nearly 2 million babies have been born HIV-free with PEPFAR support. PEPFAR’s success contributes to a coordinated global effort to end AIDS. UNAIDS reports that since 2000, 18.2 million people have access to treatment for HIV, new infections of HIV have decreased by over 1 million infections, and AIDS-related deaths have decreased by 1.4 million. There is real hope for endin