The variety of tropical medicine topics addressed at the Annual Meeting has broadened over the last few years to include other health issues affecting the global poor. This month's Q&A is with two ASTMH members who are helping to expand that focus. At the 2013 Annual Meeting, John Humphrey, MD, a fellow in infectious disease at Cornell University Medical Center, and Connie Keung, MD, a general surgery resident at Columbia University Medical Center, organized the symposium, "Surgery for Non-Communicable and Tropical Disease: The Next Global Challenge."
1) At the 2013 Annual Meeting, the two of you helped organize a symposium about surgery in resource-limited environments. What does this say about the evolution of how we have historically viewed tropical medicine?
Tropical medicine is synonymous with infectious disease for many people. This is not without reason, as these diseases remain some of the greatest challenges to global public health today. Still, the global burden of disease is changing. Surgical conditions now account for 11% of the global burden of disease, yet the unmet need for surgical care in poor countries is immense: the poorest third of the world’s population receives only 3% of all surgical procedures. There is a misconception that surgery is neither cost-effective nor feasible in resource-limited settings. We endeavored to show otherwise through our symposium, and we hope that the ASTMH Annual Meeting can be a forum for addressing the challenge of global surgery. As one author put it, surgical diseases should not be left as the final neglected tropical disease.
2) Having attended two ASTMH Annual Meetings, you’re both relatively new to our Society (and we’re glad to have you a part of it). What other topics or issues would you like to see addressed at the Annual Meeting?
It’s great to be a part of the ASTMH! As young doctors interested in global health, we both find the Annual Meeting to be so exciting. Having the chance to meet with and be mentored by other ASTMH members is truly invaluable. As far as the Annual Meeting goes, it would be helpful to have more surgery and anesthesia-themed posters, lectures, and symposia. For example, much more research is needed to understand the epidemiology of surgical disease in low-income countries. The Annual Meeting is the perfect venue to address this need.
3) If you look into a crystal ball, what does the field of global health/tropical medicine look like 20 years from now?
From our perspective, the future looks bright for global health! The number of students and young physicians interested in the field seems to grow every year. Hopefully, down the road this will result in more voices both in government and society that are willing to advocate for the global poor. Indeed, the disease challenges globalization will create in the future will require even more global-minded leaders than we have today.
4) ASTMH serves a unique convening role that brings together people from many disciplines and backgrounds. Which additional groups should ASTMH engage as we look for innovative ways to address health issues affecting the global poor?
To start, the ASTMH needs to engage surgeons and anesthesiologists as part of its global health mission. This includes collaborating with surgical societies and surgical non-governmental organizations. Government-supported global health programs could also do much more surgical research and capacity building in low-income countries, and the ASTMH should advocate for this as well.
5) Here’s the fun question. You get the opportunity to go back in time. You can either have a conversation with any scientist who has ever lived OR observe a moment of scientific history. Who or what would you choose and why?
There are so many! In keeping with our theme though, one historical moment would certainly be the first demonstration of the use of ether as a surgical anesthetic by William Morton in 1846. Painless surgery is one of our greatest medical achievements. The days before anesthesia were not long ago, yet we’ve come to a point now where surgery without it is practically unthinkable.
**If you're interested in surgery in low-resource settings and would like to help expand ASTMH's involvement in this issue, please contact John Humphrey.**
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