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My name is Lismore Nebeker, I am 24 years old and the Director of Research & Public Policy for Mobile Surgery International (MSI), a humanitarian organization based in Sandy, Utah, USA and Mexico City, Mexico. Our team operates a state-of-the-art mobile surgical hospital in Oaxaca, Mexico. Our three 16-meter trailers expand to 92 square meters creating enough space for a pre-op, post-op, and operating theater. We spent two years providing earthquake disaster relief after the September 19, 2017 earthquake that killed 370, injured over 6,000 and toppled scores of buildings, including many hospitals.

Since 2017, The Mobile Surgical Hospital has relocated three times and is now operating in Oaxaca City, Mexico treating patients with Neglected Surgical Disease (NSD). NSD’s are non-communicable birth defects, deformities, or untreated injuries which require surgical intervention, such as: cleft lip and cleft palate facial deformities, cataracts, clubfoot, hernia, obstetric fistula, untreated fractures and burns. MSI’s mission is to deliver safe and well-timed surgical care, boost surgical capacity in low and middle-income countries (LMICs), strengthen local health care systems, educate and train host national medical professionals to a high level of proficiency in comprehensive surgical care.

Since early 2018 we have been working on an advocacy initiative with the United States government when we were connected with the G4 Alliance and the International Federation of Surgical Colleges (IFSC). For over 60 years the International Federation of Surgical Colleges (IFSC) has been the steady voice for Global Surgery in particular the advancement of surgery in developing countries by promoting standards of excellence in surgical care, education, training, and research. It has been remarkable to join a body of people who all share the common goal of bringing global surgery to the forefront of global health.

I had the opportunity to work with IFSC most directly at the 2019 World Health Assembly at the United Nations in Geneva Switzerland and the United Nations General Assembly in New York City, USA. These remarkable events brought together world leaders to discuss the world’s most pressing problems and work together to find and agree on solutions.

IFSC supported my efforts in Geneva to submit the following statement for the record, which I read in front of the General Assembly:

The International Federation of Surgical Colleges (IFSC) welcomes the opportunity to submit a statement, supported by the Global Alliance for Surgery, Anesthesia, Obstetrics and Trauma care (the G4 Alliance).

We agree with the statement from the WHO’s Programme of Work that “Health emergencies weaken health systems and weak health systems amplify health emergencies” and request member states maintain a health systems approach in preparing their emergency systems.

We believe that the capability to deliver an essential package of surgical, obstetric, trauma, and anesthesia services stands as a signal function for a prepared health system with readiness to absorb shocks; whether these come from human crises or natural disasters that produce acute injury or from communicable disease epidemics that produce acute illness, both of which are expected to increase in the future.

We call upon member states not to separate emergency care systems from an integrated health system that delivers surgery, obstetric, trauma, and anesthesia capability in coordination.

We would like to emphasize succinct summaries of the essential role surgical services have within holistic and resilient health systems, that “surgery is an indivisible and indispensable part of health care” and the recent statement from Dr. Tedros in 2019 that “no country can achieve Universal Health Coverage (UHC) unless its people have access to safe, timely and affordable surgical services”.

Participating in this landmark session was an opportunity to make the crucial point that surgery plays a crucial role in the development of emergency services. Surgery is an integral part of health care systems and we must dedicate time, money, and resources to ensure that the world has safe, sustainable, and timely surgical care. When looking at the larger global health picture, I believe Dr. Tedros’ statement carries significant weight in our efforts in Mexico. Surgery is “an indivisible and indispensable part of health care.”

Each year, global deaths from conditions requiring surgical care far exceed those from HIV/AIDS, tuberculosis, and malaria – combined. However, the burden of conditions requiring surgical intervention continues to be neglected as a public health strategy. This will require the world to step up to the plate and do something truly impactful in order to change the current trajectory. How are we going to not only save lives, but transform the definition of quality of life, and develop a sustainable and comprehensive route to get there?
After the IFSC gave me the opportunity to engage with the United Nations and the World Health Organization I became increasingly hopeful that my generation and the generations to come are going to tackle even the most daunting of complex health issues.

Countries should recognize the remarkable strides the world has made in developing safe surgical practices which have grown exponentially over the last few decades. The Global Surgery community is now positioning themselves to share their improved technology, specialized surgeons, and state-of-the-art facilities with LMIC’s throughout the world.