Three Ways Smile Train is Using Technology to Better the World for Children with Clefts

This post is a guest post from G4 Alliance Member Smile Train. 

Photo Credit: Smile Train

Photo Credit: Smile Train


Each year, more than 170,000 children are born with a cleft lip and/or palate in developing countries. Unfortunately, many of these children will not receive the care they need due to lack of access to the resources required for safe and quality treatment. The impact of an untreated cleft on these children’s lives goes far beyond simply cosmetic. Often, these children cannot eat, breathe, hear or speak properly. They are routinely ostracized and don’t attend school, ultimately barring them from being employable as adults. Since 1999, Smile Train, the world’s largest cleft organization, has pioneered new technology to help these children.

Smile Train’s innovative technology solutions support our unique model. Smile Train leverages the ‘teach a man to fish’ approach, focusing on training local doctors around the world to perform cleft surgery in their own communities.

Smile Train’s innovative technology solutions support our unique model. Smile Train leverages the
‘teach a man to fish’ approach, focusing on training local doctors around the world to perform cleft surgery in their own communities. Here are three ways Smile Train is using technology to drastically improve the lives of children around the world.

1) Speech Therapy App

speech app.jpg

Many children who are born with cleft palates require speech therapy post-surgery,
provided by skilled speech-language pathologists. However, some parents of children with clefts may lack access to speech-language services, based on their socioeconomic status, income level or geographic location. And even when initial speech-language services are provided, accessing ongoing therapy can be expensive or logistically challenging. To address this need, Smile Train – which has worked in 85+ countries
around the world – created a free, interactive smartphone application for children with
speech problems caused by cleft. This app uses stories, games, and songs to help
children with clefts improve their speech, and parents are encouraged to download this
app and use it to supplement their child’s cleft treatment. The app also lowers the
burden on families to travel for therapy, and the fun curriculum encourages children to
practice more often to yield better speech outcomes. The app is currently available in
English (“Smile Train Speech Games and Practice”) which will help not only children in
the developing world, but also children all over the world who may not otherwise have
access to speech services. It’s also available in Spanish (“Smile Train Habla y Lenguaje”).
To-date, the Spanish language version has 1,500+ active users in 15+ countries and has
been downloaded more than 11,500 times. Both versions are available on both iOS and
Android devices and can be downloaded in the Apple and Google Play stores.

2) Virtual Reality

Recently, Smile Train developed two virtual reality videos, truly bringing the work of our
local partners to life. The 3-D computer generated simulation allows viewers to fully
transport themselves to India as they follow along with two cleft children, Nisha and
Vikas, on their journeys to new smiles. The intensely immersive experience provides a
firsthand view of what life is really like for children in the developing world with
untreated clefts. While booking a plane ticket to India to see Smile Train’s local

programs in action may not be practical; taking a journey through the power of virtual
reality technology enables Smile Train to raise awareness for the millions of children
with untreated clefts still waiting for their new smiles and new lives. For more
information please visit:

Nisha Holding Before(1).jpg

3) Virtual Surgery Simulator

In 2013 Smile Train partnered with BioDigital Systems to launch the Virtual Surgery
Simulator, the first web-based, 3D, interactive surgical explorer for cleft care. Smile
Train’s Virtual Surgery Simulator provides surgeons around the world with next
generation surgical training technology for learning surgical techniques in cleft lip and
palate repair. By focusing on training local doctors to perform cleft repair surgery and
provide comprehensive cleft care in their own communities, Smile Train is able to create
a long-term, sustainable system. To learn more about the Virtual Surgery Simulator
please visit

While there is still a lot of work to be done, leveraging technology, brings us one step closer to achieving our goal for all cleft children to have access to safe, quality cleft treatment enabling these children to lead healthy and productive lives.

For more information about Smile Train and ways to get involved please visit

Are you a G4 Alliance interested in profiling your work on our blog? Email us at!

Supporting National Surgical Planning: The Implementation Showcase

National Surgical Planning is an essential step in global health systems strengthening. It signifies a country's commitment to integrating and prioritizing surgical care as part of their national health plan.

On March 21st-22nd, the World Health Organization hosted a technical workshop on National Surgical Care Planning in the Eastern Mediterranean and African Regions, in partnership with the Harvard Medical School Center for Global Health Delivery in Dubai.  This workshop, attended by country representative and regional civil society organizations and stakeholders, was held to allow participants to exchange knowledge around the key steps to developing NSOAPs, discuss implementation options and tools,  and explore innovative financing mechanisms for NSOAP realization. 

Leveraging the strength of our 85+ member organizations working across the globe, The G4 Alliance was pleased to lead an Implementation Showcase that featured the work of our G4 members and partners. Participants shared examples of successful collaborations supporting national surgical planning and implementation, and they forged connections and partnerships with regional and country representatives to further additional planning efforts. 

Thank you to all participants (full list and bios here) and special thanks to partners the International Federation of Surgical Colleges and Indus Hospital for representing the G4 Alliance and chairing this session!

View the Presentation Slides Here

The Wicked Problem of Global Surgery: 2018 CUGH Global Surgery Satellite Session


Global surgery - and inequitable access to surgery around the world - constitutes a "wicked problem", noted Operation Smile’s co-founder and CEO Dr. William Magee as he spoke at the 2018 CUGH Global Surgery Satellite Session - that is, they are complex problems that cut across sectors, disciplines, and borders. This phrase was taken up and repeated by other speakers, many of whom noted the daunting scale of the wicked problem - there are 5 billion people around the world who lack access to safe surgery and anaesthesia care.

Fortunately, for every wicked problem in global surgery, there are stakeholders already collaborating across sectors to build and enact solutions to match, and there are students leaders within the next generation that are equally committed to pushing forward for progress. At the Global Surgery Satellite Session, these representatives were given a chance to convene and discuss the challenges they are facing, the solutions they have worked to implement and the results that they have seen.

Dr. Catherine deVries speaks at CUGH

Dr. Catherine deVries speaks at CUGH

The satellite session featured interactive panel discussions, presentations, and break-out sessions (review the full program here). The program included six thematic sessions on topics ranging from from the surgical ecosystem, global surgery in the regional context, multi-disciplinary approaches to program development, transitioning from trauma and disaster response to sustainable surgical care, national surgical planning, gaps in global surgical engagement, and the role of technology, innovation, and research in global surgery.

Diverse, expert panelists and featured speakers shared the insights from their own research and experience. Hon. Dr. Keith Martin (CUGH) welcomed participants and emphasized the importance of surgery to strengthen healthcare worldwide. Dr. Catherine deVries (University of Utah Center for Global Surgery), and Dr. Mamta Swaroop (Northwestern, AAS), also welcomed participants and emphasized the importance of equitable surgery to strengthen healthcare worldwide. Mr. Pape Gaye (IntraHealth International) gave a featured presentation on the current landscape of global surgery in 2018, while Dr. Ray Price (University of Utah Center for Global Surgery), Dr. Swaroop, Dr. Miliard Derbew (COSECSA), and Dr. deVries participated in a panel that explored global surgery in the regional context. Dr. John Sampson (Johns Hopkins University School of Medicine Representative) and Dr. James Cobey presented a case study on multidisciplinary approaches to global health program development. Dr. Sherry Wren and Dr. Adil Haider (Brigham and Women's Hospital) moderated a panel on gaps in the engagement of the global surgical community, joined by representatives from InCiSioN, a dynamic advocacy group of medical students dedicated to global surgery.  

Mr. Pape Gaye of IntraHealth International presents at CUGH

Mr. Pape Gaye of IntraHealth International presents at CUGH

Finally, with all panels and break-out groups concluded, the global surgery satellite session ended with a call to action from Dr. deVries and Dr. Mamta Swaroop - a call to action that urged participants to not let the lessons of CUGH to remain within event halls and panel discussions, but to integrate them into action for global surgery and neglected surgical patients. 

Partnerships, collaborations, and networks will drive the progress that is necessary to achieve safe, affordable surgical and anaesthesia care for 80% of the world by 2030. The key, however, will be the action that we take within those collaborations. We must grow our coalitions, coordinate our vision, and act in concert to effect change on the global scale. G4 Alliance members and many additional stakeholders are already doing so and have achieved incredible progress. Events like CUGH give global surgery stakeholders a chance to reflect and renew, to take the experience and partnership of others and put them into action on the ground to save lives - and to one day solve the wicked problem of global surgery. 

G4 Alliance Member Participants
(Organizer) Dr. Catherine deVries (University of Utah Center for Global Surgery) 
(Organizer) Dr. Mamta Swaroop (Northwestern, AAS) 

Mr. Pape Gaye (IntraHealth International)
Dr. Miliard Derbew (COSECSA) 
Dr. John Sampson (Johns Hopkins University School of Medicine Representative
Dr. James Cobey
Dr. Sherry Wren
Dr. Adil Haider (Brigham and Women's Hospital) 
Dr. Dan Deckelbaum (McGill University Health Centre)
Dr. Girma Tefera (American College of Surgeons)
Ms. Lina Sayed (Gradian Health) 
Dr. Laurie Baumann (Lurie's Children Hospital) 


Global Surgery and Anaesthesia at the 49th UN Statistical Commission

Panel Pic.JPG

Worldwide, 5 billion people lack access to safe, affordable surgical and anaesthesia care.
Every 2 seconds, someone dies as a result of an untreated surgical condition.
Each year, we could save 17 million lives with better access to safe surgery and anaesthesia care.
If we do not invest in expanding surgical systems now, low- and middle-income countries stand to lose 12.3 TRILLION in potential GDP by 2030.

As a global community, we understand that what gets measured, gets managed. The importance of data is clear.

These numbers, and many more like them, have inspired an incredible amount of work and progress  around the world. Because of numbers like these, we know the scale of global need. Because of numbers like these, we know the many ways in which surgery and anaesthesia are essential to achieving the Global Goals and UHC. 

As a global community, we understand that what gets measured, gets managed. The importance of data is clear.

During the 49th UN Statistical Commission in March 2018, a new global consensus statement on surgery and anaesthesia data was launched. This report -  authored by the German Global Surgery Association and the Program in Global Surgery and Social Change at Harvard Medical School, and published by The G4 Alliance - was launched alongside an expert roundtable discussion hosted in parallel with the 49th UN Statistical Commission. 

Background: The Urgent Need for Global Surgery and Anaesthesia Indicators

The SDGs represent a new global agenda that calls for universal action to eradicate poverty, protect the planet and support greater peace and prosperity for all. This inclusive and interconnected agenda provides guidelines and targets for countries and international organizations to track national and global progress, while working collectively towards sustainable development. 

One of the core tenets of the SDGs is universal health coverage (UHC), which calls upon world leaders to ensure that all people around the world have access to effective, affordable and quality health care when needed. The provision of surgical and anaesthesia care represents an integral component of UHC and the SDGs. 

Recognizing this important linkage, World Health Organization (WHO) Member States unanimously approved resolution WHA68.15 during the World Health Assembly in May 2015, calling for strengthening of emergency and essential surgical and anaesthesia care as an integral part of UHC. This resolution urges countries to prioritize surgical and anaesthesia care as part of national health plans, emphasizing the importance of service delivery, quality, training, workforce, infrastructure and data collection to support monitoring and evaluation. 

Despite this global momentum, there remains a paucity of data and information on global surgical and anaesthesia care. Experts estimate that nearly 5 billion people do not have access to safe, affordable surgical and anaesthesia care, contributing to as many as 17 million deaths each year. For those who are able to access care, out of pocket costs can be devastating. An estimated 81 million people are impoverished each year seeking essential surgical services. 

When integrated as part of health systems, surgical care represents one of the most cost-effective public health interventions. Integrating safe, effective and affordable surgery into existing health systems has been shown to contribute to economic gains. For every $1 invested in surgical capacity building at the community level, $10 is generated through increased health and productivity. 

Aligning surgical and anaesthesia care as part of UHC is a powerful strategy for saving lives, and contributes to the broader sustainable development agenda. However, a robust indicator framework will be essential to guide national, regional and global interventions, and to track progress towards UHC and the sustainable development agenda. The availability of surgical and anaesthesia data will further provide governments with the information needed to develop, implement and monitor national policies and allocate resources effectively. 

This global consensus statement focuses on the importance of data collection for surgical and anaesthesia care as an integral part of the SDG framework. The authors and signatories of this statement call for the establishment of an expert working group to analyze and provide recommendations on global surgery and anaesthesia statistics to be presented to the United Nations Statistical Commission in 2019. 

The Launch

The report was launched at a side advocacy event held in parallel with the 49th UN Statistical Commission. Hosted by the G4 Alliance and held at Gradian Health Systems, the event featured an intimate roundtable discussion with report contributors and global surgery data experts. 

Speakers included: 
Dr. Blake Alkire, MD, MPH Representative for PGSSC, Harvard Medical School

Dr. Faye Mazo Evans, Representative for WFSA

Dr. Jose Miguel Guzman, Regional Coordinator, DHS Africa, ICF International

Dr. David Ljungman, MD PhD, Report Co-Author

The session was moderated by Ms. Mira Meheš, Director of Operations with The G4 Alliance.  Special remarks were also shared by Dr. Sabrina Juran and Magdalena (Leni) Gruendl, co-authors of the global surgery and anaesthesia statement. 

We wish to thank Gradian Health Systems and CEO Mr. Stephen Rudy for welcoming us and hosting our event at Gradian's HQ in New York. 


Read the Report Here

Does your organization wish to endorse this report? Sign up Here



The Essential Role of Surgery in Achieving Universal Health Coverage

As featured in the THET February E-Bulletin

“Universal health coverage (UHC) is based upon the conviction that health is a human right, not a privilege. As Director General of the World Health Organization (WHO), I have made UHC my top priority, because I believe it is the best overall investment in health. WHO’s work is about serving people and serving humanity. As part of this mission, access to surgical services and anaesthesia is something to which I am deeply committed.”

So wrote Dr. Tedros, Director General of the WHO, in a message delivered at an official side event during the Universal Health Coverage Forum in Tokyo, Japan on December 12, 2017. This advocacy event, hosted by the WHO, and the governments of Zambia and Zimbabwe, in partnership with the G4 Alliance, the Program in Global Surgery and Social Change at Harvard Medical School, and Johnson & Johnson helped to draw recognition for the essential role of surgery and anaesthesia as part of UHC (Image 1).  World leaders, including Dr. Tedros Adhanom of the WHO, Dr. Jim Yong Kim, President of the World Bank, and Dr. Sania Nishtar, Co-Chair of the High-Level Commission on NCDs, shared strong support for the essential role of surgical and anaesthesia care (Image 2).

Around the world, 5 billion people lack access to safe, affordable surgical and anaesthesia care. This issue cuts across nearly all aspects of health including conditions such as obstructed labor, maternal hemorrhage, congenital birth defects such as clubfoot and cleft lip, traumatic injuries and accidents, soft tissue infections, as well as non-communicable conditions such as cancer and heart disease. Neglected surgical conditions, which comprise one-third of the global burden of disease, could be treated simply and cost-effectively through increased access to essential surgical and anaesthesia care. Access to essential surgical care could save the lives of nearly 17 million people each year, with millions more living free from disability and chronic disease.

The economic impact of surgical inequity also makes surgery essential in achieving UHC, which prioritizes affordability of health services for individuals and the role of health in the economic development of nations. Every year, 81 million people face catastrophic financial expenditure while seeking access to surgery. People are forced to choose between their health and their financial security, and many forgo treatment rather than face financial ruin. Nations that do not invest in surgical care, however, face a steep cost; low and lower-middle income countries stand to lose $12.3 trillion in potential GDP by the year 2030 if they do not make critical investments in surgical care. Achieving the financial imperative of UHC and working towards zero poverty as outlined by the Sustainable Development Goals will require strong health systems and the integration of surgical care as part of primary health coverage.

The barriers to care are numerous: workforce capacity, lack of infrastructure, lack of financing mechanisms, supply chain issues, and a long legacy of under-prioritization at every level of society. To holistically address each of these complex barriers, a coordinated global response was vital. In 2014, the G4 Alliance, a coalition of more than 85 of the world’s leading surgical, obstetric, trauma and anaesthesia care organizations, was formed to advocate for neglected surgical patients around the world. Through this coalition, we are working to develop a shared global advocacy and policy framework for surgical, obstetric, trauma, and anaesthesia care.

While the essential role of surgery as part of UHC has been recognized through political declarations and statements by high level officials, there is still much work to be done. The global surgical community must continue working with the WHO, Member States, and civil society to support integration of surgical care as part of national health plans, and to call for standardized monitoring and reporting of progress worldwide, as organizations like THET are already doing. You can help us take action to call upon world leaders to take the next step in prioritizing collection of surgical and anaesthesia indicators to help track national and global progress. Join us in this advocacy opportunity by February 4th, 2018, and join us throughout the year for additional opportunities to become an advocate for global surgery and health for all!

Surgery in the Spotlight at 72nd UNGA

September 12, 2017 marked the opening of the 72nd UN General Assembly (UNGA), the annual convening of world leaders that serves as the main policy-making and convening platform for the United Nations. The G4 Alliance coordinated a delegation of member advocates to attend the UNGA representing safe surgery, and promoting its essential role in achieving both the Sustainable Development Goals and universal health coverage. Thanks to the active engagement of our members and partners, there was no shortage of discussion and action around safe surgery at this year's UNGA! 

5 Highlights from 72nd UNGA

1. #SurgeryUHC Thunderclap

                 There is no #UHC without #SurgeryUHC!

                 There is no #UHC without #SurgeryUHC!

G4 members and partners came together to generate a resounding Twitter Thunderclap on Monday September 18th. Using the hashtags #SurgeryUHC and #SafeSurgery, participants called upon world leaders to recognize the essential role of surgical care as part of universal health coverage (UHC).  This campaign was timed in advance of a high-profile UNGA event entitled "World Leaders for Universal Health Coverage: A High-Level Discussion at the United Nations on Achieving the SDGs Through Health for All."  Online advocacy reached 59,724 people directly over social media, raising the profile of global surgery and world leaders.  Thanks to all who joined us!


2. Dr. Tedros Meets with G4 Members

 The G4 Alliance coordinated a delegation of members to participate at this year's UNGA .  Over 20 delegates attended a high-level event at the UN bringing together world leaders to discuss progress towards achieving universal health coverage (UHC). In addition to promoting our #SurgeryUHC campaign, our delegation had the opportunity to engage directly with a number of key leaders including Dr. Tedros Adhanom (Director General of the World Health Organization) and representatives from the World Bank, Rockefeller Foundation, UHC 2030, UHC Coalition and various UN Agencies .  A special thanks to all members who participated at UNGA, especially the team from the Harvard Program in Global Surgery and Social Change for contributing much time and energy to our campaign.  We will continue to build on these advocacy efforts to ensure leaders such as Dr. Tedros continue to advocate for the essential role of surgery to achieve UHC and health for all! 

3. Spotlight on Safe Surgery Maternal + Newborn Health

Each year, more than 300,000 women die from preventable surgical conditions during pregnancy or labor. The same conditions that kill mothers often result in the death of their newborns. These tragedies are by no means inevitable — safe surgery can prevent the maternal and newborn deaths that devastate so many families around the world.

To shed light upon this global injustice, the G4 Alliance, in partnership with Jhpiego, GE Foundation and Safe Surgery 2020, co-hosted an advocacy side event entitled, "Accelerating Progress in Maternal + Newborn Health: The Role of Surgical Innovations to Catalyze Change".  Speakers and panelists highlighted the critical role of surgery in averting preventable maternal and newborn deaths and focused upon the strategies and tools that are making an impact. Special remarks were shared by Mr. John Rice, Vice-Chairman of GE and President & CEO of GE Global Growth and Operations,  Dr. Tim Evans, Senior Director of Health, Nutrition & Population,  World Bank and Dr. Leslie Mancuso, President and CEO, Jhpiego.  The event was moderated by Ambassador Dr. Neil Parsan, G4 Alliance Board Chair & Special Advisor to the World Bank.

The panel was moderated by Wendy Taylor, Former Director, USAID Center for Accelerating Innovation. Expert panelists brought diverse perspectives to the discussion and included the following partners: 

  • Dr. Miliard Derbew, President, College of Surgeons of East, Central, and Southern Africa (COSECSA) - G4 Member
  • Dr. John G. Meara, Kletjan Professor of Global Surgery and Director of the Program in Global Surgery and Social Change, Harvard Medical School - G4 Member
  • Kris Torgeson, MSC, MPhil, Global CEO, Lifebox Foundation
  • Dr. Pierre Theodore, Vice President, Medical Devices, Johnson & Johnson
For an in-depth look at the discussion and outcomes of the event, please read these fantastic pieces from our friends at Global Health NOW and GE Reports.
"The scope of the problem is clear: More than 300,000 women will die from preventable conditions during pregnancy, such as a ruptured uterus or obstructed labor." Dayna Kerecman Myers, Writer/Editor for Global Health NOW.

"The scope of the problem is clear: More than 300,000 women will die from preventable conditions during pregnancy, such as a ruptured uterus or obstructed labor." Dayna Kerecman Myers, Writer/Editor for Global Health NOW.

“This is not sending someone to Mars,” said John Rice, GE vice chairman and president and CEO of the company’s Global Growth Organizations. “We need basic protocols, technology and training.”

“This is not sending someone to Mars,” said John Rice, GE vice chairman and president and CEO of the company’s Global Growth Organizations. “We need basic protocols, technology and training.”

4. Big, Bold Ideas: Essential Surgery & SDGs

 Essential surgery and the great work of G4 members were in the spotlight at Johnson & Johnson's UNGA event.  On September 20th, J&J hosted "Big, Bold Ideas to Achieve the SDGs: The Johnson & Johnson Commitment to Improve Health for Humanity". The event featured a Changemaker's Expo to highlight the work of J&J partners, including G4 Members Operation Smile, CCBRT/Kupona Foundation & Smile Train.   The event also featured a panel discussion showcasing the company's commitment to the Global Goals, including a commitment to bring safe, essential, and timely surgical care to 50 million people over the next 5 years. Dr. Rusty (Ross) Segan, CMO, Medical Devices and Global Medical Affairs served as the voice for surgery on the panel. Our thanks to Dr. Segan for highlighting the essential role of surgery as a cross-cutting strategy for achieving the SDGs and for noting the importance of civil society networks such as the G4 Alliance for helping to fulfill these goals. Dr. Segan spoke to the economic potential of essential surgery, emphasizing that LMIC economies stand to lose 12.3 trillion dollars without the swift integration of safe surgical and anaesthesia care. We commend Johnson & Johnson on their commitment to global surgery!

5. Surgery at Global First Ladies Alliance & Facebook Live Event

The Global First Ladies Alliance  (GFLA) is a non-profit organization that supports First Ladies in their efforts to advance positive change in their communities and around the world. On Thursday September 21st,  we were invited to participate in  The Future of Women, a day-long summit hosted in parallel with the UNGA, and co-hosted by the GFLA, Facebook, MAC AIDS Fund and OkayAfrica. The objectives of this interactive event were to "feature tangible solutions for creating more equitable societies, host working sessions on women’s empowerment, and explore the role of technology and social media in amplifying voices and impacting positive change." Founding G4 Alliance Executive Director Dr. Jaymie Henry was invited to discuss the importance of essential surgery during an intimate round table discussion with First Ladies and their cabinets.  Dr. Henry and G4 Director of Operations Ms. Mira Mehes also participated in a workshop with leadership from the GFLA and First Ladies' Chiefs of Staff to discuss how surgery can be integrated as part of national advocacy, SDG campaigns and health portfolios. Read more about the event here

Safe Surgery in the News

Too many women face death while giving birth. Here’s how we can improve their chances. By Monica Kerrigan (Jhpiego) in The Lily, Sept, 2017.

Saving Mothers: ‘No Woman Should Die Giving Life,’ Safe Surgery Partners Stress By Tomas Kellner (GE) in GE Reports, Sept, 2017.

In countries with a shortage of surgeons, other health care workers can fill in the gaps  By Dr. Tigistu Adamu Ashengo (Jhpiego) in STAT, Aug, 2017.

Childbirth Is Awe-Inspiring. Making It Safe Shouldn’t Be. By Adam Lewis (Gradian) in Huffpost, Aug, 2017.

Surgery must be a core part of health care – even in the poorest countries. By David Barash (GE Foundation) in The Guardian, Aug, 2017.

ImPACT Africa Pioneers Essential Data Collection Method

Perioperative mortality rate (POMR), or post-operation mortality, is a key global surgery indicator endorsed by the WHO, the Lancet, and the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care. It is considered to be a reliable indicator of the quality and safety of surgical and anaesthesia care, and it is essential to know this data to improve care within health systems. Data regarding this metric, however, is rarely collected in low- and middle- income (LMIC) countries, which are in urgent need of healthcare systems strengthening.

In East Africa, researchers and partners have come together to form the Perioperative Mortality Rate data collection project to fill this information gap and build a model of data collection that can be easily replicated throughout other regions. 

The project, funded by GE Foundation, is lead by researchers at Kijabe Hospital-Department of Anesthesiology and Vanderbilt University Medical Center-Department of Anesthesiology under the umbrella project "ImPACT Africa".  A team of anaesthesiologists at Kijabe Hospital designed and implemented an electronic data collection tool to track postoperative mortality within their hospital. Anaesthesia providers were able to use this device to collect valuable perioperative data in almost real time and analyze information on the outcomes of various surgical procedures. 

These G4 member organizations are working together to improve safe surgery and anaesthesia in Africa. Currently, ImPACT Africa is involved in building a sustainable model for anaesthesia capacity-building (including strengthening clinical work, education, data collection) in East Africa, with plans to extend their model beyond the region. 

Read more about their work, the results of their data collection, and commentary on the significance of this achievement below!

The Full Study

Commentary by Isabeau A. Walker, B.Sc., M.B., B. Chir., F.R.C.A., Iain H. Wilson, M.B., Ch.B., F.R.C.A. 


Safe Roads, Safe Surgery: Achieving SDG 3

Traumatic injuries from road traffic incidents (RTIs) are among the top causes of death and disability worldwide.  Approximately 1.25 million die each year and an additional 20-50 million suffer non-fatal injuries as a result of road traffic accidents. Due to increased urbanization and industrialization, low and middle-income (LMIC) countries bear a disproportionate number of injury-related deaths and will continue to bear this burden until governments invest in the expansion of infrastructure and the development of roads. Improving the survival of trauma patients hinges upon timely and effective pre-hospital and hospital-based interventions, including access to safe and affordable surgical care. 

The Sustainable Development Goals (SDGs), introduced in 2015, set 17 goals and 169 targets for the eradication of poverty, improving health, promoting education, and overall progress of humanity. SDG 3 aims to ensure healthy lives and promote well-being for all at all ages. To achieve this ambitious goal, 13 specific targets were set, including the global reduction of morbidity and mortality from RTIs by 50% by the year 2020. Development of organized and integrated pre-hospital and emergency care systems decrease morbidity and mortality from RTIs, and surgical care is an integral part of that framework. Surgical interventions, particularly in an emergency setting, are cost-effective and pivotal in preventing long-term disability.

Without investment in the surgical systems, losses in economic productivity in LMICs will total 12.3 trillion USD by 2030.

Lack of effective political advocacy and insufficient resources continue to be major barriers to providing emergency surgical care in LMICs. Without investment in the surgical systems, losses in economic productivity in LMICs will total 12.3 trillion USD by 2030. Improvements in trauma care can save up to 2 million lives annually in these countries, but only with the effective integration of surgical care. Improving health to ensure well-being is a complex matter that necessitates societal, governmental, and economic involvement. It is a public health priority to invest in safe surgical and anesthesia care to develop a sustainable health system.

Call to Action
Over 90% of RTIs occur in LMICs, causing considerable economic losses not just to the victims and their families, but also to nations as a whole. The targets set forth in SDG 3 will not be possible without the prioritization of surgical care as an essential strategy for reducing morbidity, mortality, and disability caused by these traffic injuries.

  1. Sign on to the speed vaccine campaign to reduce traffic speeds to a level safe for children. The campaign is endorsed by leading public health figures including Michael Bloomberg, Jimmy Carter, and Margaret Chan and builds on SDG 3.6 and the Habitat III New Urban Agenda call for ‘a safe and healthy journey to school for every child as a priority.’
  2. Engage in cross-sector collaboration and report back on commitments and progress to support the SDG 3 on health and wellbeing and work towards halving road deaths by 2020;
  3. Prioritize robust investments to strengthen national health systems, ensuring that universal health coverage includes essential surgical and trauma care to save lives and prevent disability resulting from road-traffic related accidents and injuries.  

Read more about the 2017 UN HLPF Advocacy Side Event we hosted with FiA Foundation and the Global Initiative for Child Health and Mobility Here


-Dr. Maryam Saeed is a global surgery research fellow working with the G4 Alliance.