REINTEGRATING A GLOBAL HEALTH PROGRAM TO ON-SITE VISITS DURING THE COVID-19 PANDEMIC

ABSTRACT

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic limited global surgical missions. As a vaccine has been developed and deployed with low-/middle-income countries (LMICs) adjusting to a post-pandemic landscape, the question remains of how and when to restart surgical missions to these locations. This study reports the experience of International Volunteers in Urology (IVUmed) with identifying metrics of “readiness” for return to global health surgical workshops. METHODS: A survey was created and emailed in September 2021 to LMIC international partners where IVUmed has previously performed or is planning surgical workshops. The survey queried if international sites were ready for the return of surgical workshops, the timing of readiness, type workshop requested first, challenges faced including equipment limitations, and vaccination status. Results were tabulated. RESULTS: Of 30 emails sent, there were 12 responses. This represented 11 unique hospitals in 10 unique cities in 9 countries. The majority of respondents were from the continent of Africa (n=9) while the others were from Asia (n=2) and the Caribbean (n=1). Most respondents lived in countries where vaccines were available (75%) with all respondents stating they were vaccinated and are required to wear masks out in public. Most sites (66.7%) responded being ready for IVUmed workshops, with a start date of February 2022 (55.6%). 83% of respondents stated their hospital infrastructure could support a workshop, with 75% stating good access to personal protective equipment;58%, however, noted difficulty obtaining surgical supplies. Two respondents stating their hospitals continue to only perform emergent surgical cases. The most popular first workshops requested were pediatric urology and laparoscopy/endourology (30% each). Themes of the biggest challenge noted since the start of COVID-19 included 7 comments on performing operations, 4 about lack of supplies, and 2 about lost learning opportunities. CONCLUSIONS: It is unclear how and when to restart global health surgical mission programs since the start of the COVID-19 pandemic, which impacted the already critically limited global surgical volumes in LMICs. While LMIC partners queried report a high vaccination status, the vaccination status of the general population in surveyed countries has not been established. While this is an ongoing research project, important considerations for resumption of surgical missions must include careful assessment of timeliness, surgical and anesthetic capacity, facility resources, and safety. Direct communication with local sites is imperative.