Strengthening Surgical, Obstetric, and Anaesthetic Care
Ministers of Health, country delegates, health experts, policymakers, and stakeholders from 29 African nations filled the bright, airy conference room of King Fahd hotel in Dakar, Senegal on May 4-6, 2022. Over 120 participants joined the International Symposium on Strengthening Surgical, Obstetric, and Anesthetic Care in Africa by 2030.
Approximately 93% of the African population lacks access to safe, affordable, and timely surgical care. Each year, as many as 40 million unmet surgical needs in Africa and vulnerable communities withstand the worst of this inadequate access. As the leaders and experts settled into the room, optimism abounded. The discussions that took place during the Symposium will play a significant role in transforming access to Surgical, Obstetric and Anaesthetic (SOA) care and save lives across the African continent.
Understanding the Current State
The Symposium was held under the patronage of His Excellency Mr Macky Sall, President of the Republic of Senegal, and meetings were chaired by Abdoulaye Diouf Sarr, Senegal Minister of Health and Social Action. Dr Marie Khemesse Ngom Ndiaye, Senegal Director General of Public Health, highlighted the importance of the International Symposium as a unique platform to build trust among stakeholders in Africa to strengthen healthcare systems on the continent.
The event was a culmination of months of painstaking planning and deliberations. It started with a critical baseline assessment study on the state of SOA care access in Africa by the scientific committee in partnership with participating countries and other partners. The study, the first of its kind in Africa, collected data on factors related to the provision, access, and operation of surgical, obstetric, and anesthetic health care systems in 28 of the 47 nations of sub-Saharan Africa, as defined by the World Health Organization (WHO).
This centralised data was key in providing insight and understanding into the current state of the continent’s healthcare systems. The WHO Regional Office for Africa, a key partner in the Symposium, helped support the data collection efforts. The Regional Director for Africa, Matshidiso Rebecca Natalie Moeti, acknowledged that the results would be invaluable: “The study is a first for the African region and the WHO Regional Office will leverage the results to complete the ongoing situational analysis of clinical and hospital services as well as finalise the regional strategy for strengthening hospital and clinical services in the African region.”
The data collected will help stakeholders understand the disparities in access to and the outcomes of surgical care. Dr Justina Seyi-Olajide, the committee’s scientific facilitator, underscored how critical the baseline assessment was. “The data we collected will provide a reference point for assessing future progress.”
During breakout sessions to discuss findings of the baseline assessment, the country delegations noted they all faced similar challenges. Some of the common ones included a lack of funding and limited human resources.
As presentations on the baseline findings were made, there was a heightened sense of urgency in addressing these challenges. Dr Pierre M’Pele, Mercy Ships Regional Director for Africa, noted that much progress has been made over the last 20 years, with mortality rates dropping by 40% in this time. Yet surgical care has taken a backseat to public health, child health, and infectious diseases and is often relegated to the bottom of priority lists. He added that the Symposium would highlight the need to get it embedded in national health plans.
Dr Serigne Magueye Gueye, a vice-chair of the International Symposium, emphasised that policymakers must act immediately. “This Symposium [is] an opportunity for the African health leadership to make sure that in every single country, we can have a surgical plan, update their plan, and contribute to the implementation of existing plans.”
Together With Africa
With each presentation, there was a push for greater collaboration and partnership to help address the complex issues and challenges plaguing SOA care access in Africa.
Dr David Ugai, Mercy Ships Guinea Country Director, spoke about the long-lasting impact of cross-sector partnerships between development organisations like Mercy Ships and African countries. “This comprehensive partnership is a natural extension of our mission once the hospital ship has left the country. It is a perfect illustration of the effective and sustainable collaboration that Mercy Ships wishes to develop with other African countries,” he said, referring to the ongoing relationship between Mercy Ships and the Gamal University dental school in Guinea.
Vice President and Regional Director for Smile Train Africa, Nkeiruka Obi, agreed: “It is crucial to synchronise efforts for multi-stakeholder engagement. Private and public stakeholders must recognize the enormous health toll and financial burden of surgical disease and avoid working in silos. The time has come for streamlining processes at the policy level.”
Ethiopia’s Dr. Abebe Bekele says African countries must commit to the sharing of knowledge and resources.
For countries like Somaliland, the symposium offered a strategic opportunity to establish relationships with countries with strong surgical plans in place. The Minister of Health Hassan Mohammed Ali says it was a chance to learn from countries that are successfully implementing surgical plans. “We are generating important lessons from these countries for setting up and implementing successful surgical plans in our country.”
Professor Adegne Togo, part of the Mali delegation, on the other hand, says being part of the Symposium gives countries without shorelines, like Mali, access to countries that have benefitted from partnerships with Mercy Ships. “We will be discussing how we can send our healthcare professionals to go learn from these countries.”
Looking to the Future
On the final day, following intense deliberations, Ministers of Health, country delegates, and health experts confirmed and formed the Dakar Declaration, a plan outlining how they would promote and strengthen SOA and nursing care in their countries. The 29 countries in attendance agreed to adopt this roadmap for the scale-up and investment of SOA and nursing care.
As the event ended, leaders were filled with hope about the future of safe surgical, obstetric, and anesthetic care in Africa.
“Looking to the future, we are optimistic that more can and will be achieved if we synergise our approaches in helping African countries meet the demands of surgical care in their individual countries,” said Professor Emmanuel Ezeome, the first Vice President/President-elect of the West African College of Surgeons.
This Dakar Declaration on access to equitable, affordable, and quality surgical, obstetric, and anesthesia care in Africa will be presented to heads of state during an event in Dakar on May 30. The approval of the Declaration will mark another key step in the path toward safer access over the next decade and beyond.
The event will be part of the Africa Celebration, where Mercy Ships will mark 30 years of partnership with its African host nations and the inauguration of the organisation’s newest and largest vessel, the Global Mercy®. Learn more about these milestone events, and how you can get involved, here.