What is humanitarian surgery?
To achieve international consensus on what ‘humanitarian surgery’ is, we have undertaken a modified Delphi process involving stakeholders around the world.
Global surgery or humanitarian surgery
Over the last decade, there has been an exponential increase in the usage of ‘global surgery’ and ‘humanitarian surgery’ in publications. However, the terms are often used interchangeably and there is no fixed definition of humanitarian surgery. This makes it difficult to compare interventions, outcomes and cost-effectiveness since a wide variety of activities are included in these global or humanitarian surgery programmes.
To address this question, a modified Delphi process was used, drawing on experts from across the world. The respondents were chosen to represent key stakeholders with an aim to include a wide range of institution types and geographical diversity. Lay representatives included patients, relatives and charity works with experience in surgery worldwide.
What is a Delphi process?
A Delphi process is a proven method of developing consensus from a group of experts through iterative rounds of anonymous voting followed by group feedback. This technique gathers the opinions of experts within a field in order to assess the level of agreement and resolve disagreement on a specific topic, and is well suited to the global health agenda as it allows large numbers of geographically dispersed experts to contribute. All respondents were listed as co-authors using a collaborative authorship model under the name of The Royal College of Surgeons of England Humanitarian Surgery Initiative.
This collaboration has now been published.
Conclusion
- This collaboration proposed the following definition of Humanitarian Surgery: 'An area for study, research, and practice that focuses on the coordinated provision of emergency surgical care, in accordance with the humanitarian principles, in conflict and post-conflict zones, in areas of sudden-onset disasters, and when the local health system is overwhelmed'.
- By agreeing on a definition, the authors aim to stimulate debate on the topic and to focus further research on when ‘Humanitarian Surgery’ may be required, and what role it should play within the broader aims of improving surgical care across the world. Additionally, an agreed definition facilitates standardisation of training, care, research, and evaluation of humanitarian surgical care against international benchmarks.
The published paper
This study was published by BJS in February 2024. Read the paper to find out the agreed full and working definition for Humanitarian Surgery.