Bethune Roundtable in General Surgery

Ab Guha Keynote Address:
Redesigning healthcare education for sustainability

Abstract Session #1: Education
Moderator – Dr. Johanna Riesel -Staff surgeon; the Hospital for Sick Children

• Cardiac Surgery in Haiti: High Need, Low Support
  In-person presentation: Dr. Louvenser Minthor
• Surgical, Anesthesia and Obstetrics (SAO) workforce production capacity in India: A retrospective analysis of residency and fellowship-level training spots across 36 states
  In-person presentation: Dr. Shirish Rao
• Ethiopia’s first minimally invasive surgery program: A novel approach in global surgical education
  Virtual presentation – Dr. Ayalew Tizazu
• Q&A

• Initial report on Collaborative Global Surgery Education Program utilizing mixed method of in-person and augmented reality technology
  In-person presentation: Dr. Michael Chua
• Global outreach to Ukraine: Alternate strategies during the Covid-19 pandemic and a war
  In-person presentation: Dr. James Rutka
• Planetary Health Courses Around the World: An Environmental Scan
  Virtual presentation: Rosemary Vayalikunnel
• Q&A

Keynote lecture:
International education partnerships to promote sustainable workforces in LMICs: Lessons learned.

Abstract Session #2: Workforce & Capacity-Building
Dr. Mercedes Pilkington – Staff surgeon; the Hospital for Sick Children

• Achieving Sustainable Development Goals: Results on Surgical Workforce Capacity in Ecuador
  Virtual presentation: Letícia Nunes Campos
• Identifying opportunities for global surgery in Cameroon: An analysis of existing health policies and events
  Virtual presentation: Berjo Dongmo Takoutsing
• Defining a framework and evaluation metrics for sustainable global surgical partnerships: A modified Delphi study
  Virtual presentation: Jayd Adams
• Q&A

• Task-Sharing Spinal Anaesthesia Care in Three Rural Indian Hospitals: A Non-Inferiority Randomised Controlled Clinical Trial
  In-person presentation: Dr. Wesley Rajaleelan
• Geographical Inequalities in Access to Bellwether Procedures in Brazil
  Virtual presentation: Sofia Wagemaker Viana
• Surgeons in Humanitarian Alliance for Reconstruction, Research, and Education: Improving Sustainability in Global Plastic Surgery Through Long-Term Collaboration
  Virtual presentation: Dr. Sukhmeet Singh Sachal
• Q&A

Joint keynote lecture:
Planetary healthcare for surgeons

• Dr. Andrea MacNeill – Founder; UBC Planetary Healthcare Lab and Surgical Oncologist, Vancouver General Hospital
• Dr. Laura Donahoe – Medical Director; Medical Device Reprocessing Unit at UHN and Thoracic Surgeon, UHN

Abstract Session #3: Surgery and Sustainable Development Goals
Moderator – Dr. Anna Dare

• Vaginal and Cesarean Birth Trends Following the 2007 Tabasco Flood in Mexico: a Population Based Study
  In-person presentation: Dr. Mehreen Zaigham
• Outpatient surgical referrals from primary care providers for people experiencing homelessness: A chart review
  Virtual presentation: Dr. Madeline McDonald
• Assessing Environmental impact of operating rooms in a low resource setting
  Virtual presentation: Dr. Samuel Negash
• Q&A

• Environmental Sustainability for Sustainable Surgical Systems: An Analysis of National Surgical, Obstetric, and Anesthesia Plans, Capacity Assessment Tools, and Global Surgical Guidelines and Recommendations
  In-person presentation: Dr. Anisa Nazir
• Catastrophic out-of-pocket payments and impoverishment related to accessing surgical care among households in rural Ethiopia
  Virtual presentation: Dr. Amezene Tadesse Robelie
• Reinventing training in Global Health: Building teams for sustainable Children?s Surgical care in LMICs
  Virtual presentation: Dr. Deeptiman James
• Q&A

Panel discussion: Decarbonizing global surgery

Moderator: Dr. Andrew Howard

Panelists: Drs. Andrea MacNeil, Laura Donahoe, Dominique Vervoort, Anisa Nazir

Abstract Session 4: Clinical Papers
Moderator: Dr. Barbara Jemec

• A Retrospective Analysis Calculating the Scale-Up Costs and Net Benefits for Meeting Unmet Needs for Cataract Coverage for 30 Indian States
  In-person presentation: Anoushka Arora
• Enhancing operation theater efficiency in view of the burke Litwin model: St Peter Specialized Hospital
  Virtual presentation: Dr. Assefa Tesfaye
• Developing and implementing a Surgical Site Infection Prevention Package among Children Undergoing Surgery at MNH Tanzania
  Virtual presentation: Dr. Godfrey Sama Philipo
  WITHDRAWN
• Q&A

• Post-operative morbidity and mortality in Indigenous patients: A scoping review and meta-analysis
  In-person presentation: Georgia Fraulin
• The Effectiveness of Safe Surgery Package in Reducing Surgical Site Infection: Pre-post Multipronged Intervention Program Evaluation
  Virtual presentation: Dr. Tewodros Liyew
• Humanitarian Reconstructive Surgery in War: How complex care in challenging environments can catalyze sustainable healthcare systems; the Swisscross experience in Iraq
  In-person presentation: Dr. Ian Furst
• Q&A

Keynote lecture:
Climate resilience and strengthening healthcare systems
Virtual presentation: Dr. Ifereimi Waqainabete – Former Minister of Health, Fiji, and President, Pacific Islands Health Association

Theme 1: Thinking Sustainably in Clinical Care

Session brief: How can we improve clinical care delivery in communities and health systems facing significant resource challenges, using innovations that also consider the environmental impact of care? How is the clinical care we deliver negatively impacting the environment, and actually contributing to a cascade of events that worsens human health, especially for those living in settings that are also most vulnerable to the negative effects of climate change? How can we rectify this in the daily actions we take, and the way we deliver clinical care in our heath systems?

• Clinical Innovations ?How I do It?
  Maryse Bouchard
• Reverse Innovation “Third Ventriculostomy and Shunts”
  Abhaya Kulkarni

Group discussion: Thinking sustainably in clinical care: innovations and approaches trainees can adopt and lead

Group A (Gallery):
Decarbonization initiatives in surgery
Colin Sue-Chue-Lam

• What are some of the key ecological harms in our operating rooms and clinical environment?
• What steps can trainees take towards decarbonization in the OR? Inpatient care? Clinic?
• Discuss how ecological harms and efforts to decarbonize may vary across resource settings, e.g.:
  • Downtown tertiary hospital in Toronto
  • Rural clinic in Northern Ontario
  • Regional referral center in Uganda
  • District hospital in rural India
  • (can change context depending on group’s background)
• What are some of the common challenges?
• What ideas can be shared and exchanged across resource settings?

Group B (Classroom): Clinical Innovations for Sustainable Surgery
Xiya Ma

• What are some key areas where innovation is required to overcome resource shortages or to mitigate ecological harms in your day to day clinical practice?
• What ideas do you have to address these?
• How could you take this idea forward? Within your team/hospital/organization?

Theme 2: Innovation in Research and Education

Session brief: What are some of the innovations happening in research and education that are enhancing sustainability and equity in global surgery and global health? How can trainees engage?

• Global Surgery Research Collaboratives: present and future
  Anna Dare
• University of Global Health Equity: rethinking how we educate
  Abebe Bekele

Group Discussion: Sustainable Innovation for Research & Education

Group A (Gallery): New Tools for Global Surgery Research: biotechnology & big data
Asha Behdinan

Group B (Classroom): Sustainable Surgical Education: Evolution or revolution?
Buddy Omar

Bethune Roundtable Trainees White Paper: A call to action for a sustainable global surgical future

Task: Develop a white paper outline (to be written up by a core writing team, authored by the Workshop group, published in CJS or BMJ Global Health) which discusses the following as they relate to a sustainable global surgical future:

• Challenges facing global surgery
• Sustainability and global surgery:
  • what’s happening, what’s needed, what did we miss
  • e.g. consider internet based connectivity versus travel
• New opportunities for global surgery to act on sustainability for people, systems and planet
• The global surgery career – sustainable or not?