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A Gender Gap With a Deadly Cost: The Need for More Women Surgeons

Five billion people worldwide are unable to access essential surgical care. To address this global health crisis, we need to encourage more women to step up to the operating table, says Karina Nagin, executive director of Mission: Restore.

Written by Karina Nagin Published on Read time Approx. 4 minutes
Around 18 million people die every year of surgically treatable conditions. Training and supporting more women surgeons could help close that gap. Courtesy of Mission: Restore

Five billion people lack access to essential surgical care around the world according to the Global Surgery 2030 Report. One of the challenges is a severe shortage of surgical specialists in many developing countries. For example, Burundi has only 19 surgeons for a population of more than 10 million people, not nearly enough to meet the overwhelming need.

There are many reasons for the shortfall: political and economic instability, few medical schools and poor continuing education training, to name a few. Sub-Saharan Africa has a very low physician-to-population ratio, with only 13 doctors for every 100,000 people. And that ratio becomes abysmal when you look at surgeons. This creates a lack of access to surgical care that amounts to a global health crisis, claiming millions of lives each year. To address this challenge, we need all hands on deck.

At first glance, the U.S. doesn’t appear to face the same surgical problems as many developing countries. However, it does share the glaring challenge of achieving gender equality in the operating room. Despite almost half of U.S. medical school students being women, they make up only 8 percent of professors of surgery and 13 percent of associate professors of surgery.

A positive step in 2017 brought an increased awareness of this imbalance. Recognition of women in surgery has been highlighted through campaigns such as #ILookLikeASurgeon, with photo submissions from female surgeons around the world bringing visibility to women working in a traditionally male-dominated field.

In advocating for women as equals in surgery, we also recognize their vital role in filling the global surgical gap. Up to 18 million people die every year of surgically treatable conditions and the Lancet Commission on Global Surgery estimates that we need an additional 2.2 million surgical professionals to close this gap.

Encouraging more women to become surgeons isn’t only about equality – it’s the only way we’re going to meet the global need. When facing this challenge, engaging women as part of the solution is a necessity. Bringing more women into the operating room can help improve the lives of millions of people.

Dr. Amanda Mulango, who is enrolled in Mission: Restore’s Educational Grant program and is currently studying in Nairobi, is an example of both the need and the opportunities for women to become leaders in the field of surgery. After working in a district hospital in Zambia for three years as a medical doctor, she wanted to have a bigger impact on her patients’ lives. She saw surgery as a way to do that. “Currently, we have only one plastic and reconstructive surgeon in my country, and he’s not Zambian,” she said. “When I graduate, I hope to be among the first Zambian reconstructive surgeons for my entire country.”

Currently studying in Kenya, Dr. Amanda Mulango hopes to return home to Zambia to work as one of the country’s first Zambian reconstructive surgeons. (Courtesy of Mission: Restore)

Female surgeons in Africa and the U.S. have shared challenges, including fewer girls studying STEM (science, technology, engineering and math) subjects and unconscious gender bias. However, many women in sub-Saharan Africa must also overcome additional hurdles, such as a shortage of schools, traditionally patriarchal societies and high dropout rates for girls (in Tanzania less than one-quarter of girls make it to secondary school).

While many organizations are tackling the challenges of girls’ education, those resources and support networks begin to dwindle the further a woman goes in her education and the fewer role models there are to emulate. Many surgeons in East Africa find themselves working in isolation as the only specialist in their hospital, region or even country. That’s why role models – such as Dr. Mulango – and support networks can have such a huge impact on retaining women in the field and encouraging more women to pursue a surgical specialty.

While we must address early childhood barriers for girls’ education, we must simultaneously ensure we are creating a professional infrastructure and support system for the trailblazers. By doing so, we will create an environment in which all surgeons can thrive.

The good news is that a growing number of organizations recognize the urgent need to improve access to surgical care and support surgical training. Organizations such as the G4 Alliance advocate on the national and global level to make the issue a political priority within ministries of health and at the World Health Organization. The College of Surgeons of East, Central and Southern Africa (COSECSA) is advancing surgical training and postgraduate education in the sub-Saharan region, and in 2015 launched the Women in Surgery Africa group to specifically support more women surgeons. Mission: Restore provides educational grants to help exceptional young surgeons continue their training and works with partners such as COSECSA and Smile Train to create support networks for training and mentorship.

By working together and fostering the next generation of women surgeons, we all win. We must operate together to address the shared challenges that women surgeons face around the world. It is this connection and our collaboration that can also create the solution.

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Women & Girls.

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