Global Neurosurgery : A Reflection from a Life in the Field

During his training, neurosurgeon Robert J. Dempsey, M.D. was told that global health was something for infectious diseases and not possible in super-specialties. This is the story of questioning that belief, of addressing a massive need by working in the areas of need, going to numerous ministers of health worldwide and showing them that with the training of even a few neurosurgeons, we can complete a trauma system in their country. The result is now we can also provide care for cancer, stroke and congenital defects of newborn children where it was previously impossible. In 2015, the Lancet Commission’s report predicted, over the next few years, 47 million unnecessary deaths worldwide due to the lack of essential surgeries. This book relates the importance of rectifying that ongoing tragedy and, more importantly, the humanizing influences that such a journey has had on a super-specialist working with the people of greatest need. It concludes that in spite of massive need,the present situation is actually very hopeful, as we have shifted the focus of global health from service alone to partnered teaching, leading us now to self-sustaining systems of care delivered for and by the people in the regions of need. Global Neurosurgery covers the thought-provoking and often frightening lessons learned over four decades of neurosurgical involvement in global health, working from a period when little or none existed to the present state of specialized healthcare in the area of need. This process starts in the U.S. and then addresses health disparity on four continents and now on U.S. tribal reservations. It emphasizes the importance of first listening, then partnering with government, medical societies, universities and private foundations, and most importantly, learning from mistakes. The programs developed allow the recipients of the care to take over the training so that it becomes about them and their patients in their home lands. It will appeal to a wide audience because its stories explain actual worldwide health conditions while giving an insight valuable to the professional or lay person into the experiences and operating rooms of a neurosurgeon working under very difficult conditions.