Five billion people—two thirds of world population—lack access to safe and affordable surgical, anesthesia and obstetric (SAO) care while a third of the global burden of disease requires surgical and/or anesthesia decision-making or treatment. Treating the sick very often requires surgery and anesthesia. Despite such huge burden of disease, safe and affordable SAO care is often overlooked.
Why? It may be because surgery and anesthesia are not disease entities. They are treatment modalities that address the breadth of human disease — infections, non-communicable, maternal, child, geriatric and trauma-related disease and injuries, and international development agencies have been focusing on vertical disease-based programs.
Prior to 2015, global data on surgery, anesthesia and obstetric care was virtually nonexistent. With the idea that “We can’t manage what we don’t measure”, the Lancet Commission on Global Surgery developed six Surgical, Obstetric and Anesthesia (SAO) indicators (discussed here) and collected data for them. The analysis of these data show large gaps in SAO care across countries by income groups.
The SAO or “surgical” workforce is extremely small in low-income countries (1 SAOs per 100,000 population) and lower middle-income countries (10 SAOs per 100,000 population) whereas there are 69 SAOs per 100,000 population in high-income countries. The discrepancy between high-income countries and low- and middle-income countries is even greater for surgical workforce density than that of physician density.
If I had to pick one critical source of exports and a key driver of economic growth for Armenia, I would pick mining.
But mining is a risky business and is fraught with hurdles. Exploration often comes up empty. Investments are very large, in excess of hundreds of millions dollars. Commodity prices can change dramatically and governments can change policies and taxes. Moreover, there can be large environmental and social risks associated with things like tailings, dams, and resettlement policies.
A risky business does not, however, mean that mining is or should be an irresponsible business. Many of these risks can be mitigated or eliminated. This requires proper policies, laws, regulations, careful implementation, and planning for life when the mine closes – all of this even before the mine opens. Supporting policies, such as easy access to updated geological information and predictability in transferring licenses, reduce the risk in exploration.
These are some of the views and reports relevant to our readers that caught our attention this week.
“When a housewife in a working-class district of Mexico City gets fed up with the lack of working lights in her local park, she logs on to Twitter and complains directly to the city's mayor.
In an age of incessant digital chatter -- and in a city of 22 million -- this might seem futile. But the mayor, who has more than 600,000 Twitter followers, replies to her complaint within hours. He orders the city's public works department to take action. Several weeks later, he posts photos of new lights being installed in the park and thanks the woman for bringing the problem to his attention.
In fact, the mayor's Twitter feed reads like a gritty chronicle of life in a megacity. Potholes, of course, but also complaints and announcements about garbage collection, crime, traffic lights, construction delays, power outages, water supplies, bike lanes, flooded sewers, corruption, air quality, and the proverbial rude bureaucrat.” READ MORE