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Help children access life-changing surgery

85 per cent of children in low and middle-income countries will need surgery before turning 15. [iStockphoto] 

Somewhere, a child’s life has been saved or made better today, thanks to a paediatric surgeon. It could be a disability that has been averted and a child has been able to resume school or engage in things that they enjoy. But it is not always easy for medics to provide surgical services to children when and they need it, even in cases where a hospital has proper equipment and human resources.

Take for example a paediatric surgeon at Kijabe Hospital who narrated how he tries to overcome his day-to-day challenges. “Our work is generally challenged by the social disposition of our patients. The mixture of poverty; not just deficiency of money - challenges of access to health and/or education. For example, we recently received a child who had been living with a condition for 14 years.

This is a daily challenge. Sometimes you do such a marvellous job…but the child needs reviewing, and because of distance and money, they don’t make it. We are then almost back to zero with the issue. I spend half my time trying to figure the social economic position of the child and then making a fit-for-purpose per child solution. Sometimes we win, sometimes we lose”.

Another example: There was a boy who had maybe seven operations in his local hospital, before going to Hospital X. He had Hirschsprung disease (a birth defect in which some nerve cells are missing in the large intestine, so one can’t move stool. They had done a main operation and his bladder was injured. Later, the child got a sponsor and travelled out of the country for treatment. But as soon as he was back, he fell ill again and went to a local hospital. At first, they were hesitant as surgery to do with the abdomen can become very tricky.

But they managed to reconstruct the bladder. Now he doesn’t have to pee stool. “We form relationships with kids and watch them grow, like this one. He’s an extremely strong-willed young man who now drives a motorcycle as a source of income. He’s quality of life matrix is at the top thanks to this surgery,” the jubilant surgeon explained.

Every day, health workers face numerous challenges which are beyond their control, as they strive to provide care to children. Yet, research shows that an estimated 85 per cent of children in low and middle-income countries will need surgery before turning 15. How will they receive care when so many countries have fewer than one paediatric surgeon per million children? And where there is workforce, 90 per cent of them work majorly in cities, leaving children in rural areas vulnerable.

Sufficient and age-appropriate surgical equipment, adequate paediatric surgical workforce, access and affordability of healthcare all have to go together for countries to strengthen their health systems. Further, the Lancet Commission on Global Surgery has highlighted an increased prevalence of death and illness attributable to non-communicable diseases and injuries. This is expected to surpass previous infectious disease challenges. The allocation of funding, however, has not followed these changes.

Today, as we celebrate World Children’s Day, I want to recognise the efforts that surgery health workforce dedicate to cater for children. All over the world, these workers make incredible effort to help children. However, we must not forget that children’s rights are universal.

Where a child is born shouldn't impact their right to life-changing surgery. As global citizens we must commit to the principles that outline the right to health as outlined in the Constitution and various international accords. We must commit, as nations, institutions, organisations, or individuals, to advocate for the rights of every child which includes access to safe, timely and affordable surgery.

The writer is the Director of Africa, Kids Operating Room