Ethical Dilemmas in Surgical Mission Trips During the COVID-19 Pandemic Otolaryngology– Head and Neck Surgery 2022, Vol. 166(5) 840–843 American Academy of Otolaryngology–Head and Neck Surgery Foundation 2021 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/01945998211038486 http://otojournal.org Brianne B. Roby, MD, Zahrah Taufique, MD, MBA, Andrew Redmann, MD, Asitha D. L. Jayawardena, MD, MPH, and Sivakumar Chinnadurai, MD, MPH

https://journals.sagepub.com/doi/pdf/10.1177/01945998211038486

Ethical Dilemmas in Surgical Mission Trips During the COVID-19 Pandemic.

The standard treatment for endemic goiter is usually total thyroidectomy. In low‐ and middle‐income countries, the management of thyroid disease, which is commonplace in fully developed countries, is not always possible. The purpose of this study is to establish a treatment algorithm to calculate the extent of thyroidectomy based on the risk factors of each patient.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/lio2.764

Goiter surgery recommendations in sub‐Saharan Africa in humanitarian cooperation

COVID-19-related travel restrictions profoundly impacted short-term medical missions (STMMs) abroad. This study describes the effect of the pandemic as perceived by STMM organisations serving Latin America and the Caribbean (LAC). Information was updated for 359 primary care STMM organisations previously active in 2015, which were contained within an existing online database. Organisations were contacted to complete an online survey that gathered quantitative and qualitative descriptions of pandemic-related adaptations and program changes. 22.5% (73/324) of previously active organisations had no website activity since 2020 or earlier, no longer existed, or had unclear website activity. Eighty-seven organisations responded to the survey. Ninety-six percent indicated that they would definitely (72/86, 84%) or probably (10/86, 12%) return to sending STMMs in the next five years, and most (46/83, 55%) of these intended to send an STMM within the next six months. Seventy-two respondents (93%) reported new adaptations, including direct funding for local healthcare professionals, sending equipment to host communities, focusing on training and teaching, and incorporating virtual care and electronic medical records. The results demonstrate resilience, flexibility and optimism among STMM organisations and an intent to return to pre-pandemic programming rapidly.

Resilience of the medical mission model: assessment of the perceived impact of the COVID-19 pandemic on short-term medical missions to Latin America and the Caribbean

Defining humanitarian surgery: international consensus in global surgery.

Since the declaration of the pandemic, humanitarian medicine has been discontinued. Until now, there have been no general recommendations on how humanitarian surgical missions should be organized. Based on our experience in the field of humanitarian surgical missions to Sub-Saharan Africa, a panel of recommendations in times of COVID-19 was developed. The fields under study were as follows: (1) Planning of a multidisciplinary project; (2) Organization of the infrastructure; (3) Screening, management and treatment of SARS-COV-2; (4) Diagnostic tests for SARS-COV-2; (5) Surgical priorization and (6) Context of patients during health-care assistance. We applied a risk bias measurement to obtain a consensus among humanitarian health-care providers with experience in this field. A total of 94.36% of agreement were reached for the approval of the recommendations. Emergency surgery must be a priority, and elective surgery adapted. For emergency surgery, we established a priority level 1a (< 24 h) and 1b (< 72 h). For an elective procedure, according our American College of Surgeon adaptation score, process with more than 60 points should be reconsidered. Due to the low life expectancy in many African countries, we consider 45–50 years as age of risk. In case of SARS-COV-2 active infection or high clinical suspicion, the screening, management and treatment should be following the international guidelines adapted to duration of the stay, available infrastructure, size of the cooperation team and medical resources. Humanitarian surgical mission in times of COVID-19 is a challenge that must extrapolate the established recommendations to the local cooperation environment.

/pdf/humanitarian-surgical-missions-in-times-of-covid-19-47jg41sr4r.pdf

Humanitarian Surgical Missions in Times of COVID-19: Recommendations to Safely Return to a Sub-Saharan Africa Low-Resource Setting.

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Humanitarian Surgical Missions in Times of COVID-19: Recommendations to Safely Return to a Sub-Saharan Africa Low-Resource Setting.