(건강) 아직도 안전한 수술을 받을 수 없을 만큼 가난한 50억 인구

출처: http://www.bbc.com/news/health-32452249

27 April 2015

Five billion people 'have no access to safe surgery' 안전한 수술을 받을 수 없을만큼 가난한 50억 인구

By Tulip MazumdarGlobal health reporter

The study said a third of all deaths in 2010 were treatable with surgery 최근 보고서에 의하면, 2010년 전체 사망자의 3분의 1은 수술로 치료가 가능했던 사람들이다

Two-thirds of the world's population have no access to safe and affordable surgery, according to a new study in The Lancet - more than double the number in previous estimates. 전에 추정했던 숫자보다 곱절인 전세계 인구의 3분의 2가 너무 가난해 수술을 감당할 수 없다고, Lancet의 최근 연구보고서는 밝히고 있다.

It means millions of people are dying from treatable conditions such as appendicitis and obstructed labour. 이는 수 백만의 사람들이 맹장염이나 차단된 분만과 같은 치료 가능한 상태에서 죽어가고 있다는 것을 뜻한다.

Most live in low and middle-income countries. 이들 대부분은 저소득이나 중간소득 국가들에서 생활하고 있다.

The study suggests that 93% of people in sub-Saharan Africa cannot obtain basic surgical care. 보고서에 의하면, 사하라사막남부 아프리카에 사는 사람들 중 93%가 기본적인 수술조차 받을 수 없다는 사실을 보여주고 있다.

Previous estimates have only looked at whether surgery was available. 이전의 추정에서는 수술을 받을 수 있는가에만 초점을 맞추었다.

But this research has also considered whether people can travel to facilities within two hours, whether the procedure will be safe, and whether patients can actually afford the treatment.

One of the study's authors, Andy Leather, director of the King's Centre for Global Health, said the situation was outrageous.

"People are dying and living with disabilities that could be avoided if they had good surgical treatment," he said.

"Also, more and more people are being pushed into poverty trying to access surgical care."

The study suggests a quarter of people who have an operation cannot in fact afford it.

Call for investment 투자 요청

Twenty-five experts spent a year and a half gathering evidence and testimony, from healthcare workers and patients, from more than 100 different countries as part of this report.

They are now calling for a greater focus on, and investment in, surgical care.

Surgeons scrub up before performing surgery - but more investment is needed

They say a third of all deaths in 2010 (16.9 million) were from conditions which were treatable with surgery.

That was more than the number of deaths from HIV/AIDS, tuberculosis and malaria combined.

The authors suggest the cost to the global economy of doing nothing will be more than $12 trillion between now and 2030.

They are calling for a $420bn global investment.

These are enormous figures and - as is nearly always the case - the greatest need is in the poorest countries.

Numbers of trained surgical specialists per 100,000 people 인구 10만명당 훈련받은 수술인력의 수

• UK: 35
• US: 36
• Brazil 35
• Japan 17
• South Africa: 7
• Bangladesh 1.7
• Sierra Leone (before Ebola): 0.1

Source: The Lancet study

'Surgery not just for urban elite' '수술은 도시에 사는 엘리트만을 위한 것이 아닌데'

A key challenge is training enough surgeons, anaesthetists and obstetricians.

In higher income countries such as the UK, there are around 35 surgical specialists per 100,000 people, whereas in Bangladesh there are 1.7 per 100,000 population.

Lead author John Meara Kletjian, professor in global surgery at Harvard Medical School, said: "Although the scale-up costs are large, the costs of inaction are higher, and will accumulate progressively with delay."

"There is a pervasive misconception that the costs of providing safe and accessible surgery put it beyond the reach of any but the richest countries," he added.

Experts in the field say surgery is a basic and crucial health need that has been largely ignored by the global health community, with tragic consequences.

"The agenda has been so much focused on individual diseases and, because surgical care is spread across so many diseases, it's been missed off," said Andy Leather said.

"There's a myth there isn't a burden of surgical disease, that it's too costly and it's just for the urban elite."

'People have given up' '이미 포기한 사람들'

London-based consultant obstetrician and gynaecologist, Shane Duffy, has recently returned from a surgical training camp in central Uganda.

There he has been teaching local doctors how to carry out very specialised 'fistula repair surgery'.

This is for women who have had obstructed labours.

Most sufferers lose their babies during child birth and are left with a damaged bladder, or bowels, which can leave them incontinent and rejected by their families.

"Unfortunately a lot of people have given up on the hospitals because they can't find surgeons there," said Dr Duffy.

"People are living in the community with debilitating conditions and they just can't find the skilled people to help them."

Facts on global surgery 지구촌 수술에 관한 사실들

• 313 million operations are carried out worldwide each year.
• Just one in 20 operations occur in the poorest countries, where over a third of the world's population lives.
• There is a global shortfall of at least 143 million surgical procedures every year.

Source: The Lancet