Eric S Nagengast1,2,3, Naikhoba C O Munabi4,5,6, Meredith Xepoleas5,6, Allyn Auslander5,7, William P Magee4,5,6,8, David Chong9. 1. Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St, Suite 415, Los Angeles, CA, 90033, USA. Eric.nagengast@med.usc.edu. 2. Division of Plastic and Maxillofacial Surgery, Children's Hospital of Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA. Eric.nagengast@med.usc.edu. 3. Operation Smile Inc., 3641 Faculty Boulevard, Virginia Beach, VA, 23453, USA. Eric.nagengast@med.usc.edu. 4. Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St, Suite 415, Los Angeles, CA, 90033, USA. 5. Division of Plastic and Maxillofacial Surgery, Children's Hospital of Los Angeles, 4650 Sunset Blvd, Los Angeles, CA, 90027, USA. 6. Operation Smile Inc., 3641 Faculty Boulevard, Virginia Beach, VA, 23453, USA. 7. Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. 8. Division of Plastic and Reconstructive Surgery, Shriners Hospital for Children, 909 S Fair Oaks Ave, Pasadena, CA, 91105, USA. 9. Department of Plastic and Maxillofacial Surgery, Royal Children's Hospital, Flemington Rd, Melbourne, Australia.
Abstract
BACKGROUND: Billions of people lack access to quality surgical care. Short-term missions are used to supplement the delivery of surgical care in regions with poor access to care. Traditionally known for using international teams, Operation Smile has transitioned to using a local mission model, where surgical service is delivered to areas of need by teams originating within that country. This study investigates the proportion and location of Operation Smile missions that use the local mission model. METHODS: A retrospective review was performed of the Operation Smile mission database for fiscal years 2014 to 2019. Missions were classified into local or international missions. Countries were also classified by their income levels as well as their specialist surgical workforce (SAO) density. As no individual patient or provider data was recorded, ethics board approval was not warranted. RESULTS: Between 2014 and 2019, Operation Smile held an average of 144.8 (range 135-154) surgical missions per year. Local missions accounted for 97 ± 5.6 (67%) of the missions. Of the 34 program countries, 26 (76%) used local missions. Of the countries that had only international missions, six (75%) were low-income countries and the average SAO density was 1.54 (range 0.19-5.88) providers per 100,000 people. Of the countries with local missions, 24 (92%) were middle-income, and the average SAO density was 30.9 (range 3.4-142.4). CONCLUSION: International investments may assist in the creation of local surgical teams. Once teams are established, local missions are a valuable way to provide specialized surgical care within a country's own borders.
BACKGROUND: Billions of people lack access to quality surgical care. Short-term missions are used to supplement the delivery of surgical care in regions with poor access to care. Traditionally known for using international teams, Operation Smile has transitioned to using a local mission model, where surgical service is delivered to areas of need by teams originating within that country. This study investigates the proportion and location of Operation Smile missions that use the local mission model. METHODS: A retrospective review was performed of the Operation Smile mission database for fiscal years 2014 to 2019. Missions were classified into local or international missions. Countries were also classified by their income levels as well as their specialist surgical workforce (SAO) density. As no individual patient or provider data was recorded, ethics board approval was not warranted. RESULTS: Between 2014 and 2019, Operation Smile held an average of 144.8 (range 135-154) surgical missions per year. Local missions accounted for 97 ± 5.6 (67%) of the missions. Of the 34 program countries, 26 (76%) used local missions. Of the countries that had only international missions, six (75%) were low-income countries and the average SAO density was 1.54 (range 0.19-5.88) providers per 100,000 people. Of the countries with local missions, 24 (92%) were middle-income, and the average SAO density was 30.9 (range 3.4-142.4). CONCLUSION: International investments may assist in the creation of local surgical teams. Once teams are established, local missions are a valuable way to provide specialized surgical care within a country's own borders.
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