Global health is a field dedicated to addressing health issues that transcend national boundaries. Rather than “international health,” which implies the medical care and health of foreign nations, the term global health indicates that we are all part of one shared humanity. No time in recent history has this been clearer than the recent outbreaks of infectious diseases such as Ebola in 2014, Zika in 2015, and SARS-CoV-2 in 2019. Whether or not we are interested in it, global health is becoming increasingly irrelevant; we no longer have the choice of remaining isolated from the global community of patients. Our world is interconnected.
Trainees in anesthesiology understand this. An overwhelming number of them demonstrated an interest in global health programs, indicating that such opportunities would influence their ranking of programs in the residency match. Historically, anesthesiologists have played a critical role in medical missions, aiming to improve the health of disadvantaged populations or in emergency disaster situations. Yet, as anesthesiologists have established themselves as leaders in perioperative medicine, critical care, and patient safety and quality improvement, the scope of anesthesiology and role of anesthesiologists in global health and human rights has substantially evolved. We are involved in cutting-edge research; we are leading governments in developing their country's anesthesia and surgical plans; and we are on the ground providing vital education to develop the entire anesthesia workforce of war-ravaged nations. We have, with authority, accepted this role as physician first, and anesthesia specialists second.
“We no longer have the choice of remaining isolated from the global community of patients. Our world is interconnected.”
My family came to this country as refugees in the 1980s, and my life's passion has been to advance the health of similarly vulnerable populations. As an anesthesiologist and human rights researcher at Weill Cornell Medicine, I study chronic pain in refugee torture survivors, first funded by the Foundation for Anesthesia Education and Research (FAER) and now by the National Institutes of Health (NIH). This career was not a conventional, resistance-free, predictable research pathway, full of knowledgeable mentors, established lines of research, and funding streams to follow. Indeed, my job description did not exist, and still does not exist anywhere else. Yet I had something invaluable: a distinctive chair who believed in the idea of research innovation, of the potential for leaders in global anesthesiology, and of the commitment to the rights of marginalized people.
The programs featured here are similarly original – supported by torch-bearing chairs at the University of California, San Francisco, Vanderbilt University, Boston Children's Hospital, Stanford University, and Weill Cornell Medicine – and the faculty who lead these programs are the newest generation of pioneers in global health in anesthesiology. These programs are a testament to the impact that institutions can have when a deep-seated passion for health justice is combined with the support of departmental leadership. Between them, these programs have substantial funding from philanthropic sources like FAER, the NIH, ASA, and the U.S. Agency for International Development; they lead National Surgical, Obstetric and Anesthesia Plans (NSOAPS) across developing countries; and they have founded the development of educational curricula and training, established residency training programs that have singlehandedly changed the scope of anesthesiology in target countries, and trailblazed the implementation of clinical trials in vulnerable refugee populations. These are their experiences and expertise, in their own words, from which we hope to demonstrate the limitless potential of anesthesiologists as leaders in global health and human rights.
By no means is this a comprehensive list of programs and people doing innovative global health work. Rather, these are a few of the shining lights in a sky full of stars. They are a testament to the idea that anesthesiology's engagement with global health is not limited to charity work. That with our unique skills in perioperative medicine, critical care, and patient safety, with our ability to troubleshoot, prioritize, and execute, and with our strength in communication, collaboration, and staying calm under pressure, anesthesiologists have an opportunity to be leaders in research, training, education, policy, government, disaster situations, and more. I invite you to explore these inspirational stories with an appreciation for the impact of a physician's voice for vulnerable and marginalized populations.