Capacity Building for Equitable Anesthesia Access

Archana Bharadwaj, MPH, CHES

Globally, there is a dearth of anesthesia access. In “Ted Talk: Capacity Building versus Short Term Medical Mission Trips,” on Sunday, March 20 at the IARS 2022 Annual Meeting, Dr. Janey Phelps made the case for capacity-building initiatives to facilitate universal access to anesthesia.

Janey Phelps, MD, PhD, Professor of Anesthesiology at the University of North Carolina at Chapel Hill, began her presentation by emphasizing the lack of global anesthesia services. According to the 2015 Bangkok Global Surgery Declaration, five billion of the seven billion people in the world lack timely and affordable access to anesthesia. Dr. Phelps emphasized that there is an anesthesia void that needs to be filled.

Although short-term mission trips might seem like a logical solution to this access issue, Dr. Phelps argues that they come with many limitations. A significant issue is that short-term mission trips lack opportunities for follow-up care. Additionally, lack of support from local host countries along with language and cultural barriers can pose problems. Furthermore, although needed surgeries are completed in the moment, short-term trips can create a significant disruption to the operating rooms.

As Program Director of Global Anesthesia, Dr. Phelps is involved in UNC Project-Malawi, a capacity-building initiative designed to address the inequity in anesthesia access. The mission is to “Identify innovative, culturally acceptable, and affordable methods to improve the health of the people of Malawi, through research, health systems, strengthening, prevention, training, and care.” The work conducted involves training clinical anesthesia officers and continuing medical education. Through participating in training programs, an impact can be made not only on the hospital, but throughout the country when the physicians take on positions elsewhere.

By building capacity, which includes teaching and training, clinical providers in global communities can develop the skills to handle cases long after the trip has ended.