A film it’s right to see

I don’t usually use this space to promote anything, or anything besides a pretty random and tired selection of past blogs, unpublished journalism, and poetry scribbles. Well, here goes:

I’m guessing you haven’t heard of The Right to Heal. The film, and the movement it stands behind, get a fraction of the publicity of other global health causes: AIDS, clean water, and women’s education, to name a few of the most worthy. Into this world of hurt comes a global health movement for access to essential surgery.

How essential can surgery really be, you might ask. When compared to the fundamentals of survival – food and water – surgery can seem a privilege of a developed society, the cream of a mature education and health care system. The word surgery conjures images of expensive medical equipment and PHDs.

If you think in these terms then The Right to Heal might blow your mind. Unlike a lot of meandering and punch-less documentaries out there, this one gets right to the point. It’s a powerful one: we should include essential surgery as part of any health plan for the developing world.

Essential surgeries are sort of like essential vitamins and minerals, except getting one of them can change a life for the better, forever. According to the International Collaboration for Essential Surgery (ICES), essential surgery means fifteen basic surgical interventions. These interventions are typically simple, cheap, and quick– low-tech fixes that can immediately save lives or make a disabled life able. Surgically removing cataracts, for example, brings sight to the blind.

The Right to Heal, which stemmed from Dr. Jaymie Ang Henry’s experiences in remote parts of the Philippines, chronicles a few individuals who suffer from one of these fifteen conditions. Although Henry’s film covers remote countries the world over – like Tanzania, Burundi, and Kenya – it doesn’t need to search far for subjects.

Many of the fifteen conditions are astonishingly common in the developing world. Club foot, which makes walking an absolute bitch, affects one in every one thousand people. Obstetric fistulas, which if you don’t know what they are you should take a deep breath and look it up, devastate hundreds of thousands of women each year. Though the global health community has made remarkable strides in tackling infectious diseases, the burden of surgical diseases in the developing world has been largely ignored. As a result, the film says, the burden of disease of surgery has recently overtaken that of infectious diseases. About 2 billion people around the world lack access to basic surgery.

The film suggests that an individual with any of the above fifteen conditions costs society somewhere between $40,000 and $200,000. Many of the conditions hamper individuals from birth, preventing them from ever working or leading productive lives while also requiring costly personal assistance. The cost to cure these conditions, on average, is about $400. Curing clubfoot or cataracts: $250.

The problem with solving such a lop-sided equation between societal cost and cure is that many developing countries have almost no surgeons to perform basic operations. Burundi, to take one example from the film, has about 15-20 surgeons for the nation’s 10 million people.

At a recent screening of the film at the University of Washington, Dr. Henry said that the challenge, as with so many global health challenges, is one of scale. The scaling up of surgical procedures requires systemic support from the global health community and a challenging mobilization of resources to remote areas.

The essential surgery movement (The Right to Heal, ICES, and 15×15) is currently developing a testable on-the-ground strategy of surgical care. But, as Henry says, the first step toward gaining support and resources is to spread awareness of the problem. Thus the purpose of this blog post: to add in some small way to the movement’s push.

As far as I can tell, few people outside of the medical community have seen the Right to Heal. I’d like to change this. Any ideas?

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