“The comparison between resources can make anaesthesia a very different experience. It makes you realize how wasteful we are, how disposable everything is for us.”
Jane is President of the American Society of Anesthesiologists.
People don’t always recognize the role of anaesthesia in safe surgery. What can you tell me about it?
There are very few medical specialties where you can literally take care of people from birth – and actually, pre-birth – all the way to end of life. Anaesthesia cares for everyone, and everything in between.
What about in lower-resource countries where you’ve worked?
The comparison between resources can make anaesthesia a very different experience. It makes you realize how wasteful we are, how disposable everything is for us.
In the U.S. we have all kinds of fancy warmers for giving blood products and fluid. In Egypt we draped it across some lights to get the ambient heat. Working in China in the late 1980s you’d see rooms chock full of inoperable equipment. Purchased or donated, it was broken and there was no one who could maintain it, no spare parts.
We know that 70,000 operating rooms around the world don’t even have a basic pulse oximeter [a monitoring device essential for safe anaesthesia]. Literally a couple of billion people don’t have access to safe anaesthetic and surgical care.
How important is access to safe surgery for women’s health?
It’s critically important. The medical care of women during their childbearing years – the majority of their lifetime – is primarily obstetric and gynecological. It’s critical that all around the world, women have access to these surgical procedures.
And when safe surgery isn’t available?
There are complications that have a huge personal and social impact on a woman and her family.
If she doesn’t have appropriate care during childbirth she risks damage to the birth canal and development of fistula that can lead to incontinence. A woman in low-resource settings without the ability to have this repaired can be ostracized from her family, her social network, her employment.
And the mom’s status clearly impacts and somewhat determines a lot of what the child’s life will be like.
What can we do to support safer anaesthesia around the world?
Nicholas Greene, one of the ‘founding fathers’ of modern anaesthesia, recognized early on the constraints that low-resource settings have in being able to provide safe surgical and anaesthetic care. His focus was on training and education, and our Global Humanitarian Outreach committee and Charitable Foundation have really taken off from there in the last decade.
What is your hope for the future of women in global anaesthesia?
It’s only in the last 40-odd years that we’ve moved away from a 25-30% female minority in the field of anaesthesia in America. I hope that women will realize the critical role that we do play in the U.S. and beyond – women all over the world are vital for providing the safest anaesthetic care possible.
We all need surgery and anaesthesia at some point – but in particular I’ll go back to the fact that we know that women really need obstetric care at certain times to prevent complications that will negatively impact themselves, their children and their families. It’s just critically important.