“In my region of East Africa, the mortality rate for children undergoing surgery is still high. It is particularly challenging to specialize in the provision of pediatric surgery in this region because of the limited infrastructure and human resources. Too often we lose our patients due to a lack of basic resources. The fact that in 2022, children are still dying during surgery due to a lack of simple resources is a terrible injustice: Surgery is a fundamental part of healthcare.” - Professor Miliard Derbew, pediatric surgeon at the College of Health Sciences, Addis Ababa University, and CEO of King Faisal Hospital, Kigali, Rwanda
Lifebox is a global nonprofit, registered in the US, UK, and Ethiopia, that works to improve surgical safety in low-income countries.
Improving access to timely, quality, and affordable surgical care for all is an essential component of global health. Surgical care is required to treat a wide variety of conditions, from cancer and injuries to obstructed labor, and birth abnormalities like cleft. Yet, five billion people cannot access safe, timely, and affordable surgical care and anesthesia. In many low-resource settings, nine out of ten people cannot access even the most basic surgical services.
Every year, an estimated 16.9 million lives are lost from conditions requiring surgical care. Yet many of these deaths are preventable. More than 4.2 million deaths occur within 30 days of surgery, half of these in low-income countries. These deaths account for 7.7% of all deaths globally, making them the third greatest contributor to lives lost globally, after heart disease and stroke.
Lifebox’s core pillars of Safer Surgery focus on three primary areas - anesthesia safety, reduction of surgical site infection, and process improvements through better teamwork in the operating room
“I was in Burundi [when] there was a power cut, we had no electricity, but our Lifebox pulse oximeter was fully charged. We used it to monitor the patient and the surgery was safer. That patient was saved and from that day I will not miss having a pulse oximeter in my box.” – William Baraka, anesthesia provider at BIOGLODI Medical Center, Bukavu, South Kivu province, DRC
1. Improving Anesthesia Safety – Safe anesthesia requires surgical procedures with a pulse oximeter. The pulse oximeter is the only device on the World Health Organization’s (WHO) Surgical Safety Checklist. In high-income countries, pulse oximeters are widely available, but in low-income countries there are over 50,000 operating rooms, intensive care units, and post-anesthesia care units where health providers don’t have access to a pulse oximeter. To address this “pulse oximetry gap”, Lifebox has distributed more than 32,000 pulse oximeters and provided training to anesthesia providers globally.
2. Reducing Surgical Infection – A patient undergoing surgery in a low-resource setting is more than twice as likely to develop a surgical site infection compared to a patient in the US or Western Europe. Our Clean Cut program focuses on quality improvement processes that don’t require a major investment in infrastructure. During our pilot in Ethiopia, Clean Cut demonstrated a 35% infection reduction in all surgical patients. The Smile Train-Lifebox Safe Surgery and Anesthesia Initiative leverages these same surgical site infection reduction strategies to elevate the quality and safety of cleft and pediatric surgery in more than 70 countries. This partnership will strengthen surgical systems in 1,000 hospitals and improve the safety of surgery and anesthesia for more than 2.6 million patients.
3. Promoting Surgical Teamwork – The WHO Surgical Safety Checklist provides a framework for Lifebox’s efforts to improve surgical teamwork by changing behavioral culture in the operating room and across professional lines to address safety gaps. The Checklist has been transformational in the global movement for safer surgery by identifying a core set of procedures to follow in every operation to improve patient safety. With proper use, the Checklist has been shown to reduce complications and mortality in the operating room by up to 40 percent.
“I believe that every patient has a right to safe anesthesia, and I think there should be minimal standards set by each country wherein a pulse oximeter should be a must.” - Dr. Reshma Ambulkar, anesthesiologist, Tata Memorial Hospital, India
Help Lifebox make anesthesia and surgical care safe and accessible for everyone, everywhere. Donate to Lifebox using CFC code #43355. Thank you.