On July 1st, 2017, the World Bank published its annual update of the World Development Indicators (WDI). From fishing to farming, education to employment, these indicators track progress in a wide variety of forms over regions, nations, and time. This year marks the second time surgical data has been included in the World Bank’s indicators. The initial adoption of these data by the World Bank was due to efforts by the Program for Global Surgery and Social Change (PGSSC), while this subsequent collection is in large part thanks to the leadership of InciSioN, the International Student Surgical Network. Formed in 2015 from the IFMSA (International Federation of Medical Students’ Associations) working group on Global Surgery, InciSioN is an international student collaboration focused on improving access to quality surgical care through education, advocacy, research and equitable peer support. It currently has over 2000 members in 70 countries, as well as 15 national working groups.
Whilst access to surgical training is problematic in many parts of the world, research opportunities are even more difficult to come by. Very few global surgery programmes are aimed at students in low and middle-income countries (LMICs) and unpaid global health internships are usually beyond the means of the majority of the medical students worldwide, requiring travel, visas and substantial financial investment. To combat this problem, InciSioN members devised the concept of a ‘virtual internship’ – an opportunity for students to get involved in internationally impactful work from the convenience of their own homes. A total of ten students were selected from the InciSioN membership through a competitive application process. Applications were marked on experience in research and leadership, language abilities, and motivation, whilst taking into account regional representation. The students were trained online in data collection and ‘met’ weekly over a period of six months to complete the data collection. In return they were given exclusive online tutorials in global surgery and research methodology from world experts in the field, providing some of the advantages of an internship without the frequently insurmountable costs and travel requirements. Data collectors came from countries as diverse as Pakistan, Malawi, Ecuador and Belgium, providing a wealth of language and cultural expertise and an inexhaustible student trait – enthusiasm! Through the hard work of this collaborative student team, updated data for the surgical indicators were again successfully included in the WDIs for 2017, keeping surgery as an integral part of the global health and development conversation. While collection of surgical indicators is unfunded internationally, it is vital that as a community we make the most of what is out there, to better the case for collection by the WHO or UN.
This project demonstrates the key role that medical students can play in advancing and advocating for global surgery on the world stage, accompanied by the necessary supervision, support, and trust to get the job done. It also demonstrated the possibilities of technology and online relationships to bridge some of the vast inequities in medical student research and educational opportunities around the world. We are very grateful to colleagues at Kings College London, the World Health Organisation, and Stanford University for their support. The full report on this round of data collection is available on the Lancet Commission on Global Surgery website.