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Comment & Response
November 2015

CommunicationImproving the View From This Side

Author Affiliations
  • 1Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
  • 2Department of Emergency Medicine, Emory University, Atlanta, Georgia
JAMA Surg. 2015;150(11):1100. doi:10.1001/jamasurg.2015.1954

To the Editor The Viewpoint by Ginwalla and Rickard1 was of particular interest to us and our colleagues who have completed more than 30 missions of the type described by them. Before commenting, we would like to acknowledge and congratulate the authors for the exceptional work they have done under difficult circumstances.

In spite of the universal interest in surgical volunteerism and capacity building, little is written about the need for cooperation between the nongovernmental organizations (NGOs) that sponsor mission trips and the host countries. This lack of communication prevents mission trips from generating the greatest possible good. Individual NGO missions will not resolve surgery being seen as, what Paul E. Farmer, MD, PhD, calls, “the neglected stepchild of global public health.”2 Individual NGO missions will not fix this. However, the creation of national and international networks coordinating NGO activities and assessing countries’ needs might help accomplish that goal. While there is a need for surgical services, as outlined, the present situation is one where missions are usually conducted on a site-specific basis with minimal focus on long-term capacity building.3

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