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Invited Critique
October 2010October 18, 2010

Surgeon, Do You Know Where Your DALYs Are?: (Can You Fix a Hernia With a Mosquito Net?): Comment on “Cost-effectiveness of Groin Hernia Surgery in the Western Region of Ghana”

Author Affiliations

Division of Pediatric Surgery, Fetal Treatment Center, University of California, San Francisco

Arch Surg. 2010;145(10):961. doi:10.1001/archsurg.2010.205

This excellent article introduces surgeons to the concept of DALYs—a metric that, in simple terms, quantifies the gap between current health status and an ideal health situation in which the entire population lives to an advanced age, free of disease and disability. The DALYs measure the outcome of an intervention in terms of the amount of reduction of premature death or disability. While the bulk of the world's public health care resources have been appropriately focused on the devastating infectious disease burdens of AIDS, malaria, and tuberculosis, the burden and distribution of surgical disease remain largely unknown and neglected. The authors demonstrate the importance of assessing surgical disease in the language of our public health policy makers. Until we merge our languages, we will not be effective advocates of eradicating surgical disease from a public health perspective and will not influence the resource allocation decisions.