THE BLOG

The Silent Epidemic

04/03/2013 10:59 am ET | Updated Jun 03, 2013

With gridlocked debates over sequestration, entitlement reforms, immigration, and domestic politics dominating the airwaves, evidence of the commonly invoked virtues of American ingenuity, innovation, and determination can get easily lost in the fray. As we are bombarded with news about our own nation 24 hours a day, all the noise can make it easy to ignore the really big issues that affect the rest of the world, and that can be solved with American know-how and resolve. When we do hear about world events, we are inundated with stories about looming wars, food shortages, painful droughts, and other tragedies that receive significant press, yet when the conversation turns to the topic of health care, a certain silent epidemic is seldom mentioned: Over 70 percent of Sub-Saharan Africa's population that lacks electricity is at risk from life-threatening surgical infections.

The scale of this problem is colossal. The WHO estimates that 11 percent of the total global disease burden is treatable by primary care surgical intervention. Because undergoing surgery is an inevitable necessity for hundreds of millions, health care-related infections and lack of safe surgery in the developing world is a massive problem. Rates of infections contracted in health care settings in developing countries range from 15 to 40 percent as contrasted to 5 to 10 percent in the developed world, a problem that only worsens as access to health care increases. These infections are known Health Care Acquired Infections (HCAI), and in the developing world, Surgical Site Infections (SSI) are the leading HCAI, afflicting up to two-thirds of patients who undergo operations.

The issue itself is simple: Surgery and many other basic health care interventions require sterile medical equipment and trained people to carry it out. Currently, there is no readily available, practical sterilization method in the developing world. As a result, patients are often treated with unsterile instruments, and the rate of infection is frighteningly high. An extraordinary number of deaths could be prevented by ensuring that instruments and tools are properly sterilized before use.

Many surgical procedures, including medical instrument sterilization, require electricity, but over 1.5 billion people in the developing world do not have electricity access. For instance, in Sub-Saharan Africa, 70 percent of people lack regular access to electricity, with a higher rate in rural areas. Worldwide, two billion people lack access to basic, primary care surgery due in large part to the lack of sterile surgical environments and equipment. The equivalent of six times the population of the United States is at risk. Worse, forecasts indicate that the developing world population will grow explosively in the decades to come. Many more people could die due to preventable surgical site infections.

Unfortunately, it is not practical or likely that electricity will be eminently available throughout these parts of the world anytime soon. Any solutions to the SSI epidemic must therefore be engineered within certain constraints. The most basic requirements for primary care surgery in a hazardous or low resource environment are manpower, proper training, and sterile surgery. One advance that might solve the first two problems is an expansion of "white space communication" technology, which, powered by solar power, could provide Internet connectivity to even the most off-the-grid rural areas. The Internet has already proven to be an incredible vehicle for information transfer. Combined with open-sourced educational tools, cutting-edge technologies could help train an army of sufficient primary care interventionists. The third problem, sterile surgery, could be solved more rapidly and with a markedly lower cost. The use of devices like the Eniware portable sterilizer -- a portable, affordable instrument sterilizer that does not rely on electricity -- would immediately produce more quality surgical outcomes.

Americans are realizing that businesses and our nation as a whole must take off the horse blinders. Inward-looking myopia is no longer an option, for issues of public health constantly transcend geographic borders and wreak havoc indiscriminately. To solve a problem as dangerously pervasive as SSIs, we will need improved global diplomacy, impactful private and public investment and a renewed collaborative effort from all sides of every aisle.