Bridging the Gap Between Surgery and Global Public Health with Dr. Barnabas Alayande
By Irene Dzirasa, Policy and Advocacy Associate, Operation Smile
A t a young age, Dr. Barnabas Alayande knew about the social determinants of health that prevented vulnerable patients from accessing quality health care services.
Growing up in Nigeria, he recalls a moment when one of his siblings was sick with severe malaria and there was no money to pay for her treatment. His mother was forced to borrow treatment on “credit” using her social capital.
This incident troubled Dr. Alayande, who wondered about the fate of most Nigerians from low-income households who are unable to pay for medical care like his family did.
What would happen to those who could not borrow medicines to treat their children?
According to Dr. Alayande, who is now an Assistant Professor of Surgery at the University of Global Health Equity (UGHE) in Rwanda, that situation was one of the lights on his runway that drove him to equity-centered surgical care. Thus, throughout his career, he has sought to create links between surgical equity and public health.
On the November 15, 2022, the Policy and Advocacy Department at Operation Smile hosted him in its Global Surgery Speaker Series. During the session, he shared about recent advances in global surgery and role of the Center for Equity in Global Surgery at UGHE is playing in advancing equitable surgical care and bridging the gap between public health and surgery.
Dr. Alayande obtained his medical education at the College of Health Sciences, University of Ilorin, Nigeria, a WHO collaborating Center for Community Based Experience and Service. During his studies, longitudinal interactions with rural communities influenced his interest in public health practice and research. After graduating from medical school with the Duro Soleye Annual Prize in public health and working in several rural contexts, he undertook his surgical residency training at the National Postgraduate Medical College and the West African College of Surgeons at the Jos University Teaching Hospital. Upon specialization, he helped build surgical systems for patients with HIV in north-central Nigeria.
His choice to specialize in surgery was influenced by several factors including his early perception of the high surgical need and capacity deficit in sub-Saharan Africa. Becoming a surgeon was also influenced by his reason (sense of purpose, what the Japanese call Ikigai), relationships (amazing surgical mentors at home and abroad), and the potential he saw for results.
With a keen understanding of the interconnectedness of surgical conditions and social determinants of health, Dr. Alayande knew that there must be a way to bring all these together in his post-surgical training career. This is when he discovered global surgery and joined the Harvard Program in Global Surgery and Social Change as a research fellow. There, he met his mentors, Dr. Robert Riviello, Dr. Bethany Hedt-Gauthier and Dean Abebe Bekele of UGHE who brought the linkages between public health and global surgery to life.
Now, Dr. Alayande plays a critical role in training the next generation of public health leaders in Africa at UGHE. He describes UGHE as a new health science university in rural Rwanda which aims to build the next generation of health care experts and practitioners.
While Africa carries about 24% of the global disease burden, it has only 3% to 4% of the world’s health care workforce.
UGHE is working with partners to address the gap of 7.2 million additional health care workers that are needed. At UGHE in his role as surgical clerkship director, he is involved in the design and delivery of undergraduate and postgraduate surgical curricula, didactics and clinical training, educational research, and mentorship.
He has externally facing roles with many academic surgery partners and fellowships such as Operation Smile, Nkafu Policy Institute, Lifebox, University of Rwanda, Harvard Medical School, Duke University, Stanford University, GlobalSurgBox box, and the University of Birmingham. He also leads and coordinates on several global surgical research projects and innovations, currently working as a Fogarty Global Health Fellow with the HBNU consortium. He also serves on the editorial board of PLOS Global Public Health.
As part of its mission, UGHE is working to build the next generation of leaders in global surgery through its Centre for Equity in Global Surgery and has partnered with Operation Smile and the Nkafu Policy Institute to launch a novel Global Surgery Advocacy Fellowship. The fellowship aims to train global surgery leaders based in low and middle-income countries to be passionate, compassionate and skilled advocates for surgical and anesthesia care within their communities and globally. Five fellows from Rwanda, Ghana, Madagascar, Ethiopia and Colombia are currently enrolled.
With close to five billion people globally lacking access to safe, timely and affordable surgically care, Dr. Alayande believes that everyone can make a difference in their own small way.
He quipped about the ancient African proverb: “If you think you are too small, to make a difference, you haven’t spent a night with a mosquito.”