Journal Article > CommentaryAbstract Only
Role of Anesthesiology in Global Health. 19 November 2014; DOI:10.1007/978-3-319-09423-6_9
Trelles M, Kahn P, Cone J, Teicher CL
Role of Anesthesiology in Global Health. 19 November 2014; DOI:10.1007/978-3-319-09423-6_9
Médecins Sans Frontières/Doctors Without Borders (MSF) has been running surgical programs since the early 1980s. This chapter provides an overview of the anesthesia component of these programs and explores some lessons learned from the experience of one of MSF’s five Operations Centers—in this case, the Belgium-based unit (MSF-Belgium). During the period from 2010 until the end of 2013, these projects provided surgical care to more than 56,000 surgical patients in 23 countries and performed over 73,000 surgical procedures. This experience has shown that surgeons and anesthetists need to discard preconceived notions of an inevitable link between the technical complexity of surgical and anesthesia techniques and the ability to reduce morbidity and mortality. On the contrary, MSF has found that keeping our interventions simple, accessible and sustainable within a given context is often the most effective way to best serve the needs of the many.
Journal Article > ReviewSubscription Only
World Policy J. 1 September 2013; Volume 30 (Issue 3); 65-77.; DOI:10.1177/0740277513506383
Cone J, Duroch F
World Policy J. 1 September 2013; Volume 30 (Issue 3); 65-77.; DOI:10.1177/0740277513506383
Journal Article > ReviewFull Text
PLoS Negl Trop Dis. 26 September 2019; Volume 13 (Issue 9); e0007447..; DOI:10.1371/journal.pntd.0007447
Forsyth C, Meymandi S, Moss I, Cone J, Cohen RM, et al.
PLoS Negl Trop Dis. 26 September 2019; Volume 13 (Issue 9); e0007447..; DOI:10.1371/journal.pntd.0007447
BACKGROUND
Chagas disease (CD) affects over 300,000 people in the United States, but fewer than 1% have been diagnosed and less than 0.3% have received etiological treatment. This is a significant public health concern because untreated CD can produce fatal complications. What factors prevent people with CD from accessing diagnosis and treatment in a nation with one of the world's most advanced healthcare systems?
METHODOLOGY/PRINCIPAL FINDINGS
This analysis of barriers to diagnosis and treatment of CD in the US reflects the opinions of the authors more than a comprehensive discussion of all the available evidence. To enrich our description of barriers, we have conducted an exploratory literature review and cited the experience of the main US clinic providing treatment for CD. We list 34 barriers, which we group into four overlapping dimensions: systemic, comprising gaps in the public health system; structural, originating from political and economic inequalities; clinical, including toxicity of medications and diagnostic challenges; and psychosocial, encompassing fears and stigma.
CONCLUSIONS
We propose this multidimensional framework both to explain the persistently low numbers of people with CD who are tested and treated and as a potential basis for organizing a public health response, but we encourage others to improve on our approach or develop alternative frameworks. We further argue that expanding access to diagnosis and treatment of CD in the US means asserting the rights of vulnerable populations to obtain timely, quality healthcare.
Chagas disease (CD) affects over 300,000 people in the United States, but fewer than 1% have been diagnosed and less than 0.3% have received etiological treatment. This is a significant public health concern because untreated CD can produce fatal complications. What factors prevent people with CD from accessing diagnosis and treatment in a nation with one of the world's most advanced healthcare systems?
METHODOLOGY/PRINCIPAL FINDINGS
This analysis of barriers to diagnosis and treatment of CD in the US reflects the opinions of the authors more than a comprehensive discussion of all the available evidence. To enrich our description of barriers, we have conducted an exploratory literature review and cited the experience of the main US clinic providing treatment for CD. We list 34 barriers, which we group into four overlapping dimensions: systemic, comprising gaps in the public health system; structural, originating from political and economic inequalities; clinical, including toxicity of medications and diagnostic challenges; and psychosocial, encompassing fears and stigma.
CONCLUSIONS
We propose this multidimensional framework both to explain the persistently low numbers of people with CD who are tested and treated and as a potential basis for organizing a public health response, but we encourage others to improve on our approach or develop alternative frameworks. We further argue that expanding access to diagnosis and treatment of CD in the US means asserting the rights of vulnerable populations to obtain timely, quality healthcare.
Journal Blog > Perspective
BMJ Opinion (blog). 19 October 2016
Cone J
BMJ Opinion (blog). 19 October 2016