Janet Martin – daughter of Bert and Naomi Frey of Hawkesville – is heading a program at Western University with colleague Davy Cheng on global surgery and anesthesia.
Martin is also the director of the Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI) and an assistant professor at Western’s Schulich School of Medicine and Dentistry. She grew up in Hawkesville and graduated from Elmira District Secondary School.
The WHO contacted Martin and Cheng asking if they’d be interested in running a collaborative research centre in partnership with the WHO. As of this month they are co-directors of the WHO Collaborating Centre on Global Surgery and Anesthesia. Martin says it’s the first of its kind in Canada and the first time Western has been asked to be an official collaborating centre with the WHO.
“It’s truly an honour and the point of it really is to improve global surgery as well as anesthesia as well as emergency services in countries around the world,” Martin said.
One particularly startling statistic she shares is that annually there are 18 million deaths worldwide due to lack of access to basic surgery services. That number is far greater than deaths due to HIV/AIDS, tuberculosis, and malaria combined.
“We have this crisis that is playing out worldwide and it seems that almost nobody is aware of it.”
Martin and Cheng’s work caught the WHO’s attention in 2012 when they completed research which was published in one of the leading medical journals, The Lancet. The research reviewed the outcomes of 21.4 million surgeries.
The goal was to look at the contemporary rates of death due to surgery or anesthesia. What they found is the rates in developed countries have declined precipitately over the last 50 years where it’s just a few per million. But in developing countries, they found the trend was flat-lining or even increasing in recent years.
“We’ve made global surgery and anesthesia at the United Nations level and at the World Health Organization level as one of the named priorities for the next 15 years. We’ve put together very distinct targets for achievements by the year 2030 so that we can improve access to basic surgical services first and have a very well coordinated evidence based plan in order to get there. It’s incredible just how much effort and how much resource is going to be required to do this. But when we take a look at the return on investment it is astounding,” Martin explained.
The next steps are going to be to create an infrastructure of people who want to be involved in this global initiative. She says they’ll be making people aware where the gaps are in global access to surgery, finding out what the death toll is and then determining the initial steps they can take in order to save lives immediately, and then incrementally save more lives as they develop infrastructure around the world.
“A lot of that is going to be working with interested people through Canada, through the U.S., through Europe and through Australia, New Zealand, all the way through every country of Africa and Southeast Asia, South America, anywhere that partners are willing to start to work together to improve not only infrastructure in the area where it’s lacking, but also training, as well as research. Our goal is to work with those who already live within their countries and want to improve surgical access,” Martin said.
Over the last 15 years Martin has been involved in a number of local and international efforts in order to get the best available evidence from clinical trials into practice. She started in areas of Ontario and then across Canada. Eventually she was asked to do some international work and partner with international universities in order to advance the field.
The World Health Assembly, which convenes at the WHO, named surgery as a global priority within the sustainable development goals. Martin explains that’s why now there is this global concerted effort and why they’ve have been invited by the WHO to be one of the global leaders in pushing this initiative forward toward getting safe surgery accessible to 80 per cent of the world population by 2030.
They believe it will save tens of millions of lives.
“We also know that we are far from perfect in our own background. In Canada we also have areas that the access is poor and less than optimal quality of surgical services. So we’re equally invested in improving access across the globe and that really has been one of the messages of the World Health Organization is that we’re talking across the spectrum of low, middle and high income countries because each country has its deficits,” Martin said.
She says this will be her passion for the remainder of her career to help improve surgery access and work with people who are likewise interested.
The recognition and the responsibility bestowed on her by the WHO means a lot.
“I would have never ever guessed as a student in Elmira there at EDSS that the World Health Organization’s a place that’s within reach and that I could work with in order to have some global impact on an issue that is of such import to populations around the world.”