What Use Is Survival If We Abandon Patients to a Lifetime of Disability?

Five billion. That is how many people in the world live without access to safe, affordable, and timely surgical care. At the inaugural Global Surgery Advocacy Certificate (GSAC) Program, Dr. Barnabas Alayande of the University of Global Health Equity reminded us of this staggering truth, tracing the history of global surgery from its colonial roots in tropical medicine to its modern fight for equity. That number really spoke volumes to me. The numbers also transported me home, to Ghana, where the statistics are not abstract but they have faces.

As a medical student in Ghana, I have seen children rushed in with severe burns, their families traveling hours from rural areas only to be told there is no bed in the specialized burn unit.

Even when a patient finds a bed, the reality can be grim. Overcrowded wards, limited sterile supplies, and inadequate hygiene practices sometimes cause more harm than good. For burn survivors, an infection picked up in the burns unit can be deadlier than the original injury.

Ghana has just a handful of plastic and reconstructive surgeons, serving a population of over 30 million. The result of this deficit is that survivors are left with preventable contractures, scars that limit function, and the lifelong stigma of visible disfigurement. This isn’t simply a medical failure. It’s society failing its people.

Dr. Alayande challenged the notion that surgery is too expensive for low-income countries, instead showing that it is one of the most cost-effective interventions for addressing the global burden of disease. He’s right. In Ghana, one timely skin graft can mean the difference between a child returning to school or living permanently disabled. It can mean the difference between dignity and despair.

Global surgery is defined by access and is built on four main pillars: care that is timely, safe, affordable, and delivered with adequate capacity. In Ghana, burn patients fall through each of these cracks. Care is rarely timely when hours are lost in travel. Safety is compromised by weak, inadequate infrastructure. Capacity is stretched thin by a handful of specialists, and affordability remains a cruel barrier for families already stretched to survive.

What use is survival if we abandon patients to a lifetime of disability?

This question haunts me. It is why I co-founded the Association of Future African Plastic and Reconstructive Surgeons. It is why I joined the GSAC program, organized by the University of Global Health Equity, Nkafu Policy Institute, and Operation Smile. And it is why I continue to advocate for surgical care not as a luxury, but as a human right.

We must advocate for surgical care not as a luxury, but as a human right. The Lancet Commission on Global Surgery issued a call for national surgical plans nearly a decade ago. Some African countries have begun that work, but we are far from done. Burn care in Ghana is just one example of the gaps we must urgently address. I write this opinion piece from the Ghanaian perspective. If the 5 billion number is correct, chances are that you, the reader, or someone you know might identify with this experience. Fortunately, the Ghanaian Ministry of Health has recognized surgical conditions as a priority and is actively working to reduce barriers to care, acknowledging the burden of plastic surgery.

If global surgery is the unfinished business of global health, then advocacy is the pen that will write the next chapter. As co-founder of the Association of Future African Plastic and Reconstructive Surgeons, I am committed to ensuring that this chapter is written with equity at its core. Together, we must amplify the voices of patients, practitioners, and communities. We must challenge the systems that perpetuate surgical neglect. And we must build a future where no one is left behind simply because they were born in the wrong place.

The journey ahead is long, but it is necessary. Because survival should never be the end of the story, it should be the beginning of a life lived with dignity, opportunity, and hope.