ORIGIN OF THE DOCUMENT
At the last WFNS Interim Meeting held in Rome on September 2015, several members of the WFNS Coordinating Committee for International Initiatives gathered in a small meeting room. Robert Dempsey, the Chairman of the Committee, Kee Park, a long time FIENS/WFNS volunteer and Walter Johnson, a neurosurgeon turned Global Surgery advocate at the World Health Organization, each gave presentations with uncanny similarities. An astounding number of people, mostly in low income countries, do not have access to lifesaving and disability averting surgical care, undoubtedly including neurosurgical care, and the global neurosurgical community is largely unaware of this disparity. That neurosurgeons should lead the effort in addressing the unmet need was implicit. Thus began a journey of advocacy for the neglected neurosurgical patients, certainly not new but with renewed energy and focus and a sense that time was right.
The article, “Global Neurosurgery: The Unmet Need”, introduced the gross inequity to the readers of World Neurosurgery. It also highlighted the need for an inclusive and consultative process of gathering opinions from the surgeons from LICs and their collaborators from HICs. A global issue required a global response.
The consensus document idea was born during the Global Initiative for Essential and Emergency Surgical Care Meeting at the WHO in Geneva last December. Present were Drs. Kee Park, Gail Rousseau, Aij-Lie Kwan, Andres Rubiano, and Walter Johnson. Together a global consultative strategy was drafted that included a document that each region of the WFNS would have a hand in drafting and culminating in a “Declaration on Global Neurosurgery” at the ICRAN Meeting in Bogota, Columbia.
EVOLUTION OF THE DOCUMENT
The document began in Phnom Penh, Cambodia during the AASNS/Cambodia Society of Neurosurgeons(CNS) Neurotrauma Meeting on March 25. Highly informative presentations from Global Surgery experts including from Nobhojit Roy of the Lancet Commission on Global Surgery and Walter Johnson from World Health Organization were followed by presentations about emergency and essential care of neurosurgical patients particularly at the local level from each participants from the region. The consultative process was facilitated by Kee Park and Peter Reilly to collect key recommendations from the participants on how best to address the unmet need.
The document underwent revisions and modifications at the AANS meeting in Chicago on May 1 through a regional consultative process hosted by the Foundation for International Education in Neurological Surgery. Drs. Robert Dempsey, Walter Johnson, and Kee Park facilitated the consensus building meeting. Present were Yong-Kwang Tu, President of WFNS, Andre Grotenhuis, President of EANS, Graham Fieggen, President of CAANS, Jack Rock, Peter Nakaji and David Adelson from FIENS and AANS and Michael Haglund from Duke/FIENS.
The next stop for the document is the CAANS Meeting in Cape Town, South Africa, for input and comments from African surgeons. Drs. Moody Qureshi and Graham Fieggen led the process.
At the EANS meeting in Athens, Dr. Andre Grotenhuis will lead the consultative process and bring the European perspective to the document.
Andres Rubiano will lead the Latin American surgeons to put the last touches to the document at the FLANC Meeting in Cancun.
The “Bogota Declaration on Global Neurosurgery” released at the ICRAN Meeting in Bogota, Colombia on Dec 8-11, 2016.