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One Young Woman's Fight For Surgery Access For 143 Million

Magdalena Grundl in Varanasi, India
Magdalena Grundl in Varanasi, India
Felix Hütten

MUNICH "To be above it all" has become Magdalena Gründl's purpose in life. By this, she doesn't mean to sound egotistical. The-25 year-old research assistant working at Harvard wants to understand the bigger picture. She hopes to make the world a better place while managing her life as a young academic at an Ivy League university, which is why treating individuals patients was never enough for the medical student.

Saving millions of lives

Gründl is determined to save the lives of millions together with other researchers on her team. It sounds utopian, but it is actually quite serious business. And it is precisely this which makes being above it all and seeing the bigger picture from that vantage point so important to Magdalena Gründl. She regularly flies back and forth between America, Africa and Asia, being on at least one long distance flight every month. It's certainly an exhausting way of getting the bigger picture.

Five billion people in the world do not have access to safe and affordable surgeries and anesthesia.

Magdalena Gründl grew up in a small town with nearly 1,000 inhabitants, but now she is one of the youngest scientists in the world who is working on cutting edge research with a single goal in mind: trying to identify how to provide lifesaving surgeries in places where they are not available.

There are a couple numbers that Gründl can recite by heart to underscore the gravity of this medical emergency. Five billion people in the world do not have access to safe and affordable surgeries and anesthesia. An estimated 143 million operations are needed in less affluent regions of the world to save lives. Nearly 17 million patients in 2010 died because they did not receive the surgical care that they required. That corresponds to about a third of all deaths worldwide and exceeds the number of deaths as a result of AIDS, tuberculosis, and malaria together.

Cardiac surgery in Senegal Photo: Pascal Deloche/ZUMA

A scientist who grabs the bull by the horns

Gründl is not angry when she recites these statistics. She doesn't particularly see herself as an activist but rather as a scientist who wants to grab the bull by the horns. After completing an internship in a hospital in Tanzania, she studied medicine in Romania as well as Germany and applied for a scholarship in Boston prior to qualifying as an MD. Nowadays, she is part of an international team of scientists which collates and processes data from around the globe.

Phase one of Magdalena Gründl's research project focuses on obtaining precise data that will provide the basis for understanding why there is such a decided shortage in medical care. In phase two the team will work with governments to develop a medical plan that will deal with the concrete problems of each particular country. Gründl emphasizes that it is of the utmost importance in that case to not take work away from local doctors and degrade them to the role of mere spectators as yet another American medical aid convoy rolls in. She believes that in the age of globalization and mobile data transfers the key to helping people in remote regions is working and communicating on equal terms.

The opinion that investing in prevention rather than curative measures still predominates the thinking among doctors.

This type of cooperation has long been the goal of international developmental aid, which is why the World Health Assembly, the legislative branch of the World Health Organisation (WHO), issued a decree to improve the global basic surgical care in 2015.

When asked to judge this proclamation, Gründl argues that, in spite of its success, the opinion that investing in prevention rather than curative measures still predominates the thinking among doctors and health officials. Clearly, she continues, it is much easier to organize vaccination campaigns than to build hospitals and roads, to train doctors and nurses, and to pay these trained individuals well. At the same time, certain surgical procedures, such as setting a broken bone, can be as easy and inexpensive as treating HIV or diabetes.

But Magdalena Gründl is sure that the international focus is directed toward other areas. Indeed, the term "surgery" is not mentioned anywhere in the UN Millennium Development Goals although the fight against HIV and malaria is specifically stated.

Legs of a man in a wheelchair after surgery in Togo Photo: Celestino Arce Lavin/ZUMA

To be sure, global surgery researchers, such as Gründl and her team, do not want to curtail the international effort to eradicate infectious diseases. But it is simply the case that approximately 26 out of 100,000 people on the African continent die annually due to traffic accidents while only 9 people die of the same causes in Europe. Many of the traffic accident victims in Africa die due to the fact that they have no access to surgeons. For example, the data that Gründl's team has collated demonstrates that in Zambia a quarter of the population lives at least a two-hours drive from the nearest hospital. Patients suffering from a stroke or cranial trauma or complications while in labor cannot survive at these distances. Every year, nearly 300,000 pregnant women around the globe die prior to giving birth because they bleed to death. In Zambia there are only 97 surgeons servicing the entire country with a population of 16 million people.

The numbers clearly demonstrate that it is not easy to decide on where to invest available funds. But if one judges an illness not only by how many people die from it but also by how many people cannot live a carefree life because of it, surgery very quickly becomes a priority. Just think of a farmer with a broken arm who who cannot feed his family.

To be above it all, to see the world from an objective vantage point has therefore become very important to Magdalena Gründl. A revolutionary article in the medical journal The Lancet, which Gründl frequently cites, states what an incredible effect good surgical provision can have on people's lives in many a part of the world. It is the triad of "lost lives, lost potential, and lost output", the vicious downward spiral that people like Magdalena Gründl attempt to combat with needle and surgical thread, x-rays, better training, and safer roads.

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FOCUS: Russia-Ukraine War

A First Look At Russia's Ukraine War Veterans, Struggling Back On The Homefront

Hundreds of thousands of Russians have taken part in the war. On returning, many face difficulties to return to normal life and finding work, as independent Russian news outlet Vazhnyye Istorii/Important Stories reports.

Image of a Man waiting in line at Military Employment Office of the Russian Armed Forces​

Man waiting in line at an employment office in Moscow

РЕДАКЦИЯ

MOSCOW — Since the beginning of the full-scale invasion of Ukraine, hundreds of thousands of Russians have taken part in the war. They range from professional soldiers, National Guardsmen, reservists and conscripts to mercenaries of illegal armed groups, including former prisoners.

The exact number of those who survived and returned home is unknown. In the past year alone, about 50,000 citizens received the status “combat veteran”. The actual number of returnees from the front is far higher, but it is often extremely difficult to obtain veteran status and veteran benefits.

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