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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Air Next: How A Crypto Scam Collapsed On A Single Spelling Mistake

It is today a proven fraud, nailed by the French stock market watchdog: Air Next resorted to a full range of dubious practices to raise money for a blockchain-powered e-commerce app. But the simplest of errors exposed the scam and limited the damage to investors. A cautionary tale for the crypto economy.

Sky is the crypto limit

Laurence Boisseau

PARIS — Air Next promised to use blockchain technology to revolutionize passenger transport. Should we have read something into its name? In fact, the company was talking a lot of hot air from the start. Air Next turned out to be a scam, with a fake website, false identities, fake criminal records, counterfeited bank certificates, aggressive marketing … real crooks. Thirty-five employees recruited over the summer ranked among its victims, not to mention the few investors who put money in the business.

Maud (not her real name) had always dreamed of working in a start-up. In July, she spotted an ad on Linkedin and was interviewed by videoconference — hardly unusual in the era of COVID and teleworking. She was hired very quickly and signed a permanent work contract. She resigned from her old job, happy to get started on a new adventure.

Others like Maud fell for the bait. At least ten senior managers, coming from major airlines, airports, large French and American corporations, a former police officer … all firmly believed in this project. Some quit their jobs to join; some French expats even made their way back to France.

Share capital of one billion 

The story began last February, when Air Next registered with the Paris Commercial Court. The new company stated it was developing an application that would allow the purchase of airline tickets by using cryptocurrency, at unbeatable prices and with an automatic guarantee in case of cancellation or delay, via a "smart contract" system (a computer protocol that facilitates, verifies and oversees the handling of a contract).

The firm declared a share capital of one billion euros, with offices under construction at 50, Avenue des Champs Elysées, and a president, Philippe Vincent ... which was probably a usurped identity.

Last summer, Air Next started recruiting. The company also wanted to raise money to have the assets on hand to allow passenger compensation. It organized a fundraiser using an ICO, or "Initial Coin Offering", via the issuance of digital tokens, transacted in cryptocurrencies through the blockchain.

While nothing obliged him to do so, the company owner went as far as setting up a file with the AMF, France's stock market regulator which oversees this type of transaction. Seeking the market regulator stamp is optional, but when issued, it gives guarantees to those buying tokens.

screenshot of the typo that revealed the Air Next scam

The infamous typo that brought the Air Next scam down

compta online

Raising Initial Coin Offering 

Then, on Sept. 30, the AMF issued an alert, by way of a press release, on the risks of fraud associated with the ICO, as it suspected some documents to be forgeries. A few hours before that, Air Next had just brought forward by several days the date of its tokens pre-sale.

For employees of the new company, it was a brutal wake-up call. They quickly understood that they had been duped, that they'd bet on the proverbial house of cards. On the investor side, the CEO didn't get beyond an initial fundraising of 150,000 euros. He was hoping to raise millions, but despite his failure, he didn't lose confidence. Challenged by one of his employees on Telegram, he admitted that "many documents provided were false", that "an error cost the life of this project."

What was the "error" he was referring to? A typo in the name of the would-be bank backing the startup. A very small one, at the bottom of the page of the false bank certificate, where the name "Edmond de Rothschild" is misspelled "Edemond".

Finding culprits 

Before the AMF's public alert, websites specializing in crypto-assets had already noted certain inconsistencies. The company had declared a share capital of 1 billion euros, which is an enormous amount. Air Next's CEO also boasted about having discovered bitcoin at a time when only a few geeks knew about cryptocurrency.

Employees and investors filed a complaint. Failing to find the general manager, Julien Leclerc — which might also be a fake name — they started looking for other culprits. They believe that if the Paris Commercial Court hadn't registered the company, no one would have been defrauded.

Beyond the handful of victims, this case is a plea for the implementation of more secure procedures, in an increasingly digital world, particularly following the pandemic. The much touted ICO market is itself a victim, and may find it hard to recover.

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