对《开普敦宣言》致函的回应

P. Zilla, R. Bolman, P. Boateng
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摘要

心脏联合会])组成了一个伞形组织(“心脏外科跨社会联盟”[CSIA]),其目标是共同促进发展中国家获得心脏手术。它得到了所有委员会的批准,由约翰霍普金斯大学主任兼STS主席罗伯特希金斯担任主席。正如《开普敦宣言》所呼吁的那样,CSIA的主要任务是促进建立当地的心脏外科能力,而不是飞来飞去的“任务”或零星的“飞出”援助,只影响少数儿童。正如我们在“全球未满足的心脏手术需求”的联合评估中所述(3),“这些飞来飞去的任务是否使少数人受益而损害了许多人,这是一个正在进行辩论的有争议的话题。虽然有人可能会争辩说,这些任务可以被视为基础设施和跨学科技能协调的试运行,这是开始当地心脏直视手术所必需的,但长期的结论在很大程度上不那么积极。从长远来看,“特派团”——由非政府组织或其政府资助,主要部署大型团队进行少数主要是先天性矫治,以及广为宣传的将少数儿童送到私人医疗企业的“飞出”特派团——为地方政府提供了遮羞布。能够表面上声称心脏手术是为他们的人民提供的,这使他们能够掩盖人民对挽救生命的手术的需求与实际上为社会提供的微不足道的救济之间的差距。”
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Response to letter on the Cape Town Declaration
Heart Federation]) formed an umbrella body (“Cardiac Surgery Intersociety Alliance” [CSIA]) – with the goal of jointly facilitating access to cardiac surgery in the developing world. It was ratified by all councils and is chaired by Robert Higgins, Chief at Johns Hopkins and President of STS. As called for in the Cape Town Declaration, the main mission of CSIA is to facilitate the establishment of local cardiac surgical capacity rather than fly-in “missions” or sporadic “fly-out” assistance affecting only a few children. As stated in our joint assessment of “Global unmet needs in cardiac surgery”(3) “The question as to whether these fly-in or fly-out missions have benefitted a few while harming the many is a controversial topic of ongoing debates. While one may argue that these missions could be seen as trial-runs for the infrastructure and interdisciplinary skills-harmonisation necessary for commencing local openheart surgery, the long-term verdict is largely less positive. In the long run, ‘missions’ – f inanced by NGOs or their governments and mostly deploying big teams for a handful of predominantly congenital corrections and well publicized ‘fly-out’ missions for a handful of children to private health businesses provided the local governments with fig leaves. Being able to superficially claim that heart surgery was offered to their population, allowed them to camouflage the gap between the population’s needs for life-saving surgery and the actually offered miniscule relief for society.”
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