Sometimes it feels like philanthropy is getting harder and harder. In the age of global information sharing, the more we learn about crisis and hardship the world over, the more compassion fatigue sets in.
The more we are exposed through 24 hour news cycles to images and tales of catastrophe, disaster, war, famine, drought, and destitution, the louder people seem to call – “but what about the problems here?”
And they have a point. For all the pictures and stories of suffering halfway across the planet we see, it is hard to grasp what we can do about it. But when there is poverty on our own doorsteps, hard-up working parents forced to go to food banks to feed their children, a growing crisis in care for an aging population, a healthcare service stretched to the limit – it is understandable why people want to tackle those issues first.
But should it have to be a matter of making choices where you apply yourself to tackle the problems facing humankind?
According to the old proverb, necessity is the mother of invention. Certainly, when it comes to innovation in science and technology, this has been proven true over and over again. Perhaps it is something in the human psyche, but so often it seems as if the greater the crisis we face is, the more adept we become at finding the solution.
This has been a part of the Proximie story – how a new application for technology in surgery was born out of a desire to take surgical expertise to the hardest to reach patients in the most dire need. But that was just the spark which fired the innovation. Far from being a tool for a crisis only, Proximie has the potential to improve mainstream surgical services the world over, for you, me and anyone else who may need access to surgery now or in the future.
Sometimes we all benefit from a little compassion.
A new surgical technology
Many great breakthroughs in medical care can be attributed to the urgency created by crisis, and the tragedy of conflict. The story of Florence Nightingale and the birth of modern nursing in the Crimean War is still taught to children in schools today. The triage system for prioritising emergency care was invented amidst the chaos and carnage of the First World War trenches, which was also where the first blood banks to aid transfusions were set up.
In a different way, Proximie can also trace its origins to the overwhelming necessities which arise from conflict. Proximie co-founder Nadine Hachach-Haram grew up in Lebanon at a time when the country was being torn apart by war. She witnessed death, mutilation, suffering, and loss. She was also struck by how, when they were needed most, there never seemed to be enough doctors, nurses and emergency workers to cope. In the nightmare of conflict, a lack of access to healthcare was a critical issue Nadine experienced first-hand, a memory that has stuck with her ever since.
Speaking at a recent NHS event, Nadine told how, when training to be a surgeon, her early experiences pushed her to explore how critical surgical care could be brought to conflict and disaster zones.
“I always knew I wanted to be a surgeon, a reconstructive surgeon because I knew I wanted to do something which made a difference,” she told the audience. “I wanted to help to improve people’s lives and to restore form and function. I learned about the work of some inspirational charities which were transforming the lives of people blighted by physical deformity, caused by disease, or violence, or extreme deprivation, in areas of the world where access to reconstructive surgery was virtually non-existent.”
It was through the work of one of these charities that Nadine came across the story of Ali, a young man from Gaza. He was the sole breadwinner of a young family and had ambitions of becoming a nurse, until one day he was caught in a bomb blast which badly mutilated his hand. Like so many in Gaza, his world was turned upside down by violence, and the outlook for him and his family looked bleak.
Ali’s salvation came in the form of a local surgeon, Dr. Hafez, who took it upon himself to help Ali. Dr. Hafez did not have the expertise or experience to carry out the reconstructive surgery required on Ali’s hand. But he had heard about the use of a new technology in surgery, Augmented Reality (AR), and how it was allowing surgeons to collaborate via an internet connection, with one guiding the other on how to carry out a procedure.
Dr Hafez got access to the technology and found a reconstructive specialist in Beirut willing to help him. Armed with an iPad, under direction from the specialist, Dr. Ghassan Abu Sitta, using the AR technology to guide him, Dr. Hafez rebuilt Ali’s hand. Out of necessity, he found a way to give a young man and his family new hope.
“This was the inspiration which helped me design the Proximie platform,” said Nadine. “The germ of this idea came from necessity. I asked myself – how can we address that imbalance between supply and demand? Where there is need for specialist surgical expertise, how can we get it there?”
Proximie is one of a number of breakthrough solutions in the vanguard of so-called remote surgery, or telesurgery – using digital telecommunications, AR, virtual reality, robotics and other technologies to enable the delivery of surgical procedures even when there is no specialist present on the ground.
The ability to collaborate, guide, discuss and demonstrate, both visually and verbally, on a smart device creates the opportunity to share expertise over distance, ensuring it can be delivered where it is needed. As in Ali’s case, this has clear applications in delivering surgical treatment to conflict zones and other crisis-hit regions.
But that is far from the be all and end all of how Proximie can be used. As Nadine told her audience: “We face a scarcity of surgical resources right here in the NHS, too. There are enormous budgetary constraints, but at the same time, demographic and cultural changes are increasing demand, with ever-growing expectations for a more efficient, leaner, quicker, sharper service.
“Rationing has become an everyday reality in all areas of healthcare provision. In surgery, this translates into specialist provision in key areas like oncology and heart disease being increasingly centralised into fewer and fewer priority settings. This might improve control over available resources, but it reduces access at a local level and increases waiting times.
“I am determined that things don’t have to be like that. Imagine if specialists, instead of being isolated in certain locations, were able to share their knowledge freely without even having to travel. Imagine how quickly waiting times would be reduced and the money that could be saved.
“Imagine as well how this free circulation of knowledge could breathe life back into surgical training, allowing students and trainees to ‘sit in’ on a greater range of procedures without leaving their location. To be inspired and mentored by world renowned experts from all over the globe no matter where they were.
“Imagine how quickly those specialists skills, rather than shrinking into isolated pockets, would blossom and spread across the country, to where people need it most.”
Most of us now carry the technology required to achieve these goals around with us in our pockets. Devices which allow us to talk, see, share and work with anyone, wherever we both happen to be. By adding AR on top of this communications platform, Proximie creates an environment for rich interaction and engagement which allows surgery to be overseen safely and effectively in local hospitals from afar.
That is not just good news for the Ali’s of this world facing daily risks in conflict zones. It is good news for all of us, as it presents a realistic opportunity to reduce waiting times, make more procedures available in local hospitals, and reduce the amount of surgery that is canceled or refused because of skills shortages and cost.
“I believe so strongly that if we look where there is most need in healthcare – in the parts of the world where even access to the basics is a major challenge – that this is where we can find solutions relevant to us all,” said Nadine. “For it is in these places that we find the courage to embrace the unknown and make the steps which truly take us forward.”