Tiaji Salaam-Blyther was planning a career in law, but a six-month stint in Zimbabwe changed her life trajectory. The year was 1997 and HIV/AIDS was fulminant in southern Africa. While staying in a rural village, Ms. Salaam-Blyther noticed that funerals were being held on a regular basis for inexplicable ailments, like a broken heart. She later came to understand that the ailments were HIV/AIDS. It was common practice for people to return to their home villages to be cared for and ultimately to die. After learning the secret language, Salaam remarked; “I couldn’t believe that people died from something that was preventable and treatable.” The stark realities of these health disparities created a sense of frustration. A sentiment that she channeled into action - she wanted to make a change. She went back to the U.S. and earned a Masters in International Affairs with a concentration in African Studies from the Johns Hopkins University School of Advanced International Studies (SAIS) and later a Masters in Health Administration and Policy from the Uniformed Services University of the Health Sciences (USUHS).
Ms. Salaam-Blyther has served as a specialist in global health since 2002. She has, in this capacity, assisted in the development of legislation on issues pertaining to health system strengthening, maternal and child health and Ebola. As a previous Project Manager for Africa at the U.S. Department of Labor, she has also led several international projects in countries such as Namibia and Zimbabwe.
On Thursday, July 18, 2019, we had the pleasure of welcoming Tiaji Salaam-Blyther as a guest speaker for our Thursday morning report here at PGSSC. She remarked:
“Global health is often thought of as helping the poorest of poor. Global surgery, however, is often tied to non-communicable diseases. Non-communicable diseases are, in some people’s mind, a problem of affluence. They don’t understand that you can be poor and have diabetes. It is a problem of overcoming that hurdle.”
The assumption that non-communicable diseases (NCDs) is a secondary or minor issue in low- and middle-income countries (LMICs) is false. According to the World Health Organization (WHO), 15 million people between the ages of 30 and 69 years die from NCDs each year; over 85% of these "premature" deaths occur in LMICs. Another point to note is that the level of surgical care in a hospital is a good indicator of the quality of the health system as a whole. Hospitals that can deliver the Bellwether procedures (emergency caesarean section, laparotomy and treatment of an open fracture) in a safe manner, live up to a certain level of workforce density, access to operating rooms, a reliable source of electricity, and access to equipment and sterility.
Traditionally, international and national healthcare planning has been structured in silos with separate strategies to combat different categories of disease as well as earmarked budget categories aimed at interventions against particular diseases, like HIV/AIDS. In this structure, there is no room for scale-up of surgical care. Hence, raising awareness that ensuring safe surgeries is a part of health systems strengthening can be an uphill-battle. So how do we overcome the hurdle?
To tackle this challenge, the global health community needs to integrate policy recommendations into broader discussions around safe surgeries and research findings. We must look outside academia and reach policymakers and voters with information that makes a clear and evidenced-based message.
In discussing the policy making process, Ms. Salaam-Blyther describes the variety of issues that policy makers often consider:
“What might my constituents say? What are the stakeholders saying? Who might be impacted by this policy decision? How might my opponents respond?”
The end-goal of global surgery research is not just publishing papers. If we are to live up to our bold vision of surgical care for all by 2030, we need to reconsider the way we engage with policymakers and the broader community so that we, together, can walk the talk.
We thank Ms. Salaam-Blyther for her enlightening and inspiring visit.
Author: Lotta Velin
Editor: Jackie Corley