Dear Dr. Neil
Thank you so much for adding me to HIFA. It is an absolute honor to be here!
A brief introduction about myself:
My name is Ramitha Eshan Ruwanpathirana. I am originally from Sri Lanka, born and raised in a rural village in the North Central Province.
I completed my medical education and gained my first clinical experience in rural Nepal, where I spent most of my time caring for hard-to-reach communities in the Pokhara mountains. When I returned to Sri Lanka, I worked as a research assistant under Dr. Tamara Worlton (a US military surgeon), who introduced me to global surgery and the Association for Academic Global Surgery (AAGS). This led me to become completely invested in rural healthcare and equitable surgical access. As a result, I became involved in several global surgery societies and projects focused on surgical care in LMICs.
As Vice Chair of Research at the AAGS, I co-led a team of dedicated global surgery researchers on a multinational Delphi study. This study focused on developing consensus-based guidelines for equitable and ethical global surgery research partnerships. My co-lead was Dr. Joshua Kamstra, a trauma surgeon from the US. This study was funded by Massachusetts General Hospital. We completed the first phase of this two-phase study and published the paper: "Establishing best practices guidelines for collaborative research in global surgery: developing a Delphi survey", which was published in the Journal of Global Health. As Chair of Research at the AAGS, I continued this study. We used the Delphi Method to get feedback from a curated set of experts in global surgery across 15 countries. We developed a set of final guidelines and submitted them for publication as "Guidelines for Equitable and Ethical Conduct of Collaborative Research in Global Surgery: A Modified Delphi Process".
During this time, I completed my Fellowship in Global Surgery Policy and Advocacy at the Center for Global Surgery in the Department of Surgery at Baylor College of Medicine in Houston, Texas, USA. I trained in health policy analysis at Rice University's Baker Institute for Public Policy, conducted health-policy advocacy on Capitol Hill through the American College of Surgeons, and collaborated with Harvard's Program in Global Surgery and Social Change (PGSSC) to help develop Nepal's National Surgical, Obstetric, and Anesthesia Plan (NSOAP) alongside its Ministry of Health. I continued this work after completing my fellowship and returning to Nepal.
I am now looking to use all I have learned to benefit developing and disadvantaged communities around the world.
Recently, I returned to Sri Lanka and started working as a Global Surgery Policy Fellow at the Department of Surgery, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka. With my previous contacts from the Harvard PGSSC, Baylor College of Medicine, and several Sri Lankan Surgeons working in the USA, I am presently leading a subnational evaluation of access to essential surgery for all 25 districts in Sri Lanka (the first indicator of the Lancet Commission on Global Surgery). We aim to measure the populations across Sri Lanka that are within reach of the three Bellwether Procedures within 2 hours (and also within the "Golden Hour" and 45 minutes, as Sri Lanka is a small island). We also aim to measure the current nationwide, facility-wise distribution of surgeons, anesthesiologists, and obstetricians (SOA providers); distribution and access to blood services; and which Bellwether-capable facilities are located in highly disaster-prone zones. This is especially important in light of the recent damage to healthcare facilities in Sri Lanka by Cyclone Ditwah.
Two days ago, I was at the Ministry of Health and Mass Media advocating for a Good Samaritan Law in Sri Lanka due to the increasing burden of road traffic accidents. Although this work has been in the pipeline for nearly a decade, the law has not yet passed. During my advocacy, the Ministry took up this to be written into the upcoming National Health Strategy. This is a work in progress, and we are waiting to see what new developments emerge.
Interest in health policy and advocacy is relatively lacking in South Asia, unlike in developed nations. I have taken to teaching the workforce and medical students in both Nepal and Sri Lanka all that I have learned in the US. To mention the latest, in January, I am
conducting a seminar series for medical students and residents at the University of Colombo on Health Policy and Advocacy. I think it is very important that LMIC HCWs are educated and made aware of the possibilities these tools offer.
I hope to match into surgical residency eventually in the United States after my Step 2. My wife, a Nepali anesthesiologist, is also on the same path. We want to bridge the knowledge gap between developed and developing countries and contribute to the eventual achievement of equitable care and UHC regardless of location.
I have attached a copy of my CV for your perusal [*see note below]. Please let me know anything else I can share with you to help with this process Dr Neil.
Thank you so much for this opportunity!
Warmest regards from the beautiful island,
Ramitha Eshan Ruwanpathirana, MBBS
Global Surgery Research Fellow
Department of Surgery
Faculty of Medicine, University of Ruhuna
Galle, Sri Lanka
HIFA profile: Ramitha Eshan Ruwanpathirana is a Physician, Global Surgery Research Fellow, University of Ruhuna, Sri Lanka. Professional interests: global surgery, access to surgery, equitable healthcare, equitable research collaborations. oakflute AT gmail.com
[*Note from HIFA moderator (NPW): Thank you Dr Ramitha for your introduction. HIFA does not carry attachments but HIFA members can get in contact with you as needed. We look forward to working with you and others to help bridge the knowledge gap, particularly for emergency care and surgery. You mention you are advocating for Sri Lanka to adopt the Good Samaritan Law, whereby witnesses of accidents who try to provide first aid would be protected from legal and financial consequences. I learned that this law only applies in some countries. Even where it does apply, many people are unaware of it and decide not to offer assistance in the case of (for example) a serious road accident. It must be commonplace, therefore, that people do not receive assistance because of lack of knowledge of the Good Samaritan Law, and that avoidable harm or death may result.]