As a society, we have a tendency to think that advances in medical care must offer big, bold solutions to critical healthcare issues that are impacting a population. We have a tendency to think that innovation has to be transformative to be impactful.
But for the people living in rural communities in the remote, high-mountainous province of Badakhshan in North-East Afghanistan, scientific development is about small progresses that make a meaningful difference to their quality of life. Here, scientific development is about health solutions that are accessible.
For a community that lacked formal health care and whose health care facilities were damaged in the wars of the last quarter century, Aga Khan Health Services' (AKHS) offering of laparoscopic surgery at the Faizabad Provincial Hospital has been nothing short of revolutionary.
Though the first laparoscopic operation was performed in Sweden in 1910, several systemic challenges – such as the financial resources required to purchase technology, health system readiness, and surgeon training – have limited its availability in Badakhshan.
And while the Aga Khan Development Network (AKDN), through Aga Khan University (AKU), has worked closely with the Governments of Afghanistan, France and Canada to improve medical education and post-graduate physician training in the country, much of this work has been concentrated in tertiary hospitals in the capital Kabul like the French Medical Institute for Mothers and Children (FMIC).
For this reason, bringing innovations like laparoscopy – a mainstay in modern surgical technique – to rural communities like Faizabad and Badakhshan has been a core priority for AKHS.
Laparoscopy is a type of surgery in which small incisions are made in a patient’s abdominal wall to allow a fiber-optic scope to be inserted to help a surgeon view the organs in the abdomen and pelvis. A variety of other surgical instruments can also be used through these incisions to perform procedures without the need for larger incisions. Laparoscopic surgery offers a less invasive option for routine procedures, decreasing the average length of hospital stay for patients. Often patients can be discharged within 24 hours of a procedure as compared to 3-5 days after a major surgery and can get back to their normal routine within a week (vs one month with major surgery). Laparoscopic surgery also offers patients other benefits, such as reduced post-operative pain, fewer post-op complications, as well as less dependency on antibiotics and painkillers.
Since its introduction in December 2019, the Faizabad Provincial Hospital has performed 28 laparoscopic procedures like cholecystectomies, making this minimally invasive option more accessible for the roughly 1 million people living in the province of Badakhshan. Faizabad is the only provincial hospital in Afghanistan that has introduced laparoscopic surgery.