Interest in global health is on the rise among surgical and anesthesia trainees. In one recent survey of general surgery residents, 92 percent of respondents reported interest in international surgical electives.1 In a similar survey of 35 anesthesia residency programs, 91 percent believed that international electives had educational value, and 64 percent offered a global health opportunity.2 Unfortunately, residents face many barriers in participating in international medicine, with surveys citing funding and logistics as the most significant hindrances to global health care training. Although not every resident may have the opportunity to go abroad themselves during their training, everyone has a chance to contribute to the efforts being made in global medicine.
Lifebox is an international non-profit organization supported by ASA, the World Health Organization (WHO) and the World Federation of Societies of Anaesthesiologists. Its mission is to make surgery and anesthesia safer by putting a pulse oximeter in every operating room (O.R.) in the developing world. Lifebox has negotiated with manufacturers to produce a durable, versatile and easy-to-use pulse oximeter for only $250. This price covers the cost of distribution as well as the necessary education to ensure proper use. The implementation of pulse oximetry has also been included on the WHO’s Surgical Safety Checklist, being encouraged for use in O.R.s across the developing world. A recent article in the Annals of Surgery demonstrated that the combination of the introduction of this checklist and pulse oximetry decreases the total complication rate from 21 percent to 8.8 percent while significantly reducing rates of infection and hypoxic events.3
Lifebox relies on donations to accomplish its mission. Last year, ASA members funded 400 pulse oximeters (through $100,000 in combined donations) with a variety of fundraising efforts. Many of these efforts were orchestrated by residents and medical students. The New Jersey Medical School raised $1,225 last spring with a variety show. The University of Rochester raised $6,966 with a combination of presentations on anesthesia in developing countries and a stand-up comedy event called “Laughs for Lifebox.” Emory residents raised $7,800 through a raffle, with a weekend at the Ritz-Carlton as the grand prize. In Boston, five different residency programs compete annually in “The Lifebox Challenge,” a citywide fundraising competition. To date, funds raised total more than $20,000, with events ranging from bake sales to trampoline dodge-ball contests. The biggest event, “The Lifebox Cup,” is a golf tournament that has raised more than $6,000 since its inception in 2012. And in an especially remarkable act of humanitarianism, the University of Florida collected more than $33,000 for Lifebox in 2011 by challenging every member of its anesthesia department to fund one pulse oximeter.
Considering that a single pulse oximeter used for three surgeries per day, five days per week for one year, would help make surgery safer for almost 800 patients, the $250 purchase price of one Lifebox becomes insignificant. In fact, it amounts to just 3 cents per patient – surely worth the expense to prevent another tragic and needless hypoxic event. Individual donations are important, but in the hopes of accelerating progress toward the Lifebox mission of eradicating unsafe operating conditions, the ASA Resident Component is introducing the First Annual Lifebox National Challenge – a nationwide competition among residency programs to raise money for Lifebox. Programs are asked to raise money in whichever fashion they determine most appropriate. Totals will be adjusted based on the number of residents in each program, such that the program with the highest sum raised per resident will win. The winning program and its fundraising strategies will be featured at next year’s ASA annual meeting.
Great strides have already been made through the efforts of anesthesiologists and anesthesia residents across the country as a part of Lifebox, but there is much work left to do. Though Lifebox has distributed more than 4,200 pulse oximeters to over 70 countries, an estimated 77,000 pulse oximeters are still needed to make surgery safer in the developing world. Visit www.asahq.org/lifebox for more information on how your program can participate in the First Annual Lifebox National Challenge or go to www.asacharity.org to make a personal donation.
FUN-draising for Lifebox
To help residents get started, here are a few pearls of wisdom to ensure fundraising success:
1. We do not have because you do not ask
The direct approach is the easiest route. Anesthesiology providers can be shockingly generous. Fundraising can be as simple as making a strong case for a cause you believe in and allowing others to support it. This is the most-high yield approach.
2. Giving is good for you
Recent research suggests that givers are happier and less prone to stress than matchers or takers.4 So by asking someone to donate to a good cause, we are offering him or her a chance to feel better.
3. Remember your audience
You know your department better than anyone else. Whether it’s golf, chess, poker or eating, tailoring an event to your department’s interests or needs will improve the odds of success. If you are at a program full of singles, you might consider a date auction. If your program is more family-oriented, then perhaps a movie night would be more appropriate. A bake sale is a tried and true option that appeals to the masses.
4. Use your strengths
Fundraising does not have to be uncomfortable if you choose a modality that fits your style. If you enjoy public speaking, give a talk about Lifebox to your co-residents and faculty. If you are in a band, consider hosting a charity concert.
5. Set a goal and don’t be shy
People respond to deadlines and goals, so set an objective that is lofty but achievable, and give a time frame. Frequent reminders to donate, carefully disguised as updates on progress, can be helpful in spurring action and, of course, a celebration is in order once the goal has been reached.
6. Do it again
Lifebox needs your help. It relies on donations to provide safe anesthesia and surgical services to populations in poverty. If you’ve been successful once, do it again.
7. There are no losers in fundraising
Any amount raised for this cause is greatly appreciated and goes directly toward the provision of high-quality perioperative care for those who need it most. Plan an event, set a goal and strive to achieve it. Be proud of your efforts, no matter how big or small.
8. Time your request
People are more likely to make charitable contributions at the end of the holiday season and prior to tax season. Plan the timing of your event and request for funds with consideration for these important seasonal events.
9. Team up for success
Partner with key groups at your institution to raise funds. In particular, engage with medical students interested in anesthesiology and global humanitarian efforts. Groups of medical students, nurses and other paraprofessional groups may want to join the effort as well.
1. Powell AC, Casey K, Liewehr DJ, Hayanga A, James TA, Cherr GS. Results of a national survey of surgical resident interest in international experience, electives, and volunteerism. J Am Coll Surg. 2009;208(2):304-312.
2. Hau AT, McClain C. A national survey of global health education and opportunities in anesthesiology residency programs [abstract COA-18]. Presented at: Pediatric Anesthesia: Safety Knows No Borders; October 11-12, 2012; Washington, DC. http://www.pedsanesthesia.org/meetings/2012ia/syllabus/abstracts.html. Accessed December 4, 2013.
3. Kwok AC, Funk LM, Baltaga R, et al. Implementation of the World Health Organization surgical safety checklist, including introduction of pulse oximetry, in a resource-limited setting. Ann Surg, 2013;257(4):633-639.
4. Smith EE. Career advice: give. The Atlantic website. http://www.theatlantic.com/health/archive/2013/04/career-advice-give/275337/. Published April 30, 2013. Accessed November 12, 2013.