More than 80 leaders from orthopaedic societies around the world gathered at the International Presidents’ Breakfast and World Opinion Forum during the 2010 AAOS Annual Meeting to discuss global orthopaedic care and education.

Jesse B. Jupiter, MD, International Committee chair, opened the meeting by welcoming Mexico as the 2010 Annual Meeting Guest Nation and introducing the event’s Special Guests of Honor: Dr. Hans Larsen, president of the Société Haitienne de Traumatologie et d’Orthopedie (SHTO); Dr. Bernard Nau, general secretary of the SHTO; and Dr. Hernan Guzman Porras from Chile.

Guest Nation honored
During his introduction of the Guest Nation Program, Dr. Jupiter announced the leadership from the Asociación Mexicana de Ortopedia y Traumatología (AMOT) and the Colegio Mexicano de Ortopedia y Traumatología (CMOT). He then presented the Guest Nation Award to José Cymet Ramirez, MD, of CMOT and Jaime J. Gutierrez, MD, of AMOT.

Guest Nation representatives Raymundo G. Gonzalez, MD, and Jorge Lopez Curto, MD, presented “Universal Access to Health Systems and Unsuccessful Paradigms.”

“Universal access to health systems is a worldwide problem,” said Dr. Curto. “Medical systems should guarantee the right to health and also guarantee patients’ rights, including the right to information, choice, confidentiality, and privacy.”

Unfortunately, he continued, many current healthcare paradigms fall short of this goal. The solution, Dr. Curto believes, involves decentralized services with less bureaucracy and lower administrative costs, nonprofit organizations as providers of hospital services, and specialized medical insurance companies. “Medicine,” he said, “must be an instrument of social cohesion.”

Responding to disasters
The AAOS created the World Opinion Forum as a global initiative to address issues shared by orthopaedic societies around the globe. This initial forum focused on long-term relief efforts for Haiti in the wake of the recent earthquake. A secondary goal was to outline the parameters of an organized plan of action that could be followed in future disasters.

The forum was moderated by Dr. Jupiter and Peter G. Trafton, MD, a member of the AAOS International Committee who treated Haitian patients aboard the USNS Comfort. The other panelists included Dr. Larsen, SHTO; Prof. Cody Eric Bunger, MD, president, International Society of Orthopaedic Surgery and Traumatology (SICOT); Dr. Curto, CMOT; Dr. Fernando de la Huerta, AMOT; Sieja Jingushi, president, Japanese Orthopaedic Association; Dr. Romeu Krause Gonçalves, president, Brazilian Orthopaedic Society; and Dr. Michael Bell, president, British Orthopaedic Association.

Each of the panelists was allowed 2 minutes to share their opinions. Dr. Larson began by acknowledging the tremendous outpouring of support and aid from the global orthopaedic community in response to the earthquake and thanked all the volunteers for their efforts. He then outlined the tremendous need that exists in Haiti for rebuilding the orthopaedic infrastructure, including instrumentation, education, and training.

The open forum discussions proposed several possible solutions to the problems that became evident during the Haiti relief efforts. The following ideas were among those presented:

• coordinating intervention efforts with regional leadership
• gaining the support of international organizations such as the United Nations and the World Health Organization
• collaborating with national and international military organizations that are prepared to mobilize and deliver necessary equipment and personnel
• holding a meeting with countries that have experienced similar tragedies, as a forum for learning what works and what doesn’t, which may aid in the development of clear protocols for expediting orthopaedic care in the wake of future disasters

Having the support of local government was also stressed; the country receiving aid must be able to bear the costs of the systems (such as transportation and emergency medicine systems) being implemented.

An international role for AAOS
It was clear that many countries look to the AAOS for guidance and assistance in developing a framework to organize orthopaedic disaster-response efforts. Moving forward, the charge is to help Haiti develop the orthopaedic infrastructure and skilled resources necessary for recovery.

“We have to remember that natural disasters are going to continue to occur, and that a coordinated response will be needed,” said Dr. Jupiter. “I hope that all of you will continue to think about this issue within your own organizations and regions, as we at the AAOS will.”

Maureen Leahy is assistant managing editor of AAOS Now. She can be reached at leahy@aaos.org