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Investigation

“A Chance to Cut is a Chance to Cure”

Statistics are the lifeblood of public health. From epidemiology to health care management, knowing the numbers is essential to the development, implementation and management of public health initiatives and policy decisions.

“The public health community can no longer afford to leave surgery out of the conversation.”

Shailvi Gupta, MD, MPH ’14

The advances in public health over the past century have been in large part driven by statistics, and the field of public health has become increasingly adept at collecting quantitative data. While information about public health coming out of developing countries was, at best, anecdotal decades ago, today it’s common to be able to call up everything from HIV rates to maternal death ratios to polio vaccination percentages whenever they’re needed.

But information about cancer? That’s another story…and it’s one that Adam L. Kushner, MD, MPH ’99, wants to begin to rewrite.

“Only the strongest are making it to the hospital,” says Kushner, an associate in International Health at the Johns  Hopkins Bloomberg School of Public Health. “We don’t know how many are dying without getting to the hospital, dying in the villages. We just have no idea.”

To advocate for more surgical care in developing countries, he needs data.

Kushner and his colleagues at both the Bloomberg School and the nonprofit Surgeons OverSeas (an organization he founded) are working to collect the data on cancer they’ve been lacking. Working in countries like Rwanda, Sierra Leone and Nepal, Kushner and people like his former student Shailvi Gupta MD, MPH ’14, have been in the field doing surveys to determine breast cancer rates. Because many women (and a few men) in these countries often don’t seek treatment for their breast cancer because of cost, lack of knowledge or distrust in the medical establishment, it has been difficult to determine the overall prevalence of breast cancer in these countries. And not knowing these basic numbers has hindered the ability to treat people suffering from what is, in many cases, a treatable disease.

“This is important because breast cancer is the most common cancer in women,” says Kushner. “It’s very treatable if you diagnose it early. A chance to cut is a chance to cure.”

Like Kushner, Gupta also recognizes the need to gather more information on cancer and other conditions that can be treated with surgical intervention if the public health community is going to be mobilized to address these issues on an international scale.

“Surgery is such a daily need,” says Gupta. “If someone has a hernia, if someone has breast cancer, if someone has road trauma, they need surgical care. The public health community can no longer afford to leave surgery out of the conversation.”