Power, Partnerships, and the Reality of Global Surgery Collaboration

In this episode of the Behind the Knife Global Surgery Series, we take a closer look at the real-world complexity of global surgery partnerships between high-income institutions and partners in the Global South. Words like equity, bidirectionality, partnership, and decolonization are used often in global surgery—but what do they actually mean when funding, mobility, research access, publication opportunities, and institutional power are unequally distributed?

Host Mike Mallah is joined by Dr. Hugo Stark from George Hospital in South Africa and Dr. Sydney Bertram from Emory for a candid discussion about the benefits and tensions of collaborations in an unequal world. Together, they explore how global surgery partnerships can create meaningful educational and clinical value, how good intentions can still reproduce unequal systems, and how surgeons can build partnerships that are locally useful, honest about power, and ultimately centered on better surgical care for patients.

Hosts/Guests:

- Mike M. Mallah, MD, FACS, FICS
Director of Global Surgery at Medical University of South Carolina
@MikeMMallahMD
@MUSCGlobalSurg
mallahm@musc.edu

- Hugo Stark, MD
Head of Department - Surgery, George Hospital, Western Cape, South Africa
Head of Surgical Services, Central Karoo Region
Sydney Bertram, MD
General Surgery Resident, Emory University
Trainee Advisory Council, Consortium of Universities for Global Health
@Sydney_Bertram

Learning objectives:
• Describe how global surgery partnerships can provide educational, clinical, professional, and research value for both high-income and Global South partners.
• Identify how asymmetries in funding, mobility, publication access, and institutional agenda-setting can create inequity within otherwise well-intentioned global surgery partnerships.
• Discuss practical principles for ethical global surgery engagement, including centering local needs, avoiding extraction, building durable partnerships, and focusing on patient access to surgical decision-making.

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