Improvement of the abdominal surgery services over the cross-border area

The common territorial challenge addressed jointly in the project is represented by the low access rate of the cross-border population to laparoscopic surgery services, caused by lack of information and poor finance on the part of the patients, as well as lack of proper medical equipment and lack of qualification of the medical staff on the part of the local healthcare institutions.Although the advantages of laparoscopic surgery are far greater than traditional open surgery, there is a relatively low rate of laparoscopic surgeries within the total number of abdominal surgeries over the cross-border region, which translates into over 21.000 patients being subjected to open abdominal surgery each year throughout the cross-border area, most of which could otherwise benefit from the advantages of the laparoscopic surgery. This is mainly caused by a deficit of capacities, both from the point of view of the available equipment and of the qualification of the medical staff. As laparoscopic surgery represents a new technique with a fast pace of development, the lack of qualification of the regional medical staff plays an important factor for the low rate of laparoscopic surgeries. The overall objective of the project is improvement of the quality of life for the population from the cross-border area with abdominal pathologies. Last generation surgical equipment and advanced training for expert surgeons ensured through the joint actions of the two project partners will create access for the entire population of the cross – border area to modern high quality abdominal surgery services in Timisoara and Smederevo. The expected change that the project will make to the current situation is found in providing, throughout the duration of the project, high quality abdominal surgery services, available for free to all the citizens of the cross-border area. As early diagnosis is of particular importance for the treatment of the abdominal pathologies (especially cancers), free high quality diagnosis services will be offered in Timisoara and Smederevo to patients from the entire cross-border area throughout the duration of the project. In addition, the project partners take the commitment to continue to supply the diagnosis and surgery services for the citizens of the cross-border area without any direct charges, after the end of the implementation period. The awareness campaign lead by the 2 project partners will improve prevention and early diagnosis of abdominal diseases, with important effects on the quality of life of the population. The network of specialists developed through the project around the 2 poles (Timisoara and Smederevo) will increase significantly and with immediate effect the access of the population from remote areas to specific healthcare services, as well as the quality of these services. More specifically, laparoscopic surgery equipment exist in hospitals from each of the 9 counties/departments of the cross-border region. Still, all hospitals are limited to a small range of simple laparoscopic surgeries, as their medical staff is only trained in basic laparoscopic surgical procedures. Through the activities of the project, at least 2 expert surgeons from each county/district will be trained in advanced laparoscopic surgery procedures, which will instantly activate the capacities for such procedures throughout the entire cross-border area (acceptable laparoscopic equipment already exists in several hospitals). With immediate effect, patients will have acces to advanced procedures locally, thus avoiding subjecting themselves to open surgery. The project will also contribute to the improvement of the diagnosis procedures throughout the cross-border area. Through all its activities, the project will show particular attention to disadvantaged persons and minorities that show special tendencies of not taking medical investigations in time or cannot afford high quality medical investigations and high quality surgery services. In terms of main outputs produced and beneficiaries, during the 24 months of implementation, 2.925 citizens of the cross-border area will benefit from high quality diagnosis or surgery services. Thus, a minimum of 1.800 medical investigations and 825 surgical procedures will be performed without charge for the citizens of the cross-border area. Synthetically, the following outputs and beneficiaries will be approached: Free medical investigations for 1.800 patients; Free abdominal surgery services for 825 patients; Training courses for 40 experienced surgeons and residents; Training for 200 medical students; Memberships to the network of specialists for 100 physicians; Guides for best practices in the field of laparoscopic surgery for 200 surgeons, residents, students and family doctors; Guides for patients and family doctors concerning the costs and benefits of open and laparoscopic surgery for 200 recipients; Guides for hospitals, surgeons and cost benefit analysis experts concerning the costs and benefits of open and laparoscopic surgery for 200 recipients; Counselling services over the online portal for 200 patients; Training conferences for 100 family doctors; Free medical investigations for 900 disadvantaged persons; Free abdominal surgery services for 413 disadvantaged persons; Conferences for raising awareness for the Roma population (100 participants instructed); Improved health services for 2.925 citizens of the cross-border area; Citizens involved in the activities of the project: 3.965. The common cross-border challenge is approached in a unified way, with focus on all aspects that could affect (both directly and indirectly) its long term disposal, while capitalizing on existing opportunities (cooperation, infrastructure and knowledge between the two partners) in order to provide sustainable solutions to the common problems and needs of the cross-border stakeholders involved (medical staff and population alike), while maximizing the expected outcomes and results. Accordingly, it was jointly decided that the Lead Beneficiary will be the “Victor Babes” University of Medicine and Pharmacy of Timisoara with Dr. Varcus Florina as Project Manager, capitalizing on both existing knowledge and experience in managing EU funded projects (as detailed in section B1). Both cross-border partners made available their existing infrastructure for the project’s activities (the “Victor Babes” University of Medicine and Pharmacy of Timisoara through an existing protocol with the County Emergency Hospital “Pius Brinzeu” Timisoara), identifying as necessary acquisitions only the specific high-tech medical equipment that they do not have at the moment. All identified needs were transposed into a specific implementation activity of the project (3.1. Developing a network of specialists in laparoscopic surgery, focused on the needs for training, consultations, best practices exchanges and live assistance of surgeons from the cross-border area; 3.2. Medical diagnose, oriented tocross-border persons with specific symptomatology as well as disadvantaged groups, based on the current reality that the population with low levels of income rarely or even neverundergoes high quality medical investigations, while early diagnosis of abdominal pathologies is particularly important in its treatment; 3.3. Abdominal surgery, provided to croos-border patients in need for abdominal surgery, with focus on disadvantaged persons since their access to laparoscopic surgery is often restrictedbecause of high costs which are not entirely covered by the public insurance policy; 3.4. Campaign for raising awareness of gallbladder, appendix, hernia, colon and rectum pathologies, aimed at determining the cross-border population to slowly change its attitude towards medical investigations in the field, and thus covering their need for proper information, as one of the most important factors that determine undertaking medical investigations in time). As for the need of the cross-border/transnational approach, it should be noted that the process of providing health care and education always entails cooperation as there are numerous stakeholders involved in ensuring effective, high quality and sustainable health services, no matter the country. In the project’s context, cross-border cooperation involves collaborative activities between different health care actors, located in neighboring countries, for the purpose of transferring or exchanging health care related services, knowledge and information. This is the case of the Romanian-Serbian border region, where cross-border cooperation on health related issues has been ongoing in an informal manner amid common health care problems, interests, knowledge gaps, patient mobility and even deficiencies related to the local shortage of health care professionals. Both cross-border partners tackle a common health issue (increased cancer burden throughout the population), consequence of common habits in diet and life style, with the prevalence of certain forms of cancer higher in this cross-border area as opposed to all other regions. Furthermore, the cross-border population tends to avoid medical investigations and procedures thus rendering an early diagnosis difficult.

The project addresses the need for developing the abdominal surgery capabilities within the cross-border area. Although the advantages of laparoscopic surgery are far greater than traditional open surgery, there is a relatively low rate of laparoscopic surgeries within the total number of abdominal surgeries over the cross-border region. This is mainly caused by a deficit of capacities, both from the point of view of the available equipment and of the qualification of the medical staff. As laparoscopic surgery represents a new technique with a fast pace of development, the lack of qualification of the regional medical staff plays an important factor for the low rate of laparoscopic surgeries. The overall objective of the project is improvement of the quality of life for the population from the cross-border area with abdominal pathologies. Last generation surgical equipment and advanced training for expert surgeons ensured through the joint actions of the two project partners created access for the entire population of the cross – border area to modern high quality services of abdominal surgery in Timisoara and Smederevo. Thus, throughout the entire project implementation period, high quality abdominal surgery services were available for free to all citizens from the cross-border area. As early diagnosis is of particular importance for the treatment of abdominal pathologies (especially cancers), free high quality diagnosis services were offered in Timisoara and Smederevo to patients from the entire cross-border area. The network of specialists developed through the project around the 2 poles (Timisoara and Smederevo) managed to increase significantly and with immediate effect the access of the population from remote areas to specific healthcare services, as well as the quality of these services. More specifically, laparoscopic surgery equipment exists in hospitals from each of the 9 counties/departments of the cross-border region. Still, all hospitals are limited to a small range of simple laparoscopic surgeries, as their medical staff is only trained in basic laparoscopic surgical procedures. Through the activities of the project, expert surgeons from each county and district were trained in advanced laparoscopic surgery procedures. With immediate effect, patients will have access to advanced procedures locally, thus avoiding subjecting themselves to open surgery. Through all its activities, the project showed particular attention to disadvantaged persons and minorities that have special tendencies of not taking medical investigations in time or cannot afford high quality medical investigations and high quality surgery services.

During the 24 months of implementation, 2.925 citizens of the cross-border area will benefit from high quality diagnosis or surgery services. Thus, a minimum of 1.800 medical investigations and 825 surgical procedures will be performed without charge for the citizens of the cross-border area. The project partners will continue to supply the diagnosis and surgery services for a minimum of 1.000 citizens of the cross-border area / year without any direct charges, for a minimum of 5 years after the end of the implementation period.