Regional Perspectives and International Representation
In addition to open general sessions, the assembly featured six region-specific networking and community building sessions, adopting the World Health Organization regional model. To address region-specific needs and issues in these sessions, OC members who had first-hand understanding of the sociopolitical and cultural contexts of medical students and trainees in that region were appointed as session moderators to facilitate open discussions and build a sense of community. After the event, participants noted that the regional sessions motivated them to take an active role in future local GEIGS initiatives. Each regional session focused on a unique set of topics and challenges related to gender equity. Examples included prevailing societal notions of SOA medical specialties being “better suited” for cisgender men, homophobia and transphobia in the local healthcare workplace, and the overestimation of gender equity progress in countries that have adopted the issue into their national agenda.
Despite the expected differences, overarching themes also emerged. One unifying topic discussed by different regions was the silencing of non-English-speaking experts from academic conferences. Echoing the oppressive colonially rooted history of global health, many international scientific and medical conferences today continue to favor English-proficient experts for keynote speeches and other prominent speaking roles. At the same time, the availability of translating services for attendees is often lacking due to the additional costs, logistical difficulty, or lack of planning. The gravity of how much valuable learning is lost from these practices was deeply understood following the session on gender inclusivity on Day 1, which featured speaker and transgender activist Ms. Sophie Nouveau, a member of the State LGBT Health Technical Committee of Rio Grande do Sul in Brazil. This session was able to take place because of the interconnected, international network of the OC, and GEIGS, which made a Portuguese-English translator easily available. Not surprisingly, the session was very well-received by participants and frequently mentioned in region-specific debrief sessions. The session highlighted that English is not the only language spoken by experts, and conversely, not all experts in the field speak English. Removing linguistic barriers in academic spheres increases access to unique perspectives, which are otherwise missed when the discourse only takes place in English.
Global Outreach, Social Media, and Capacity Building
The focus of this general assembly was capacity building for an international network of activists for gender equity in SOA specialties. Challenged by the current need for social distancing and dangers of travel, GEIGS piloted a virtual approach for hosting its first global-scale general assembly that would still encompass small-group community building, interactive learning, and concurrent sessions. In total, there were 199 attendees from 46 different countries; a world map depicting these countries and levels of attendance by country is shown in Figure 1.
Figure 1. Map showing the countries of registrants for the GEIGS general assembly.
Stratification of participants using the World Bank income categories shows that: 43 (21.6%) were from HICs, 80 (40.7%) from upper-middle income countries, 54 (27.6%) from lower-middle income countries, and 19 (9.5%) from low-income countries.
Of note, the recruitment window between the launch of the first promotional materials on social media and the first day of the event was only 11 days, demonstrating the wide outreach of and interest in the topic of gender equity in global surgery. Social media platforms, such as Twitter and Facebook, have long been a popular medium for more equitable information sharing, and play a prominent role in the global surgery movement. The recruitment success of the social media campaign in such a short time frame mirrors what other organizations, societies, and studies have seen regarding an increase in the interest for and utilization of online platforms during the COVID-19 pandemic.
The vast engagement on GEIGS social media during and immediately following the general assembly highlights a key point to benefit events even in the post-pandemic era. The GEIGS general assembly had 34 tweets but as many as 27,141 Twitter impressions for the days that the event took place. GEIGS twitter impressions and engagement counts over a 60-day span that encompasses the general assembly, as well as the days preceding and following the event, are depicted in Figure 2.
Figure 2. GEIGS Twitter engagement and impressions before, during, and after general assembly.
On Facebook, GEIGS saw a 394% increase in video engagement and a net 8% increase in followers following the livestreaming of the general assembly events on our initiative page. With its opportunity for instantaneous global connectivity and discussions, social media platforms can have an important role complementary to conferences in terms of enhancing both scholarly dissemination and capacity building.
Learner Interest and Knowledge Gaps in SOA Gender Inclusivity Education
The social media engagement on the general assembly sessions highlighted attendee interest in diversity, equity, and intersectionality, traditionally defined as the investigational framework of inequities exacerbated at the intersection of gender and race . Particularly, the “Intersectionality in Global Surgery” and the “The Value of Equity, Social Justice and Diversity in Surgical Education'' sessions garnered the most attention and engagement. The aims of these sessions were to expand gender equity in SOA fields beyond the cisnormalized gender binary view and to highlight the additional inequities at intersection with these social identities, particularly regarding racism. These are topics for which academic SOA resources and discussions are severely lacking.
Another session that proved to be challenging for the OC to organize, mainly due to the paucity of existing educational resources, was the session focusing on Gender Equity and National Surgical, Obstetric, and Anesthesia Plans (NSOAPs). Despite NSOAPs being a central theme in global surgery, to the authors’ knowledge, there are no existing or openly available lectures, lesson plans, or academic presentations focusing on the integration of gender equity and NSOAPs. This finding is striking given that gender equality is listed as one of the fundamental SDGs.