Globally speaking

SPE19 – What is Diversity, Equity and Inclusion in the Global Context?
Saturday, October 14 | 9:15-10:15 a.m.
South 209/210

Diversity, equity, and inclusion (DEI) within the anesthesiology workforce isn’t just a local challenge. It’s front and center on the global stage, and leaders from around the world are weighing in during this morning’s session, “What is Diversity, Equity and Inclusion in the Global Context?”

As part of the World Federation of Societies of Anaesthesiologists (WFSA) commitment to encouraging DEI in anesthesiology, international speakers representing its member societies by region will share their diverse backgrounds and practice environments. Panelists will address DEI disparities relevant to their region as well as strategies and solutions for creating an inclusive, equal, and fair work environment. Tips include mitigation strategies for bias, career development programs, and implementation of a DEI curriculum.

San Pedro Sula, Honduras, anesthesiologist and intensive care physician Carolina Haylock Loor, MD, is among the panelists who will address applying DEI principles in an inequitable region. Dr. Haylock Loor is Chair of the WFSA’s Diversity, Equity and Inclusion Committee and its Director of Programs.

“The WFSA is a nonprofit organization representing 133 member societies, 140 countries, and 300,000-plus anesthesiologists worldwide, empowering and uniting them to improve patient care and access to safe anesthesia,” Dr. Haylock Loor said.

The WFSA divides its member societies into geographical regions, which include Africa and the Middle East; Asia; Australia, New Zealand, and the Pacific Islands; Europe; Central and South America, Mexico and the Caribbean Islands; and North America.

Not surprisingly, the WFSA encourages fair and equitable delivery of safe health care across populations, values diversity among individuals and within member societies, and strives for inclusiveness within the organization and its membership, Dr. Haylock Loor said.

In anesthesiology, however, there are some general DEI disparities across all regions as well as specific ones, mostly in unique contexts and challenges faced by each region. As such, the WFSA has developed several DEI-boosting initiatives and encouraged its regions to increase awareness of DEI issues. There has been some success; for example, in raising female representation in the WFSA bodies from 29% in 2016 to 43% in 2020, and the proportion of female speakers to WCA (World Congress of Anaesthesiologists) from 14% in 2016 to over 39% in 2021. The bar is expected to be set higher for WCA 2024 in Singapore.

An increasing number of WFSA Member Societies have also launched their own local Gender Balance or DEI Committees.

“In Africa and the Middle East, this is a region that faces unique challenges due to DEI disparities, within socioeconomic and cultural contexts, and constrained health systems,” she said. “The Africa Regional Section (ARS) and the Pan Arab Federation of Societies of Anaesthesia, Intensive Care and Pain Management (PAFSA) have been focusing on diverse initiatives aiming to address gender disparities in anesthesiology, increase access to anesthesia education and training, request that governments improve the infrastructure and supplies in underserved areas, and raise awareness of the benefits of working for DEI values.”

In Asia, she said, some initiatives for addressing DEI disparities in anesthesiology include increasing access to specialized training programs, raising awareness in advocating for gender parity, and promoting cultural competency education. According to Dr. Haylock Loor, the South Asian Association for Regional Co-operation-Association of Anaesthesiologists (SAARC-AA) and the Asian Australasian Regional Section (AARS) have made efforts to support these initiatives and encourage collaboration among anesthesiologists in the region.

Australia, New Zealand, and the Pacific Islands are challenged by underrepresentation of certain minority groups from culturally and linguistically diverse backgrounds, including indigenous people, she said. Several efforts are being made to foster inclusivity, diversity, and equity in anesthesiology and to integrate these cultures into the anesthesia practice, address health inequities, and enhance cultural competencies among indigenous groups. The AARS has implemented mentorship programs and leadership development opportunities to increase the representation of these minority groups within the anesthesiology profession.

In Europe, underrepresentation of certain minority groups, unconscious bias, discrimination, and other issues have contributed to disparities across the continent. However, some initiatives, like raising awareness of these DEI disparities, improving opportunities, mentorship programs, and efforts by the European Society of Anaesthesiology and Intensive Care, have brought attention to the importance of DEI through advocacy during conferences and in publications and guidelines. 

In Central and South America, Mexico, and the Caribbean Islands, it’s much worse, Dr. Haylock Loor said.

“Latin America is one of the most inequitable regions in the world, and DEI disparities are no exception. Underrepresentation of certain minority groups, gender inequity within a socioeconomic and cultural context, political corruption, and constrained health systems are some of the factors resulting in anesthesiology DEI disparities,” she said. “Several initiatives have been made by local anesthesia societies in their countries, starting by raising awareness of the inequity and implementing DEI values through their DEI committees, increasing access to specialized training programs, mentorship programs, improving opportunities for a fair representation of female anesthesiologists in meetings, directories, and politics, and advocating for safer anesthesia practice by requesting that governments improve the infrastructure and supplies in underserved areas.”

Finally, in North America, Dr. Haylock Loor said underrepresentation of certain minority groups, including indigenous, Black, and Hispanic people, is the primary challenge. Initiatives like creation of the ASA DEI Committee have addressed these disparities by supporting education, mentorship, and promoting inclusive policies and practices within the specialty.

In addition to Dr. Haylock Loor’s presentation, the session will include discussion from moderator Adrian Gelb, MBChB, FRCPC, from the University of California, San Francisco; Daniela Filipescu, MD, PhD, DESA, FESAIC, of the University Carol Davila, in Romania; and Odinakachukwu Ehie, MD, FASA, from the University of California, San Francisco.