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Erschienen in: World Journal of Surgery 6/2011

01.06.2011

Surgical Care in the Solomon Islands: A Road Map for Universal Surgical Care Delivery

verfasst von: Eileen S. Natuzzi, Adam Kushner, Rooney Jagilly, Douglas Pickacha, Kaeni Agiomea, Levi Hou, Patrick Houasia, Phillip L. Hendricks, Dudley Ba’erodo

Erschienen in: World Journal of Surgery | Ausgabe 6/2011

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Abstract

Background

Access to surgical care and emergency obstetrical care is limited in low-income countries. The Solomon Islands is one of the poorest countries in the Pacific region. Access to surgical care in Solomon Islands is limited and severely affected by a country made up of islands. Surgical care is centralized to the National Referral Hospital (NRH) on Guadalcanal, leaving a void of care in the provinces where more than 80% of the people live.

Methods

To assess the ability to provide surgical care to the people living on outer islands in the Solomon Islands, the provincial hospitals were evaluated using the World Health Organization’s Global Initiative for Emergency and Essential Surgical Care Needs Assessment Tool questionnaire. Data on infrastructure, workforce, and equipment available for treating surgical disease was collected at each provincial hospital visited.

Results

Surgical services are centralized to the NRH on Guadalcanal in Solomon Islands. Two provincial hospitals provide surgical care when a surgeon is available. Six of the hospitals evaluated provide only very basic surgical procedures. Infrastructure problems exist at every hospital including lack of running water, electricity, adequate diagnostic equipment, and surgical supplies. The number of surgeons and obstetricians employed by the Ministry of Health is currently inadequate for delivering care at the outer island hospitals.

Conclusions

Shortages in the surgical workforce can be resolved in Solomon Islands with focused training of new graduates. Training surgeons locally, in the Pacific region, can minimize the “brain drain.” Redistribution of surgeons and obstetricians to the provincial hospitals can be accomplished by creating supportive connections between these hospitals, the NRH, and international medical institutions.
Literatur
2.
Zurück zum Zitat Kushner AL, Cherian MN, Noel L et al (2010) Addressing the millennium development goals from a surgical perspective: essential surgery and anesthesia in 8 low- and middle-income countries. Arch Surg 145:154–159PubMedCrossRef Kushner AL, Cherian MN, Noel L et al (2010) Addressing the millennium development goals from a surgical perspective: essential surgery and anesthesia in 8 low- and middle-income countries. Arch Surg 145:154–159PubMedCrossRef
4.
Zurück zum Zitat Kingham TP, Kamara TB, Cherian MN et al (2009) Quantifying surgical capacity in Sierra Leone: a guide for improving surgical care. Arch Surg 144:122–127PubMedCrossRef Kingham TP, Kamara TB, Cherian MN et al (2009) Quantifying surgical capacity in Sierra Leone: a guide for improving surgical care. Arch Surg 144:122–127PubMedCrossRef
5.
Zurück zum Zitat Anonymous (2009) United Nations Development Programme. UNDP human development report 2009: overcoming barriers: human mobility and development. Palgrave Macmillan, Washington, DC Anonymous (2009) United Nations Development Programme. UNDP human development report 2009: overcoming barriers: human mobility and development. Palgrave Macmillan, Washington, DC
7.
Zurück zum Zitat Anonymous (2009) National parliament report of Solomon Islands, Special Select Committee on the Quality of Medical Services at the National Referral Hospital. NP-paper no. 51/2009 Anonymous (2009) National parliament report of Solomon Islands, Special Select Committee on the Quality of Medical Services at the National Referral Hospital. NP-paper no. 51/2009
10.
Zurück zum Zitat Debas HT, Gosselin R, McCord C et al (2006) Surgery. In: Jamison D (ed) Disease control priorities in developing countries, 2nd edn. World Bank, Washington, DC, pp 1245–1260 Debas HT, Gosselin R, McCord C et al (2006) Surgery. In: Jamison D (ed) Disease control priorities in developing countries, 2nd edn. World Bank, Washington, DC, pp 1245–1260
11.
Zurück zum Zitat Farmer PE, Kim JY (2008) Surgery and global health: a view from beyond the OR. World J Surg 32:533–536PubMedCrossRef Farmer PE, Kim JY (2008) Surgery and global health: a view from beyond the OR. World J Surg 32:533–536PubMedCrossRef
12.
Zurück zum Zitat Perkins S, Casey K, McQueen K (2010) Addressing the global burden of surgical disease: proceedings from the 2nd annual symposium at the American College of Surgeons. World J Surg 34:371–373PubMedCrossRef Perkins S, Casey K, McQueen K (2010) Addressing the global burden of surgical disease: proceedings from the 2nd annual symposium at the American College of Surgeons. World J Surg 34:371–373PubMedCrossRef
14.
Zurück zum Zitat Weiser T, Regenbogen S, Thompson K et al (2008) An estimation of the global volume of surgery: a modeling strategy based on available data. Lancet 372:139–144PubMedCrossRef Weiser T, Regenbogen S, Thompson K et al (2008) An estimation of the global volume of surgery: a modeling strategy based on available data. Lancet 372:139–144PubMedCrossRef
15.
Zurück zum Zitat Paxton A, Bailey P, Lobis S et al (2006) Averting maternal death and disability: global patterns in availability of emergency obstetric care. Int J Gynecol Obstet 93:300–307CrossRef Paxton A, Bailey P, Lobis S et al (2006) Averting maternal death and disability: global patterns in availability of emergency obstetric care. Int J Gynecol Obstet 93:300–307CrossRef
16.
Zurück zum Zitat Bickler S, Ozgediz D, Gosselin R et al (2010) Key concepts for estimating the burden of surgical conditions and the unmet need for surgical care. World J Surg 34:374–380PubMedCrossRef Bickler S, Ozgediz D, Gosselin R et al (2010) Key concepts for estimating the burden of surgical conditions and the unmet need for surgical care. World J Surg 34:374–380PubMedCrossRef
17.
Zurück zum Zitat Nordberg EM (1984) Incidence and estimated need of caesarean section, inguinal hernia repair, and operation for strangulated hernia in rural Africa. Br Med J (Clin Res Ed) 289:92–93CrossRef Nordberg EM (1984) Incidence and estimated need of caesarean section, inguinal hernia repair, and operation for strangulated hernia in rural Africa. Br Med J (Clin Res Ed) 289:92–93CrossRef
18.
Zurück zum Zitat Blanchard RJ, Blanchard ME, Toussignant P et al (1987) The epidemiology and spectrum of surgical care in district hospitals of Pakistan. Am J Public Health 77:1439–1445PubMedCrossRef Blanchard RJ, Blanchard ME, Toussignant P et al (1987) The epidemiology and spectrum of surgical care in district hospitals of Pakistan. Am J Public Health 77:1439–1445PubMedCrossRef
19.
Zurück zum Zitat Mhando S, Young B, Lakhoo K (2008) The scope of emergency paediatric surgery in Tanzania. Pediatr Surg Int 24:219–222PubMedCrossRef Mhando S, Young B, Lakhoo K (2008) The scope of emergency paediatric surgery in Tanzania. Pediatr Surg Int 24:219–222PubMedCrossRef
20.
Zurück zum Zitat Contini S, Taqdeer A, Cherian M et al (2010) Emergency and essential surgical services in Afghanistan: still a missing challenge. World J Surg 34:473–478PubMedCrossRef Contini S, Taqdeer A, Cherian M et al (2010) Emergency and essential surgical services in Afghanistan: still a missing challenge. World J Surg 34:473–478PubMedCrossRef
21.
Zurück zum Zitat Althabe F, Sosa C, Belizan JM et al (2006) Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high-income countries: an ecological study. Birth 33:270–277PubMedCrossRef Althabe F, Sosa C, Belizan JM et al (2006) Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high-income countries: an ecological study. Birth 33:270–277PubMedCrossRef
22.
Zurück zum Zitat Sani R, Nameoua B, Yahaya A et al (2009) The impact of launching surgery at the district level in Niger. World J Surg 33:2063–2068PubMedCrossRef Sani R, Nameoua B, Yahaya A et al (2009) The impact of launching surgery at the district level in Niger. World J Surg 33:2063–2068PubMedCrossRef
23.
Zurück zum Zitat Ozgediz D, Galukande M, Mabweijano J et al (2008) The neglect of the global surgical workforce: experience and evidence from Uganda. World J Surg 32:1208–1215PubMedCrossRef Ozgediz D, Galukande M, Mabweijano J et al (2008) The neglect of the global surgical workforce: experience and evidence from Uganda. World J Surg 32:1208–1215PubMedCrossRef
24.
Zurück zum Zitat Gosselin R, Gyamfi Y, Contini S (2011) Challenges of meeting surgical need in the developing world. World J Surg 35:258–261PubMedCrossRef Gosselin R, Gyamfi Y, Contini S (2011) Challenges of meeting surgical need in the developing world. World J Surg 35:258–261PubMedCrossRef
26.
27.
Zurück zum Zitat Gruen R (2006) Template for surgical training in resource-poor countries. ANZ J Surg 76:871–872PubMedCrossRef Gruen R (2006) Template for surgical training in resource-poor countries. ANZ J Surg 76:871–872PubMedCrossRef
28.
Zurück zum Zitat Kevau I, Watters D (2006) Specialist surgical training in Papua New Guinea: the outcome after 10 years. ANZ J Surg 76:937–941PubMedCrossRef Kevau I, Watters D (2006) Specialist surgical training in Papua New Guinea: the outcome after 10 years. ANZ J Surg 76:937–941PubMedCrossRef
30.
Zurück zum Zitat Brauchli K, Jagilly R, Oberli H (2004) Telepathology on the Solomon Islands: a two year experience with a hybrid Web and email based telepathology system. J Telemed Telecare 10(Suppl 1):14–17PubMedCrossRef Brauchli K, Jagilly R, Oberli H (2004) Telepathology on the Solomon Islands: a two year experience with a hybrid Web and email based telepathology system. J Telemed Telecare 10(Suppl 1):14–17PubMedCrossRef
31.
Zurück zum Zitat Riviello R, Ozgediz D, Hsia R et al (2010) Role of collaborative academic partnerships in surgical training, education, and provision. World J Surg 34:459–465PubMedCrossRef Riviello R, Ozgediz D, Hsia R et al (2010) Role of collaborative academic partnerships in surgical training, education, and provision. World J Surg 34:459–465PubMedCrossRef
32.
Zurück zum Zitat Anonymous (2008) Ministry of health and medical services and health sector support program 2008 annual report, vol III, Attachment 6. National Referral Hospital Bed Statement Annual Report Anonymous (2008) Ministry of health and medical services and health sector support program 2008 annual report, vol III, Attachment 6. National Referral Hospital Bed Statement Annual Report
34.
Zurück zum Zitat Rosseel P, Trelles M, Guilavogui S et al (2010) Ten years of experience training non-physician anesthesia providers in Haiti. World J Surg 34:453–458PubMedCrossRef Rosseel P, Trelles M, Guilavogui S et al (2010) Ten years of experience training non-physician anesthesia providers in Haiti. World J Surg 34:453–458PubMedCrossRef
35.
Zurück zum Zitat Mullan F, Frehywot S (2007) Non-physician clinicians in 47 sub-Saharan African countries. Lancet 370:2158–2163PubMedCrossRef Mullan F, Frehywot S (2007) Non-physician clinicians in 47 sub-Saharan African countries. Lancet 370:2158–2163PubMedCrossRef
36.
Zurück zum Zitat Pereira C, Bugalho A, Bergstrom S et al (1996) A comparative study of ceasarean deliveries by assistant medical officers and obstetricians in Mozambique. Br J Obstet Gynaecol 103:508–512PubMedCrossRef Pereira C, Bugalho A, Bergstrom S et al (1996) A comparative study of ceasarean deliveries by assistant medical officers and obstetricians in Mozambique. Br J Obstet Gynaecol 103:508–512PubMedCrossRef
37.
Zurück zum Zitat Feasly J, Lawrence R (1998) Pacific partnerships for health: charting a new course. National Academy Press, Washington, DC Feasly J, Lawrence R (1998) Pacific partnerships for health: charting a new course. National Academy Press, Washington, DC
Metadaten
Titel
Surgical Care in the Solomon Islands: A Road Map for Universal Surgical Care Delivery
verfasst von
Eileen S. Natuzzi
Adam Kushner
Rooney Jagilly
Douglas Pickacha
Kaeni Agiomea
Levi Hou
Patrick Houasia
Phillip L. Hendricks
Dudley Ba’erodo
Publikationsdatum
01.06.2011
Verlag
Springer-Verlag
Erschienen in
World Journal of Surgery / Ausgabe 6/2011
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-011-1097-4

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