Surgery in the developing world

Surgical provision for many people in the world is wholly and dangerously inadequate. Surgical care is an essential element of a functioning health system and vital for managing diverse conditions from traumatic injuries, obstructed labour, malignancies and many other conditions. Resources to ensure the continued provision of surgical care are often missing and, as the Lancet Commission on Surgery reported in 20141, five billion people do not have access to even the basic level of surgical care. 

In many hospitals visited by the author in Sub Saharan Africa and beyond, the issues are very broad with low numbers of qualified staff working in dreadful conditions, for long hours with little leadership at a local level. They have poor equipment which frequently breaks or is just broken and has to be discarded due to lack of maintenance or repair facilities. In addition, they have very little access to further education or training and struggle on with often poor understanding of the rationale for doing things the way they were taught.

The issues so starkly described in the Lancet Commission cannot continue to be ignored – there are millions of people dying every year unnecessarily. The need for affordable and equitable access to surgical services is projected to further increase in the next few years, as many of the most affected countries increase their rates of trauma, cancer and cardiovascular disease.