World Journal of Surgery

, Volume 30, Issue 4, pp 495–504

Rural Surgery in Southern Sudan

  • Giuseppe Meo
  • Dario Andreone
  • Umberto De Bonis
  • Giorgio Cometto
  • Stefano Enrico
  • Guido Giustetto
  • Alberto Kiss
  • Marino Landra
  • Maria Palmas
  • Laura Sacchi
  • Peter Taliente
  • Guido Vergnano
Article

DOI: 10.1007/s00268-005-0093-y

Cite this article as:
Meo, G., Andreone, D., De Bonis, U. et al. World J. Surg. (2006) 30: 495. doi:10.1007/s00268-005-0093-y

Abstract

Introduction

This article reports a retrospective analysis of a 6-year experience of providing surgical care in remote areas of southern Sudan under extremely adverse conditions.

Methods

Teams of expatriate consultants (surgeon, anesthetist, scrub nurse) carried out 28 “surgical missions” with the aims of treating surgical cases previously selected and of training local personnel in basic surgery on the job.

Results

A total of 1642 patients (71% males, 30% under the age of 16) have undergone an operation. Altogether, 1264 elective procedures (77%) and 378 emergency procedures (23%) were performed. Hernia surgery comprised the main workload, followed by proctologic and gynecologic operations. Most operations were performed under spinal anesthesia. Other cases required ketamine, and a small number of patients had local anesthesia. There were 14 fatal complications, most of them related to the delay in obtaining medical attention. Based on the training results, the Sudanese personnel of two of the five health centers involved in the program are already fully autonomous. Two doctors and two nurses are proficient in essential surgery; two not qualified nurses are proficient in “primary” anesthesia; and others are proficient in scrubbing and surgical nursing.

Conclusions

This report demonstrates that it is feasible to establish surgical services in rural areas of developing countries by utilizing simple facilities, providing them with basic equipment, and employing local personnel selected and trained on the job by teams composed of a consultant surgeon, anesthetist, and scrub nurse. This seems to be the only realistic possibility for providing surgical care to the rural populations of the least developed countries.

Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

  • Giuseppe Meo
    • 1
    • 11
  • Dario Andreone
    • 2
  • Umberto De Bonis
    • 3
  • Giorgio Cometto
    • 4
  • Stefano Enrico
    • 2
  • Guido Giustetto
    • 5
  • Alberto Kiss
    • 6
  • Marino Landra
    • 7
  • Maria Palmas
    • 8
  • Laura Sacchi
    • 9
  • Peter Taliente
    • 10
  • Guido Vergnano
    • 6
  1. 1.Comitato Collaborazione Medica (CCM) Consultant SurgeonMedical Coordinator of the program “Surgery in Remote Areas of Sudan”Italy
  2. 2.CCM Consultant Surgeon, General SurgeonS. Luigi Gonzaga HospitalOrbassanoItaly
  3. 3.CCM Consultant AnaesthetistAnaesthetist Ospedale Civile
  4. 4.CCM Regional Medical CoordinatorNairobi Office for SudanKenya
  5. 5.CCM Consultant PhysicianTutor in Family Medicine, Torino UniversityItaly
  6. 6.CCM Consultant Surgeon, General SurgeonOspedale Maggiore di ChieriItaly
  7. 7.CCM Consultant Plastic Surgeon, General SurgeonOspedale Civile Santa Croce di CuneoItaly
  8. 8.CCM Consultant Surgeon, General Surgeon (retired)Ospedale Civico di Ghilarza (Oristano)Italy
  9. 9.CCM Consultant Surgeon, General Surgeon (retired)Ospedale S. Croce di MoncalieriItaly
  10. 10.CCM Consultant Surgeon, General SurgeonOspedale Morelli di Sondalo (Sondrio)Italy
  11. 11.Comitato Collaborazione MedicaItaly