Abstract
Background
Surgery is rapidly becoming a part of public health initiatives in developing countries.
Methods
In collaboration with the Sierra Leone Ministry of Health and Sanitation, a team of local surgeons and surgeons from the organization Surgeons OverSeas (SOS) used the WHO Tool for Situational Analysis to Assess Emergency Surgical Care to quantify surgical capacity in Sierra Leone. These data were then compared to data collected from the Medical and Surgical History of the Civil War, a work documenting surgical care and hospitals during the US Civil War.
Results
There are 0.2 government hospital surgeons/100,000 people in Sierra Leone compared to 300 surgeons/100,000 soldiers in the Union Army. In Sierra Leone it is rare to have running water, fuel, anesthesia, and reliable X-rays. In comparison, US Civil War hospitals had reliable running water, fuel, and anesthesia. It is rare to manage open fractures, limb dislocations, amputations, and conditions requiring chest tubes in Sierra Leone, while these procedures were commonly employed in US Civil War hospitals.
Conclusions
Government hospitals in present day Sierra Leone lack the infrastructure, personnel, supplies, and equipment to adequately provide emergency and essential surgical care. In a comparison of present day Sierra Leonean and US Civil War hospitals, the US Civil War facilities are equivalent and in many ways superior. It is hoped that such a comparison will aid advocacy efforts so that greater resources are devoted to improving emergency and essential surgical care in low- and middle-income countries.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Murray CJ, Lopez AD (1997) Global mortality, disability, and the contribution of risk factors: global burden of disease study. Lancet 349(9063):1436–1442
Debas HT, Gosselin R, McCord C et al (2006) Surgery in disease control priorities in developing countries. Oxford University Press, New York
Farmer PE, Kim JY (2008) Surgery and global health: a view from beyond the OR. World J Surg 32(4):533–536
United Nations Development Index. http://hdr.undp.org/en/statistics/. Accessed 7 Feb 2010
Kingham TP, Kamara TB, Cherian MN et al (2009) Quantifying surgical capacity in Sierra Leone: a guide for improving surgical care. Arch Surg 144(2):122–127 discussion 128
Blaisdell FW (1988) Medical advances during the civil war. Arch Surg 123(9):1045–1050
World Health Organization Integrated Management for Emergency and Essential Surgical Care Tool Kit (2009). www.who.int/surgery. Accessed 07 Feb 2010
Robertson JE (ed) (1991) The medical and surgical history of the civil war, vol VI. Broadfoot Publishing Company, Wilmington, DE
McCord C, Chowdhury Q (2003) A cost effective small hospital in Bangladesh: what it can mean for emergency obstetric care. Int J Gynaecol Obstet 81(1):83–92
Gosselin RA, Thind A, Bellardinelli A (2006) Cost/DALY averted in a small hospital in Sierra Leone: what is the relative contribution of different services? World J Surg 30(4):505–511
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Crompton, J., Kingham, T.P., Kamara, T.B. et al. Comparison of Surgical Care Deficiencies between US Civil War Hospitals and Present-Day Hospitals in Sierra Leone. World J Surg 34, 1743–1747 (2010). https://doi.org/10.1007/s00268-010-0564-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-010-0564-7