World Journal of Surgery

, Volume 33, Issue 6, pp 1194–1196 | Cite as

Universal Precautions and Surgery in Sierra Leone: The Unprotected Workforce

  • T. Peter Kingham
  • T. B. Kamara
  • K. S. Daoh
  • Soccoh Kabbia
  • Adam L. Kushner



Surgical patients and healthcare workers in sub-Saharan Africa are at an increased risk of contracting HIV. Sierra Leone is one of the poorest countries in the world and has a documented HIV prevalence rate of 2%. Because surgeons and other healthcare staff in sub-Saharan Africa are at risk for HIV exposure from their patients, an assessment of protective supplies and equipment was considered essential.


A Society of International Humanitarian Surgeons team in cooperation with the Sierra Leonean Ministry of Health and Sanitation undertook a survey of HIV-protective supplies and equipment at government hospitals in Sierra Leone. The presence of eye protection, sterile gloves, aprons, functioning suction machines, and sharps containers was recorded and compared with a local mission hospital and a local private hospital.


Only 20% of government hospitals in Sierra Leone have adequate stores of sterile gloves or eye protection. Suction pumps and aprons are available in only 30–40% of facilities, respectively, and only half have functioning sterilizers and sharps containers. The mission and private hospitals were fully stocked.


Although surgical healthcare workers are at risk for exposure to HIV, resources for their protection at government hospitals in Sierra Leone are severely lacking. The Society of International Humanitarian Surgeons is developing a program to provide protective supplies and equipment to hospitals in Sierra Leone, but additional efforts by other organizations working to decrease the spread of HIV are essential.


Healthcare Worker Acquire Immune Deficiency Syndrome Male Circumcision Government Hospital Universal Precaution 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Olapade-Olaopa EO, Salami MA, Afolabi AO (2006) HIV/AIDS and the surgeon. Afr J Med Med Sci 35(suppl):77–83PubMedGoogle Scholar
  2. 2.
    Davies CG, Khan MN, Ghauri AS, Ranaboldo CJ (2007) Blood and body fluid splashes during surgery—the need for eye protection and masks. Ann R Coll Surg Engl 89:770–772PubMedCrossRefGoogle Scholar
  3. 3.
    Marasco S, Woods S (1998) The risk of eye splash injuries in surgery. Aust N Z J Surg 68:785–787PubMedCrossRefGoogle Scholar
  4. 4.
    Consten EC, van Lanschot JJ, Henny PC, Tinnemans JG, van der Meer JT (1995) A prospective study on the risk of exposure to HIV during surgery in Zambia. AIDS 9:585–588PubMedCrossRefGoogle Scholar
  5. 5.
    Kedir M (2008) Seroprevalence, pattern and outcome of HIV/AIDS among surgical patients at Gondar University Hospital. Ethiop Med J 46:15–18PubMedGoogle Scholar
  6. 6.
    Mkony C, Kwesigabo G, Lyamuya E, Mhalu F (2003) Prevalence and clinical presentation of HIV infection among newly hospitalised surgical patients at Muhimbili National Hospital, Dar es Salaam, Tanzania. East Afr Med J 80:640–645PubMedGoogle Scholar
  7. 7.
    Lewis DK, Callaghan M, Phiri K et al (2003) Prevalence and indicators of HIV and AIDS among adults admitted to medical and surgical wards in Blantyre, Malawi. Trans R Soc Trop Med Hyg 97:91–96PubMedCrossRefGoogle Scholar
  8. 8.
    Obi SN, Waboso P, Ozumba BC (2005) HIV/AIDS: occupational risk, attitude and behaviour of surgeons in southeast Nigeria. Int J STD AIDS 16:370–373PubMedGoogle Scholar
  9. 9.
    Ozgediz D, Galukande M, Mabweijano J et al (2008) The neglect of the global surgical workforce: experience and evidence from Uganda. World J Surg 32:1208–1215PubMedCrossRefGoogle Scholar
  10. 10.
  11. 11.
    Bailey RC, Moses S, Parker CB et al (2007) Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial. Lancet 369(9562):643–656PubMedCrossRefGoogle Scholar
  12. 12.
  13. 13.
    Aisien AO, Ujah IA (2006) Risk of blood splashes to masks and goggles during cesarean section. Med Sci Monit 12:CR94–CR97PubMedGoogle Scholar
  14. 14.
    Adebamowo CA, Ezeome ER, Ajuwon JA, Ogundiran TO (2002) Survey of the knowledge, attitude and practice of Nigerian surgery trainees to HIV-infected persons and AIDS patients. BMC Surg 2:7PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  • T. Peter Kingham
    • 1
    • 4
  • T. B. Kamara
    • 2
  • K. S. Daoh
    • 3
  • Soccoh Kabbia
    • 3
  • Adam L. Kushner
    • 4
  1. 1.Department of Surgical OncologyMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of SurgeryConnaught HospitalFreetownSierra Leone
  3. 3.Ministry of Health and SanitationFreetownSierra Leone
  4. 4.Society of International Humanitarian SurgeonsNew YorkUSA

Personalised recommendations