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Clinical Orthopaedics and Related Research

, Volume 466, Issue 10, pp 2297–2305 | Cite as

ABJS/C.T. Brighton Workshop on Musculoskeletal Trauma in Developing Countries: Editorial Comment

  • David A. Spiegel
Symposium: ABJS/C.T. Brighton Workshop on Trauma in the Developing World

Injuries are a neglected epidemic in low- and middle-income countries (LMICs), accounting for 11% of the world’s disease burden in 2001, and ranking 11th in all causes for both mortality and morbidity [9]. Road traffic crashes are predicted to be the eighth leading cause of death, and the fourth leading cause of DALYs (disability adjusted life years) by 2030 [10]. Each year, many of the 20 to 50 million injury survivors are left with a permanent disability, most often related to the musculoskeletal system. The economic and social costs of injuries are profound, and undoubtedly contribute to the vicious cycle of poverty in many developing nations. Despite the weight of evidence of this huge burden, research concerning the prevention and treatment of injuries in LMICs has been underfunded, and limited resources have been allocated for strengthening the delivery of medical services for the injured, including surgical care. Providing universal access to safe, timely, and effective...

Notes

Acknowledgments

Along with course co-chairmen Mark Vrahas and John Dormans, I wish to thank all the individuals who dedicated their time and energy to the workshop. It was a pleasure for us to make new friends, and to share knowledge and experiences with colleagues from around the world. Special thanks go to our local host Manjul Joshipura, a champion in the quest to strengthen trauma care systems globally. We thank Meena Cherian and Charles Mock for broadening our perspective on the delivery of musculoskeletal trauma care, and Richard Brand for his leadership, editorial assistance, and support throughout the entire process. Colette Hohimer worked tirelessly on organizing the workshop and maintaining communication with the course chairs, members of the steering committee, and all of the workshop participants. We recognize the efforts of the ABJS/ CT Brighton Workshop Steering Committee (Manjul Joshipura, Marcos Musafir, Mahendra Patel, Wahid Al-Kharusi, John Dormans, Cyril Toma, Mark Vrahas, Bruce Browner, and Richard Brand). Special thanks go to the workshop participants (Appendix 1) for their excellent presentations, and their contributions to the breakout sessions. Finally, we would like to recognize our sponsors, the Association of Bone and Joint Surgeons, the Orthopaedic Research and Education Foundation, Synthes, and the Stryker Company.

References

  1. 1.
    Cherian MN, Noel L, Buyanjargal Y, Govind S. Essential emergency surgical procedures in resource-limited facilities: A WHO workshop in Mongolia. World Hosp Health Serv. 2004;40:24–29.PubMedGoogle Scholar
  2. 2.
    Data and Statistics. The World Bank Web site. Available at: http://go.worldbank.org/D7SN0B8YU0. Accessed February 18, 2008.
  3. 3.
    Debas HT, Gosselin RA, McCord C, Thind A. Surgery. In: Jamison DT, World Bank, Disease Control Priorities Project, eds. Disease Control Priorities in Developing Countries, 2nd Ed. New York, NY: Oxford University Press; 2006:1245–1260.Google Scholar
  4. 4.
    Gosselin RA, Thind A, Bellardinelli A. Cost/DALY averted in a small hospital in Sierra Leone: what is the relative contribution of different services? World J Surg. 2006;30:505–511.PubMedCrossRefGoogle Scholar
  5. 5.
    Gross National Income per capita 2007, Atlas method and PPP. World Bank Web site. Available at: http://siteresources.worldbank.org/DATASTATISTICS/Resources/GNIPC.pdf. Accessed February 18, 2008.
  6. 6.
    Integrated Management for Emergency and Essential Surgical Care tool kit. WHO Web site. Available at: www.who.int/surgery/publications/imeesc. Accessed July 3, 2008.
  7. 7.
    Jena TK, Agarwal AK. Surgical training-distance education. A training tool for rural surgeons. Ind J Surg. 2003;65:50–54.Google Scholar
  8. 8.
    Laxminarayan R, Mills AJ, Breman JG, Measham AR, Alleyne G, Claeson M, Jha P, Musgrove P, Chow J, Shahid-Salles S, Jamison DT. Advancement of global health: key messages from the Disease Control Priorities Project. Lancet. 2006;367:1193–1208.PubMedCrossRefGoogle Scholar
  9. 9.
    Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, eds. Global Burden of Disease and Risk Factors. New York, NY: World Bank and Oxford University Press; 2006.Google Scholar
  10. 10.
    Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3:e442.PubMedCrossRefGoogle Scholar
  11. 11.
    Mock CN, Lormand JD, Goosen J, Joshipura M, Peden M, eds. Guidelines for Essential Trauma Care. Geneva, Switzerland: World Health Organization; 2004.Google Scholar
  12. 12.
    Onuminya JE. Performance of a trained traditional bonesetter in primary fracture care. S Afr Med J. 2006;96:320–322.PubMedGoogle Scholar
  13. 13.
    Per capita health expenditure: World Health Report 2006. WHO Web site. Available at: http://www.who.int/whr/2006/annex/06_annex3_en.pdf. Accessed July 21, 2008.
  14. 14.
    Spiegel DA, Gosselin R. Surgical services in low-income and middle-income countries. Lancet. 2007;370:1013–1015.PubMedCrossRefGoogle Scholar
  15. 15.
    Surgical Care at the District Hospital—The WHO Manual. WHO Web site. Available at: www.who.int/surgery/publications/scdh_manual. Accessed July 3, 2008.
  16. 16.
    Weiser TG, Regenbogen S, Thompson K, Haynes A, Lipsitz S, Berry W, Gawande AA. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008; June 24 epub ahead of print.Google Scholar
  17. 17.
    World Health Statistics 2007. Life expectancy at birth (estimates for 2006). WHO Web site. Available at: www.who.int/whosis/whostat2007/en/index.html. Accessed February 18, 2008.
  18. 18.
    World Health Statistics 2007. Number of physicians and physician density. WHO Web site. Available at: www.who.int/whosis/whostat2007/en/index.html. Accessed February 18, 2008.
  19. 19.
    World Health Statistics 2007. Population. WHO Web site. Available at: www.who.int/whosis/whostat2007/en/index.html. Accessed February 18, 2008.

Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  1. 1.Division of Orthopaedic SurgeryChildren’s Hospital of Philadelphia, University of Pennsylvania School of MedicinePhiladelphiaUSA

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