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Measuring Global Surgical Disparities: A Survey of Surgical and Anesthesia Infrastructure in Bangladesh

World Journal of Surgery volume 37, pages 24–31 (2013)Cite this article

Abstract

Background

Surgically treatable diseases weigh heavily on the lives of people in resource-poor countries. Though global surgical disparities are increasingly recognized as a public health priority, the extent of these disparities is unknown because of a lack of data. The present study sought to measure surgical and anesthesia infrastructure in Bangladesh as part of an international study assessing surgical and anesthesia capacity in low income nations.

Methods

A comprehensive survey tool was administered via convenience sampling at one public district hospital and one public tertiary care hospital in each of the seven administrative divisions of Bangladesh.

Results

There are an estimated 1,200 obstetricians, 2,615 general and subspecialist surgeons, and 850 anesthesiologists in Bangladesh. These numbers correspond to 0.24 surgical providers per 10,000 people and 0.05 anesthesiologists per 10,000 people. Surveyed hospitals performed a large number of operations annually despite having minimal clinical human resources and inadequate physical infrastructure. Shortages in equipment and/or essential medicines were reported at all hospitals and these shortages were particularly severe at the district hospital level.

Conclusions

In order to meet the immense demand for surgical care in Bangladesh, public hospitals must address critical shortages in skilled human resources, inadequate physical infrastructure, and low availability of equipment and essential medications. This study identified numerous areas in which the international community can play a vital role in increasing surgical and anesthesia capacity in Bangladesh and ensuring safe surgery for all in the country.

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Acknowledgments

The authors are grateful to the Bangladesh Ministry of Health and Family Welfare, members of the Obstetrical and Gynaecological Society of Bangladesh, the Bangladesh Society of Anaesthesiologists, the Society of Surgeons of Bangladesh, and other professional organizations, hospital directors, physicians, and staff, without whose help and incomparable hospitality this study would never have been possible.

Conflict of interest

None.

Author information

Affiliations

  1. Thomas J. Watson Foundation, 11 Park Place, New York, NY, 10007, USA

    Drake G. LeBrun

  2. North South University, 15 Ariful Haque Chowdhury Road, Dhaka, Bangladesh

    Debashish Dhar

  3. Dhaka Medical College Hospital, Ramna, Dhaka, Bangladesh

    Md. Imran H. Sarkar

  4. Shahid Suhrawardi Medical College, Shar-e-Bangla Nagar, Dhaka, Bangladesh

    T. M. Tanzil A. Imran

  5. Tejgaon College, 16 Indira Road, Farmgate, Dhaka, Bangladesh

    Sayadat N. Kazi

  6. Department of Anesthesiology, Vanderbilt University, 1301 Medical Center Drive, #4648 TVC, Nashville, TN, 37232, USA

    K. A. Kelly McQueen

  7. 3725 Kimble Dr, Plano, TX, 75025, USA

    Drake G. LeBrun

Authors
  1. Drake G. LeBrun
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  2. Debashish Dhar
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  3. Md. Imran H. Sarkar
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  4. T. M. Tanzil A. Imran
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  5. Sayadat N. Kazi
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  6. K. A. Kelly McQueen
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Corresponding author

Correspondence to Drake G. LeBrun.

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LeBrun, D.G., Dhar, D., Sarkar, M.I.H. et al. Measuring Global Surgical Disparities: A Survey of Surgical and Anesthesia Infrastructure in Bangladesh. World J Surg 37, 24–31 (2013). https://doi.org/10.1007/s00268-012-1806-7

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  • DOI: https://doi.org/10.1007/s00268-012-1806-7

Keywords

  • District Hospital
  • Clubfoot
  • Medical College Hospital
  • Village Doctor
  • Equipment Availability