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The Role of Anesthesiology in Global Health pp 117–126Cite as

Anesthesia in Resource-Poor Settings: The Médecins Sans Frontières Experience

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Abstract

Médecins Sans Frontières/Doctors Without Borders (MSF) has been running surgical programs since the early 1980s. This chapter provides an overview of the anesthesia component of these programs and explores some lessons learned from the experience of one of MSF’s five Operations Centers—in this case, the Belgium-based unit (MSF-Belgium). During the period from 2010 until the end of 2013, these projects provided surgical care to more than 56,000 surgical patients in 23 countries and performed over 73,000 surgical procedures. This experience has shown that surgeons and anesthetists need to discard preconceived notions of an inevitable link between the technical complexity of surgical and anesthesia techniques and the ability to reduce morbidity and mortality. On the contrary, MSF has found that keeping our interventions simple, accessible and sustainable within a given context is often the most effective way to best serve the needs of the many.

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References

  1. Chu K, Rosseel P, Trelles M, et al. Surgeons without borders: a brief history of surgery at Médecins Sans Frontières. World J Surg. 2010;34(3):411–4.

    Article  PubMed  Google Scholar 

  2. Meara JG, Hagander L, Leather AJM. Surgery and global health: a Lancet Commission. Lancet. 2014;383(9911):12–3.

    Article  PubMed  Google Scholar 

  3. Lavy C, Sauveen K, Mkandawine N, et al. State of surgery in tropical Africa: a review. World J Surg. 2011;35(2):262–71.

    Article  PubMed  Google Scholar 

  4. Grimes CE, Henry JA, Maraka J, et al. Cost-effectiveness of surgery in low- and middle-income countries: a systematic review. World J Surg. 2014;38(1):252–63.

    Article  PubMed  Google Scholar 

  5. Gosselin RA, Maldonado A, Elder G. Comparative cost-effectiveness analysis of two MSF surgical trauma centers. World J Surg. 2010;34(3):415–9.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Spiegel D, Gosselin R. Surgical services in low-income and middle-income countries. Lancet. 2007;370(9592):1013–5.

    Article  PubMed  Google Scholar 

  7. Wong EG, Trelles M, Dominguez L, et al. Surgical skills needed for humanitarian missions in resource-limited settings: common operative procedures performed at Médecins Sans Frontières facilities. Surgery. 2014;156(3):642–9.

    Article  PubMed  Google Scholar 

  8. Debas HT. Disease control priorities in developing countries. In: Jamison D et al., editors. Disease control priorities in developing countries. New York: Oxford University Press; 2006. p. 1245–60.

    Google Scholar 

  9. World Health Organization. Pulse oximetry training manual, Geneva. 2011. www.who.int/patientsafety/safesurgery/pulse_oximetry/tr_material/en/.

  10. Luboga S, Mcfarlane SB, von Schreeb J, et al. Increasing access to surgical services in Sub-Saharan Africa; priorities for national and international agencies recommended by the Bellagio Essential Surgery Group. PLoS Med. 2009;6(12):1–5.

    Article  Google Scholar 

  11. Chu KM, Ford NP, Trelles M. Providing surgical care in Somalia: a model of task shifting. Confl Health. 2010;5:12. doi:10.1186/1752-1505-5-12.

    Article  Google Scholar 

  12. Ginzburg E, O’Neill WW, Goldschmidt-Clermont PL, et al. Rapid medical relief—Project Medishare and the Haitian earthquake. N Engl J Med. 2010;362:e31. doi:10.1056/NEJMp1002026.

    Article  CAS  PubMed  Google Scholar 

  13. Mavalankar D, Sriram V. Provision of anaesthesia services for emergency obstetric care through task shifting in South Asia. Reprod Health Matters. 2009;17(33):21–31.

    Article  PubMed  Google Scholar 

  14. Chu KM, Trelles M, Ford NP. Quality of care in humanitarian surgery. World J Surg. 2011;35(6):1169–73.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Dawson AJ, Buchan J, Duffield C, Homer CS, Wijewardena K. Task shifting and sharing in maternal and reproductive health in low-income countries: a narrative synthesis of current evidence. Health Policy Plan. 2014;29(3):396–408.

    Article  PubMed  Google Scholar 

  16. Marchbein D. Humanitarian surgery: a call to action for anesthesiologists. Anesthesiology. 2013;119(5):1001–2.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. MSF-Belgium, Brussels, Belgium

    Miguel Trelles

  2. MSF-USA, New York, NY, USA

    Patricia Kahn & Jason Cone

  3. Epicentre, New York, NY, USA

    Carrie Teicher

Authors
  1. Miguel Trelles
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  2. Patricia Kahn
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  3. Jason Cone
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  4. Carrie Teicher
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Corresponding author

Correspondence to Miguel Trelles .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA

    Ram Roth

  2. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA

    Elizabeth A.M. Frost

  3. Department of Anesthesiology, LSU Health Sciences Center, New Orleans, Louisiana, USA

    Clifford Gevirtz

  4. Department of Anesthesiology, Oregon Anesthesiology Group, Adventist Medical Center, Portland, Oregon, USA

    Carrie L.H. Atcheson

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© 2015 Springer International Publishing Switzerland

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Trelles, M., Kahn, P., Cone, J., Teicher, C. (2015). Anesthesia in Resource-Poor Settings: The Médecins Sans Frontières Experience. In: Roth, R., Frost, E., Gevirtz, C., Atcheson, C. (eds) The Role of Anesthesiology in Global Health. Springer, Cham. https://doi.org/10.1007/978-3-319-09423-6_9

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  • DOI: https://doi.org/10.1007/978-3-319-09423-6_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-09422-9

  • Online ISBN: 978-3-319-09423-6

  • eBook Packages: MedicineMedicine (R0)

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