Skip to main content

Advertisement

SpringerLink
Log in

Surgical Care in the Solomon Islands: A Road Map for Universal Surgical Care Delivery

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Access to surgical care and emergency obstetrical care is limited in low-income countries. The Solomon Islands is one of the poorest countries in the Pacific region. Access to surgical care in Solomon Islands is limited and severely affected by a country made up of islands. Surgical care is centralized to the National Referral Hospital (NRH) on Guadalcanal, leaving a void of care in the provinces where more than 80% of the people live.

Methods

To assess the ability to provide surgical care to the people living on outer islands in the Solomon Islands, the provincial hospitals were evaluated using the World Health Organization’s Global Initiative for Emergency and Essential Surgical Care Needs Assessment Tool questionnaire. Data on infrastructure, workforce, and equipment available for treating surgical disease was collected at each provincial hospital visited.

Results

Surgical services are centralized to the NRH on Guadalcanal in Solomon Islands. Two provincial hospitals provide surgical care when a surgeon is available. Six of the hospitals evaluated provide only very basic surgical procedures. Infrastructure problems exist at every hospital including lack of running water, electricity, adequate diagnostic equipment, and surgical supplies. The number of surgeons and obstetricians employed by the Ministry of Health is currently inadequate for delivering care at the outer island hospitals.

Conclusions

Shortages in the surgical workforce can be resolved in Solomon Islands with focused training of new graduates. Training surgeons locally, in the Pacific region, can minimize the “brain drain.” Redistribution of surgeons and obstetricians to the provincial hospitals can be accomplished by creating supportive connections between these hospitals, the NRH, and international medical institutions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Anonymous (2007) Bellagio Essential Surgical Group Report. http://globalhealthsciences.ucsf.edu/bellagio/docs/bellagio_report.pdf. Accessed 26 Oct 2010

  2. Kushner AL, Cherian MN, Noel L et al (2010) Addressing the millennium development goals from a surgical perspective: essential surgery and anesthesia in 8 low- and middle-income countries. Arch Surg 145:154–159

    Article  PubMed  Google Scholar 

  3. Anonymous (2005) WHO report: WHO meeting towards a global initiative for emergency and essential surgical care (GIEESC). http://www.who.int/surgery/mission/GIEESC2005_Report.pdf. Accessed 26 Oct 2010

  4. Kingham TP, Kamara TB, Cherian MN et al (2009) Quantifying surgical capacity in Sierra Leone: a guide for improving surgical care. Arch Surg 144:122–127

    Article  PubMed  Google Scholar 

  5. Anonymous (2009) United Nations Development Programme. UNDP human development report 2009: overcoming barriers: human mobility and development. Palgrave Macmillan, Washington, DC

    Google Scholar 

  6. Anonymous (2009) World Bank Gross National Income Per Capita 2009. http://siteresources.worldbank.org/DATASTATISTICS/Resources/GNIPC.pdf

  7. Anonymous (2009) National parliament report of Solomon Islands, Special Select Committee on the Quality of Medical Services at the National Referral Hospital. NP-paper no. 51/2009

  8. Anonymous (2010) WHO Health Care in Solomon Islands. http://www.wpro.who.int/NR/rdonlyres/89FB09F8-751D-4688-BB5D-08ABF4C27807/0/35SolomonIslands08.pdf. Accessed 26 Oct 2010

  9. Anonymous (2010) Solomon Islands UNGASS country progress report 2010. http://data.unaids.org/pub/Report/2010/solomonislands_2010_country_progress_report_en.pdf

  10. Debas HT, Gosselin R, McCord C et al (2006) Surgery. In: Jamison D (ed) Disease control priorities in developing countries, 2nd edn. World Bank, Washington, DC, pp 1245–1260

    Google Scholar 

  11. Farmer PE, Kim JY (2008) Surgery and global health: a view from beyond the OR. World J Surg 32:533–536

    Article  PubMed  Google Scholar 

  12. Perkins S, Casey K, McQueen K (2010) Addressing the global burden of surgical disease: proceedings from the 2nd annual symposium at the American College of Surgeons. World J Surg 34:371–373

    Article  PubMed  Google Scholar 

  13. Theo V (2009) Improving the quantitative basis of the surgical burden in low-income countries. www.plosmedicine.org

  14. Weiser T, Regenbogen S, Thompson K et al (2008) An estimation of the global volume of surgery: a modeling strategy based on available data. Lancet 372:139–144

    Article  PubMed  Google Scholar 

  15. Paxton A, Bailey P, Lobis S et al (2006) Averting maternal death and disability: global patterns in availability of emergency obstetric care. Int J Gynecol Obstet 93:300–307

    Article  CAS  Google Scholar 

  16. Bickler S, Ozgediz D, Gosselin R et al (2010) Key concepts for estimating the burden of surgical conditions and the unmet need for surgical care. World J Surg 34:374–380

    Article  PubMed  Google Scholar 

  17. Nordberg EM (1984) Incidence and estimated need of caesarean section, inguinal hernia repair, and operation for strangulated hernia in rural Africa. Br Med J (Clin Res Ed) 289:92–93

    Article  CAS  Google Scholar 

  18. Blanchard RJ, Blanchard ME, Toussignant P et al (1987) The epidemiology and spectrum of surgical care in district hospitals of Pakistan. Am J Public Health 77:1439–1445

    Article  PubMed  CAS  Google Scholar 

  19. Mhando S, Young B, Lakhoo K (2008) The scope of emergency paediatric surgery in Tanzania. Pediatr Surg Int 24:219–222

    Article  PubMed  CAS  Google Scholar 

  20. Contini S, Taqdeer A, Cherian M et al (2010) Emergency and essential surgical services in Afghanistan: still a missing challenge. World J Surg 34:473–478

    Article  PubMed  Google Scholar 

  21. Althabe F, Sosa C, Belizan JM et al (2006) Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high-income countries: an ecological study. Birth 33:270–277

    Article  PubMed  Google Scholar 

  22. Sani R, Nameoua B, Yahaya A et al (2009) The impact of launching surgery at the district level in Niger. World J Surg 33:2063–2068

    Article  PubMed  Google Scholar 

  23. Ozgediz D, Galukande M, Mabweijano J et al (2008) The neglect of the global surgical workforce: experience and evidence from Uganda. World J Surg 32:1208–1215

    Article  PubMed  Google Scholar 

  24. Gosselin R, Gyamfi Y, Contini S (2011) Challenges of meeting surgical need in the developing world. World J Surg 35:258–261

    Article  PubMed  Google Scholar 

  25. WHO GIEESC: strategies. http://www.who.int/surgery/en. Accessed 1/2011

  26. Chung S, Watters D (2008) Academic surgery in Papua New Guinea. ANZ J Surg 78:347–349

    Article  PubMed  Google Scholar 

  27. Gruen R (2006) Template for surgical training in resource-poor countries. ANZ J Surg 76:871–872

    Article  PubMed  Google Scholar 

  28. Kevau I, Watters D (2006) Specialist surgical training in Papua New Guinea: the outcome after 10 years. ANZ J Surg 76:937–941

    Article  PubMed  Google Scholar 

  29. Solomon Islands NCD Risk Factors. STEPS Report. WHO Western Pacific region. http://www.who.int/chp/steps/2006_Solomon_Islands_STEPS_Report.pdf. Accessed 11/2010

  30. Brauchli K, Jagilly R, Oberli H (2004) Telepathology on the Solomon Islands: a two year experience with a hybrid Web and email based telepathology system. J Telemed Telecare 10(Suppl 1):14–17

    Article  PubMed  Google Scholar 

  31. Riviello R, Ozgediz D, Hsia R et al (2010) Role of collaborative academic partnerships in surgical training, education, and provision. World J Surg 34:459–465

    Article  PubMed  Google Scholar 

  32. Anonymous (2008) Ministry of health and medical services and health sector support program 2008 annual report, vol III, Attachment 6. National Referral Hospital Bed Statement Annual Report

  33. Chu K, Rosseel P, Gielis P, et al (2009) Surgical task shifting in Sub-Saharan Africa. www.plosmedicine.org

  34. Rosseel P, Trelles M, Guilavogui S et al (2010) Ten years of experience training non-physician anesthesia providers in Haiti. World J Surg 34:453–458

    Article  PubMed  Google Scholar 

  35. Mullan F, Frehywot S (2007) Non-physician clinicians in 47 sub-Saharan African countries. Lancet 370:2158–2163

    Article  PubMed  Google Scholar 

  36. Pereira C, Bugalho A, Bergstrom S et al (1996) A comparative study of ceasarean deliveries by assistant medical officers and obstetricians in Mozambique. Br J Obstet Gynaecol 103:508–512

    Article  PubMed  CAS  Google Scholar 

  37. Feasly J, Lawrence R (1998) Pacific partnerships for health: charting a new course. National Academy Press, Washington, DC

    Google Scholar 

Download references

Acknowledgment

The authors funded this work personally.

Author information

Authors and Affiliations

  1. Loloma Foundation, Encinitas, CA, USA

    Eileen S. Natuzzi & Phillip L. Hendricks

  2. Society of International Humanitarian Surgeons, 225 East 6th Street, Suite 7F, New York, NY, 10003, USA

    Eileen S. Natuzzi & Adam Kushner

  3. William Moore Stack Foundation, Encinitas, CA, USA

    Eileen S. Natuzzi

  4. Department of Surgery, National Referral Hospital, Guadalcanal, Solomon Islands

    Rooney Jagilly, Douglas Pickacha & Dudley Ba’erodo

  5. Department of Anesthesia, National Referral Hospital, Guadalcanal, Solomon Islands

    Kaeni Agiomea

  6. Department of Obstetrics and Gynecology, National Referral Hospital, Guadalcanal, Solomon Islands

    Levi Hou

  7. Department of Orthopedic Surgery, National Referral Hospital, Guadalcanal, Solomon Islands

    Patrick Houasia

Authors
  1. Eileen S. Natuzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adam Kushner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rooney Jagilly
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Douglas Pickacha
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kaeni Agiomea
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Levi Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Patrick Houasia
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Phillip L. Hendricks
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Dudley Ba’erodo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eileen S. Natuzzi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Natuzzi, E.S., Kushner, A., Jagilly, R. et al. Surgical Care in the Solomon Islands: A Road Map for Universal Surgical Care Delivery. World J Surg 35, 1183–1193 (2011). https://doi.org/10.1007/s00268-011-1097-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-011-1097-4

Keywords

Search

Navigation