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ESSENTIAL SURGERY THROUGH SURGICAL HEAL THCARE DELIVERY PLATFORMS The 44 essential surgeries listed by WHO are critical to life, and 29 of them can be done at a district hospital. The bellwether procedures include caesarean sections, laparotomies and treatmen...

FURTHER READING Bath M, Bashford T , Fitzgerald JE. What is ‘global surgery’? Defining the multidisciplinary interface between surgery , anaesthesia and public health. BMJ Glob Health 2019; 4 (5): e001808. Debas HT , Donkor P , Gawande A et al. (eds). Essential...

GLOBAL SURGICAL METRICS AND RESEARCH Surgeons are familiar with vital-sign-based scoring systems for individual patients and with hospital metrics for inpatient hospital stay , surgical site infection or ventilator-associated pneumonia. Global surgery requires...

INTRODUCTION AND DEFINITION Global health is the health of populations in the global context. Global surgery is surgery with an understanding of public health. Surgeons understand the needs of their individual patients, while public health adds the understa...

CH A P T E R

Learning objectives To de /f_i ne: The term global surgery • To describe: The role of a global surgeon • To understand: That surgery can be cost-effective • Concepts of surgery and impoverishment • Learning objectives To de /f_i ne: The term global surgery • T...

SURGERY AND IMPOVERISHMENT Surgeons are tasked to operate and, in so doing, aim to successfully treat the surgical condition. A hernia not operated upon in a timely fashion costs the nation (and the individual) more when it becomes incarcerated. A delayed caes...

SURGERY AS AN ESSENTIAL AND COST-EFFECTIVE INTERVENTION With the decline in the burden of communicable diseases in the world, one-third of the total disease burden is now due to surgical disease, with the majority being injury and cancers. In 2015, respondin...

SURGERY AS AN ESSENTIAL AND COST-EFFECTIVE INTERVENTION With the decline in the burden of communicable diseases in the world, one-third of the total disease burden is now due to surgical disease, with the majority being injury and cancers. In 2015, respondin...

THE GLOBAL SURGICAL WORKFORCE A surgeon, anaesthetist and obstetrician (SAO) at the district hospital are considered essential sta ffi ng. In many LMICs the SAO density is less than 5 per 100 /uni00A0 000 population. As the SAO number increases, there is a drama...

ENVIRONMENT Children, especially infants, should be managed in a warm environment. Compared with adults, children lose more heat and fluid with surface area to weight ratios being higher; - Table Outline the presentation, resuscitation and operation for • pylor...

INTRODUCTION In high-income countries paediatric surgeons have subspecial ised, whereas in low-income countries surgeons must maintain diverse skills and knowledge. Some conditions, previously managed by paediatric surgeons, are now managed by others (e.g . cl...

Learning objectives After studying this chapter, you will be able to: Outline subspecialisations within children’s surgery • Safely prescribe perioperative /f_l uids in children • Compare and contrast inguinal hernias and hydroceles • Discuss the causes and ma...

Anorectal malformations In an anorectal malformation, there is usually no opening in boys, and the rectum ends either blindly (notably in aneuploi dies) or with a fistula to the bulbar urethra ( Figure 18.13a prostate or bladder neck. Occasionally , there is a ...

Biliary atresia/choledochal malformation Congenital or acquired (e.g. cytomegalovirus) extrahepatic biliary atresia is a progressive obliterative cholangiopathy with absent or narrow bile ducts. Type I involves the common bile duct, type II the common hepatic ...

Congenital mesoblastic nephroma This renal tumour may present as a large palpable mass in a newborn with some having hypertension and hypercal - caemia (paraneoplastic syndromes). Cross-sectional imaging distinguishes a tumour from a multicystic dysplastic kid...

Duodenal atresia The obstruction in duodenal atresia usually lies just distal to the ampulla of Vater. The proximal duodenum and pylorus dilate with swallowed amniotic fluid, rendering the pylorus temporarily incompetent. Occasionally , there is a web that may...

Exomphalos Exomphalos describes a central abdominal wall defect in which prolapsed viscera are covered in a thin, three-layered membrane (peritoneum, Wharton’s jelly and amnion) in continuity with the umbilical cord. Exomphalos minor (<5 /uni00A0 cm, liver not...