tailieunhanh - Báo cáo y học: " Providing surgical care in Somalia: A model of task shifting"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Providing surgical care in Somalia: A model of task shifting. | Chu et al. Conflict and Health 2011 5 12 http content 5 1 12 CONFLICT AND HEALTH RESEARCH Open Access Providing surgical care in Somalia A model of task shifting Kathryn M Chu1 2 Nathan P Ford1 3 and Miguel Trelles4 Abstract Background Somalia is one of the most political unstable countries in the world. Ongoing insecurity has forced an inconsistent medical response by the international community with little data collection. This paper describes the remote model of surgical care by Medecins Sans Frontieres in Guri-El Somalia. The challenges of providing the necessary prerequisites for safe surgery are discussed as well as the successes and limitations of task shifting in this resource-limited context. Methods In January 2006 MSF opened a project in Guri-El located between Mogadishu and Galcayo. The objectives were to reduce mortality due to complications of pregnancy and childbirth and from violent and nonviolent trauma. At the start of the program expatriate surgeons and anesthesiologists established safe surgical practices and performed surgical procedures. After January 2008 expatriates were evacuated due to insecurity and surgical care has been provided by local Somalian doctors and nurses with periodic supervisory visits from expatriate staff. Results Between October 2006 and December 2009 2086 operations were performed on 1602 patients. The majority 1049 65 were male and the median age was 22 interquartile range 17-30 . 1460 70 of interventions were emergent. Trauma accounted for 76 1585 of all surgical pathology gunshot wounds accounted for 89 584 of violent injuries. Operative mortality of all surgical interventions was not higher when Somalian staff provided care compared to when expatriate surgeons and anesthesiologists. Conclusions The delivery of surgical care in any conflict-settings is difficult but in situations where international support is limited the challenges are more extreme. In this model task shifting or the .