Surgery safe in conflict zones, aid group says

NEW YORK Tue Aug 17, 2010 5:45pm EDT

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NEW YORK (Reuters Health) - With a few simple precautions, surgery can be safely performed in conflict and post-conflict zones, doctors from an international aid group said Tuesday.

Earlier studies had suggested that putting people on the operating table in these areas -- often remote villages without established health services -- could be risky, with as many as one in 10 people dying during surgery.

"Even in resource-limited countries, emergency surgery can be safe," said Dr. Kathryn Chu, of Medecins Sans Frontieres (MSF), who led the new research. "There really is no excuse for having a high operative mortality rate."

Chu, whose findings appear in the Archives of Surgery, said there appeared to be a huge need for surgery in low-income countries, especially those plagued by war or natural disaster.

But, she added, "Nobody has really gone to these countries to find out what the needs are."

With colleagues from MSF, an international medical aid organization, Chu examined data from MSF programs in 13 developing countries, almost all of them sub-Saharan conflict or post-conflict zones.

They found that 31 deaths (0.2 percent) had occurred during nearly 20,000 surgeries, including emergency procedures, Cesarean sections and injuries.

"This study shows that on the operating table we are not doing too bad," Chu told Reuters Health.

But she added it was hard to compare the situation to high-income countries such as the U.S., because the doctors weren't able to follow the patients after they had surgery to see if they developed wound infections or other complications.

Chu said MSF's programs use both local and foreign staff. They all have certain minimum requirements, including things like clean water, electricity, sterilized equipment, blood products, antibiotics use and having a postoperative recovery unit.

Dr. T. Peter Kingham, founder of Surgeons OverSeas, a small New York City-based non-profit, said the new study stood out because few aid organizations collect data on surgical outcomes.

"It shows their system works," he told Reuters Health. "But this isn't necessarily representative of the outcomes in every low-income country."

Kingham said surgery had recently become a part of public health in many low-income countries that used to focus on vaccination and medicines.

"An article like this helps us focus on the fact that there are a lot of unmet needs for surgery," he said.

SOURCE: link.reuters.com/but55n Archives of Surgery, August, 2010.

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