Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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176 Surgery and Healing in the Developing World
of a nylon pursestring suture around the bladder neck which is brought out the
abdominal wall and tied over gauze or a button. It is removed 48 h later. This technique
guarantees more sleep for the surgeon but also saves a great deal of costs for
irrigation fluid, blood transfusions and nursing care. It also reduces complications.
Summary
In the US 13% or more of a very large gross national product is spent on health
care. In many countries, less than 1% of the national budget is spent on health care.
Much of this should be spent on preventive care and healthy water and sewer systems.
Yet many health conditions will require surgery, regardless of how much education
and prevention is emphasized. It is truly possible to do many operations at a
total hospital cost of $US25 per case with appropriate measures in place where labor
costs are inexpensive. Cost-cutting efforts in the developed world are gaining new
emphasis. It may well be that the men and women who have labored hard and long
in the developing world will have much to teach their colleagues abroad.
Acknowledgments
The author gratefully acknowledges the suggestions and input from Dr. Bill Ardill
MD, FACS, current Associate Lecturer in Surgery, University of Jos, Jos, Nigeria
and Dr. Don Meier MD, FACS, Department of Pediatric Surgery, University of
Texas Southwestern Medical School and former Consultant Surgeon, Baptist Medical
Centre, Ogbomosho, Nigeria.
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