Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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188 Surgery and Healing in the Developing World
Table 3. Amount of time spent at the hospital
Hospital Stay Average Range
Number of days 88.10 7 to 375
Number of Admissions 1.70 1 to 4
Financial Cost
Because of the daily rise in inflation during our country’s socio-economic crisis
and monetary reform, we made our calculation of the financial charges in US dollars.
The average cost of a day in the hospital was $ 2.77 per patient. The total cost
of taking care of CPO ranged from $ 49.48 to $ 563.84 per patient, with the average
being $ 243.89. This price was comprised of the hospital bed, bandages, medication
and surgical operations. At our hospital, the patients’ nutrition is their own
responsibility, with exceptions being made only for the very poor.
Distance of Patient from Health Centre Hospital
Our patients came from 42 localities in North-East of Democratic Republic of
Congo, which were classified as follows (Table 4). Group A: those coming from our
village itself (Nyankunde) or from the immediate surrounding area (Bunia, Tchomia,
Mongwalu, etc). This area has a reference hospital with a physician in charge. Group
B: those coming from localities where there is a health centre or post headed by a
nurse. Group C: those in localities where there is no health centre or post. The
villages of Group C are 2-5 km away from the hospital, health post where appropriate
care could be obtained. We excluded all cases of bone infection after an open
fracture.
Discussion
CPO has been and will remain a medical and social problem in our area. It’s high
frequency puts us back, as it were, into the “preantibiotic” area. At the dawn of the
21 st century, it is inconceivable to have such a high occurrence of a preventable
disease.
It has been shown in previous studies of CPO 5,6 that there was a male predominance,
and that the bones of lower limb (femur and tibia) were the most often
affected. Our study did not show a male predominance, but rather the distribution
between the sexes was almost equal. This indicates that the poor working conditions
in our area do not spare women. As stated by Ogunjumu, 5 barefoot walking, hard
Table 4. Distribution of patient localities
Group No. of Localities Percentage
A 12 28.57
B 20 47.62
C 10 23.81
Total 42 100.00