Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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1 4 Surgery and Healing in the Developing World with a number greater than 15, Tums, (or its equivalent) an ointment for rash, simple bandages, a tweezers, lip balm, an ear syringe if you are prone to wax buildup, You may wish to ask your dentist for CAVIT to temporarily replace a lost filling. A Swiss knife provides one with many handy little tools. Post 9/11 this should be carried only in checked luggage. Carry with you your eyeglass prescription in case your glasses are lost, broken or stolen. The matter of your water supply is of great importance. In much of the developing world, available water sources cannot be relied upon to provide safe water. It may be wise for you bring along a water purification device. There are many of these available, coming in all shapes, sizes and prices. At least one company has a “travel cup” available; it purifies water poured into it in 30 seconds and can be used over and over to a total of 60 gallons. This can be purchased from TEALBROOK in Hastings, MN. Their fax is 612-480-8786; email is tealbrook@aol.com. In general, any drinks made with boiled water, (tea, coffee, etc.) can be safely consumed; this should be true also of bottled beer or soft drinks. Ice cubes are always suspect since you cannot know their water source. Bottled water too must always be viewed with some question in that bottled water is no safer than its source, which may be very questionable. Planning for leisure time is important. Take along tapes and cassettes but do take along a player which is or can be battery powered. (and take extra batteries). Electrical power in developing countries is usually not available on a full time and dependable basis. In one of the countries in which I have worked (the name of the country will remain unmentioned) the power company was named NEPA; on the basis of its sporadic performance, we took this acronym to mean “never enough power always”. Take along enough books and magazines to carry you through as well. A journal will help you very much in recalling details of your experience after you return. This may be a written journal or you may wish to dictate your journal into a recorder, which again should be battery powered. And take plenty of photos and or videos. Video has the advantage of timely narration. These will be priceless for you personally and will help you very much in sharing your experience with interested friends. When you get your photos back, write pertinent details on the back immediately; details become fuzzy much sooner than expected. Before taking photos however, be certain that doing so is acceptable to the people you are interacting with. Certain cultures believe that picture taking will bring a curse upon the person being photographed. Other cultures believe that these photos will be presented in a demeaning way in the First World and therefore are not at all interested in being photographed. One way of encouraging cooperation is to take along a polaroid camera; if you can show immediately what you have captured on film and can give them a copy, this will break down a lot of resistance and produce a lot of rapport. And do allow them to “dress up” for pictures; you will have many opportunities to get photos of everyday activities in everyday dress. Malaria is a very real problem in many parts of the world. For many years, all four of the Plasmodium species were susceptible to chloroquine, which was well tolerated and quite inexpensive. It was used both for prophylaxis and treatment. As time goes on, however, more and more areas are showing resistance to chloroquine; this is especially true of P. falciparum. Therefore, the recommended antimalarial for prophylaxis in most areas no longer is chloroquine but Mefloquine. In the US, Roche markets this under the trade name Lariam. It is quite expensive. It must be taken once per week and must be started one week before arriving in a malarial area
Preparation Time and after return it must be taken for four weeks. Mefloquine has gotten bad press in Europe and many European countries recommend that chloroquine plus paludrine be used as a prophylaxis. Protection with this regimen is definitely inferior to that achieved with Mefloquin (which I have used repeatedly without side effects) and the newer Malarone (Glaxo Smith Kline). Malarone must be taken daily and is quite expensive. There are several malaria self-test kits available today but none of them has proved entirely satisfactory. If you with to pursue this further, I would advise calling CDC in Atlanta directly and ask to speak to one of the experts in the Malaria Section. 1-800-311-3435 may be a helpful number. 5 1
Page 1 and 2: Surgery and Healing in the Developi
Page 3 and 4: Contents Foreword .................
Page 5 and 6: 25. Dentistry .....................
Page 7 and 8: Editor Contributors Harold P. Adolp
Page 9: Foreword Surgery and Healing in the
Page 12 and 13: “poor, but modern”, as for exam
Page 14 and 15: There may be at least one considera
Page 16 and 17: It is that higher accountability th
Page 18 and 19: 1 2 Surgery and Healing in the Deve
Page 22 and 23: CHAPTER 2 Surgery in Developing Cou
Page 24 and 25: 2 8 Surgery and Healing in the Deve
Page 26 and 27: 2 10 Surgery and Healing in the Dev
Page 34 and 35: CHAPTER 4 International Surgical Ed
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7 54 Surgery and Healing in the Dev
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CHAPTER 9 Lab-in-a-Suitcase: Saving
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10 72 Surgery and Healing in the De
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CHAPTER 12 Communication in the Thi
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CHAPTER 13 Anesthesia in the Third
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13 100 Surgery and Healing in the D
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CHAPTER 15 Basic Obstetrics and Obs
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CHAPTER 16 Pointers for American Su
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CHAPTER 20 Chronic Pyogenic Osteomy
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CHAPTER 23 Cleft Lip and Palate Sur
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CHAPTER 24 Outreach Dentistry: A Wo
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CHAPTER 1 CHAPTER 26 Reconstructive
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Reconstructive Surgery in the Tropi
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CHAPTER 1 CHAPTER 27 Factors Influe
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Distribution and Incidence of Tropi
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CHAPTER 1 CHAPTER 28 Population Dyn
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Population Dynamics Of Surgical Tro
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Metabolic Maladaptation 289 Introdu
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Metabolic Maladaptation 291 some of
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Metabolic Maladaptation 293 In this
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Metabolic Maladaptation Table 1. Si
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Metabolic Maladaptation Table 4. Go
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Metabolic Maladaptation 299 the rev
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Metabolic Maladaptation Table 5. As
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Metabolic Maladaptation Table 6. Co
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Metabolic Maladaptation 305 the ris
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Metabolic Maladaptation Table 8. Go
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Metabolic Maladaptation Table 10. G
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Metabolic Maladaptation Table 12. C
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Metabolic Maladaptation 313 cell an
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Metabolic Maladaptation 315 Biologi
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Metabolic Maladaptation 317 from io
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Metabolic Maladaptation 319 25. Lon
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CHAPTER 1 CHAPTER 30 Nutrition and
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Nutrition and Development in Africa
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CHAPTER 1 CHAPTER 31 Uterine Ruptur
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Uterine Ruptures in Rural Zaire Tab
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Uterine Ruptures in Rural Zaire 329
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CHAPTER 1 CHAPTER 32 Vesicovaginal
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Vesicovaginal Fistula in Democratic
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CHAPTER 1 CHAPTER 33 Ophthalmology
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Ophthalmology Figure 2. Refractive
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Ophthalmology Figure 4. A tonometer
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Ophthalmology 341 ml of 40 mg/ml IV
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Ophthalmology Figure 6. Axis determ
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Ophthalmology 345 thalmic set prepa
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Ophthalmology 347 Procedures Region
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Accommodating Deficits in Material
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Abscesses and Other Infections Trea
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CHAPTER 1 CHAPTER 36 Surgical Train
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Surgical Training of Nurses for Rur
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Training of Medical Assitants in Mo
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CHAPTER 1 CHAPTER 38 Training Surge
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Training Surgeons in the Developing
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Mobile Surgery Figure 1. 405 of tec
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Mobile Surgery Figure 3. 407 Childr
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Mobile Surgery 409 We have realized
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CHAPTER 1 CHAPTER 40 Public Health
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Public Health Problems on Burma Fro
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Medical Adventures in the Nigerian
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CHAPTER 1 CHAPTER 42 Wanted Glenn G
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Wanted 431 Studies Center (//www.am
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Wanted 433 MacArthur (The John D. a
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Wanted 435 most pathologic presenta
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Wanted 437 “outliers” in the he
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World Health 439 challenge: name fo
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CHAPTER 1 CHAPTER 44 Treating Other
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Treating Others: Human Sciences in
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Treating Others: Human Sciences in
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CHAPTER 1 CHAPTER 45 The Impact of
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The Impact of a Volunteer Medical M
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CHAPTER 1 CHAPTER 46 Field Notes on
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Field Notes on a Typical Day in a H
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