Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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382 Surgery and Healing in the Developing World
Table 5. Routine surgery* (890 cases excluding ophthalmological operations:
28)
Operation Number %
Caesarean section 170 22.9
Dilatation and curettage 95 12.8
Herniorrhaphy 53 7.1
Hysterectomy 44 5.9
Skin graft 34 4.6
Diverse Biopsies 34 4.6
Tumour excision 33 4.4
Tubal ligation 33 4.4
Salpingectomy 32 4.3
Laparoscopy 26 3.5
Fracture reduction 24 3.2
Appendicectomy 17 2.3
Bone nailing 15 2.0
Hydrocelectomy 14 1.9
Ovarian cystectomy 14 1.9
Amputations 13 1.7
Drainage of the ATO & Adhesi 12 1.6
Sequestrectomy 12 1.6
Colostomy 11 1.5
Obstruction of the bowel 10 1.3
Other laparotomies 32 4.3
TOTAL 743
To help to decrease the surgical burden of the surgeon/physician (often busy
and alone) in our rural hospitals.
To be able to perform some basic operations which do not require advanced
surgical training and which can be performed in isolated areas and a long
way from centres of reference.
Conditions for Admission to the Programme
A nurse with a diploma (4 years after 4 years secondary school) or a degree (3
years university) preferably with at least two years of nursing experience.
Recommended by a community where the necessity of surgical assistance in
the health centre has clearly been shown.
Where the isolation of a rural health centre and the distance from a referral
centre does not mean total inaccessibility should emergency assistance be
required (e.g., at least an airstrip should be available).
The assurance of supervision by the district medical officer.
Distribution of Time Per Service During the Training of
Surgical Nurse (Total Duration: 18 Months).
Maternity: 1 month
Cleanliness of the operating room and of materials, and familiarity of surgical
instruments (2 weeks).