Surgery and Healing in the Developing World - Dartmouth-Hitchcock

Surgical Training of Nurses for Rural Areas
Table 6. Distribution according to the type of Anaesthesia used
Type of Anaesthesia Number %
Ketalar 387 42.2
Spinal 329 35.8
General with intubation 137 14.9
Local 65 7.2
TOTAL 918
383
Anaesthesia (6 weeks)
Minor surgery, anaesthesia and consultation (1 month)
Assistance in minor surgical cases, consultations and ward rounds (1 month)
Major surgical operations (7 months).
Responsibility; for surgical emergencies and routine operations (3 months)
At the end of his or her stay, the nurse must be able to do all the urgent, routine
surgery, and then some of the urgent sugery which is seen less frequently. Finally he/
she is involved in elective routine and nonroutine surgery.
Results
By the end of their training, the nurses had given local anaesthetics (4.7%),
spinal anaesthesia (69.6%) and to give a general anaesthesia using Ketalar (25.7%).
They were able to do endotracheal intubation, but this is less important as their
health centres would have the facilities for this.
Seven nurses have already been trained since we initiated this programme. Up to
now all these nurses have worked in remote places in the bush, the most distant ones
Table 7. Type of work done by the three nurses
(a) Surgery Performed
Station General Surgery Orthopedics Gyn-Ob Urology Total
Adi 211 25 159 2 397
Aru 73 0 119 0 192
Aungba 36 3 35 2 76
(a) Type of Anaesthesia Used
Station Local Spinal Ketalar Other Total
Adi 20 275 102 0 397
Aru 8 34 50 0 192
Aungba 3 54 19 0 76
TOTAL 31 463 171 0 665
36