Surgery and Healing in the Developing World - Dartmouth-Hitchcock

CHAPTER 39
Mobile Surgery
Edgar Rodas and Edgar B. Rodas
Introduction
In this age of technology, informatics and communication, those of us who have
access to these amazing tools, have a great advantage and can utilize them for our
well-being and benefit. However, we cannot overlook the immense disparity that
exists between first and Third World countries. Therefore the word “globalization”
should make us reflect on the responsibility we must all share for bridging the immense
gap between these worlds.
In the medical field, an ongoing challenge in developing countries is acquiring
the means to reach the majority of the population and offer them the advances and
benefits of today´s science and technology. We have been able to equip and staff the
major hospitals with near the same capabilities as those seen in developed nations.
However due to the widespread geographical location of the patient population,
high costs, and inadequacy of roads and communications, these benefits are unfortunately
reachable to only a small percentage of the population, leaving the majority
of those in need without coverage or access to, even the most basic healthcare needs.
As surgeons working in the developing world, our duty is not only to take care of
the patient population that can easily reach us, but rather to search for ways to reach
out and treat those unable to attend our institutions.
History and Fundamentals
The concept of performing operations on the field is certainly not new. In ancient
times it is known that a rudimentary type of surgery was in place. One of the
many examples constitute our ancestors, The Incas in the Andean mountains of
South America. Skilled individuals in this culture performed trephinations in an
attempt to heal certain conditions although with little success. In the seventeen
century many military surgeons, such as the Frenchman Ambroise Pare, were bound
to take their instruments, knowledge and art into the battlefields and carry out gross
surgical procedures in a desperate attempt to save the wounded men.
In modern days MASH (Mobile Ambulatory Surgical Hospital) units have proven
to be superb examples of the efficiency of mobile surgical care. In times of peace,
several mobile healthcare delivery systems have also been organized and assembled
with the use of technology. These mobile systems take advantage of the various
means of transportation available to reach underprivileged areas worldwide.
Parting from the needs of our people, a nonprofit institution (CINTERANDES)
was born and the concept of Mobile Surgery (MS) was developed, in part inspired
by the effectiveness and experiences observed in several of the above mentioned
mobile systems. Advances in surgery and anesthesia have enabled us, with the help
Surgery and Healing in the Developing World, edited by Glenn Geelhoed.