Published in:
01-12-2012 | Invited Commentary
Volunteer Orthopedic Surgical Trips in Nicaragua: A Cost-Effectiveness Evaluation
Published in: World Journal of Surgery | Issue 12/2012
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Thousands of surgeons from countries with advanced medical systems donate their services in places where modern surgical treatment is not easily available. Usually, it takes the form of short trips (often a week or two, sometimes a few months) to places where surgical skills, facilities, supplies, and/or equipment are believed to be lacking. We know that the burden of untreated surgical conditions represents at least 10 % of the “disease burden” in these countries, so this outside help could be an important contribution to health there. In the past, this potential has not been fully realized because serious limiting factors were not addressed.-
Preparation: patients with problems likely to be amenable to short-term surgical treatment must be identified and brought together in a place where surgery can be done with a good prospect of success.
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Burden: The number of persons suffering from correctable conditions must be enough to justify a trip.
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Local capacity: If local staff has the ability to do the job, there is limited need for outside experts.
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Continuity: There must be reasonable assurance that patients will be followed up and that service will be continued after the team departs—through repeated visits, or (better) through a local staff that has benefited from short-term training.
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Appropriate technology: Local resources should be adequate to support continued use of the techniques introduced. Video-assisted surgery is generally not appropriate. Disposable supplies and equipment usually are not available on a continuing basis or are too expensive.