Surgical Care at the District Hospital

  • ISBN 9789241545754

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Many patients who present to district (first referral) level hospitals require surgical treatment for trauma, obstetric, abdominal or orthopaedic emergencies. Often surgery cannot be safely postponed to allow their transfer to a secondary or tertiary-level hospital, but many district hospitals in developing countries have no specialist surgical teams and are staffed by medical nursing and paramedical personnel who perform a wide range of surgical procedures, often with inadequate training. The quality of surgical acute care is often further constrained by poor facilities, inadequate, low-technology apparatus and limited supplies of drugs, materials and other essentials. The mission of the team responsible for devices and clinical technology in the World Health Organization Department of Blood Safety and Clinical Technology is to promote the quality of clinical care through the identification, promotion and standardization of appropriate procedures, equipment and materials, particularly at district hospital level. The department has identified education and training as a particular priority, especially for non-specialist practitioners who practise surgery and anaesthesia.
It has therefore developed this text as a practical resource for individual practitioners and for use in undergraduate and postgraduate programmes, in-service training and continuing medical education programmes. The manual is the successor of three earlier publications: "General Surgery at the District Hospital"; "Surgery at the District Hosptial: Obstetrics, Gynaecology, Orthopaedics and Traumatology"; and "Anaesthesia at the District Hospital". This manual draws together material from these three publications into a single volume which includes new and updated material, as well as material from "Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors".
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