Comparison of surgical care deficiencies between US civil war hospitals and present-day hospitals in Sierra Leone Journal Article


Authors: Crompton, J.; Kingham, T. P.; Kamara, T. B.; Brennan, M. F.; Kushner, A. L.
Article Title: Comparison of surgical care deficiencies between US civil war hospitals and present-day hospitals in Sierra Leone
Abstract: Background: Surgery is rapidly becoming a part of public health initiatives in developing countries. Methods: In collaboration with the Sierra Leone Ministry of Health and Sanitation, a team of local surgeons and surgeons from the organization Surgeons OverSeas (SOS) used the WHO Tool for Situational Analysis to Assess Emergency Surgical Care to quantify surgical capacity in Sierra Leone. These data were then compared to data collected from the Medical and Surgical History of the Civil War, a work documenting surgical care and hospitals during the US Civil War. Results: There are 0.2 government hospital surgeons/100,000 people in Sierra Leone compared to 300 surgeons/100,000 soldiers in the Union Army. In Sierra Leone it is rare to have running water, fuel, anesthesia, and reliable X-rays. In comparison, US Civil War hospitals had reliable running water, fuel, and anesthesia. It is rare to manage open fractures, limb dislocations, amputations, and conditions requiring chest tubes in Sierra Leone, while these procedures were commonly employed in US Civil War hospitals. Conclusions: Government hospitals in present day Sierra Leone lack the infrastructure, personnel, supplies, and equipment to adequately provide emergency and essential surgical care. In a comparison of present day Sierra Leonean and US Civil War hospitals, the US Civil War facilities are equivalent and in many ways superior. It is hoped that such a comparison will aid advocacy efforts so that greater resources are devoted to improving emergency and essential surgical care in low- and middle-income countries. © 2010 Société Internationale de Chirurgie.
Keywords: united states; comparative study; organization and management; statistics; war; health care quality; standard; surgery; surgical procedures, operative; developing countries; developing country; health care delivery; public hospital; hospitals, public; general surgery; quality of health care; sierra leone; delivery of health care; equipment and supplies, hospital; surgery department, hospital; manpower; hospital department; hospital equipment; american civil war
Journal Title: World Journal of Surgery
Volume: 34
Issue: 8
ISSN: 0364-2313
Publisher: Springer  
Date Published: 2010-08-01
Start Page: 1743
End Page: 1747
Language: English
DOI: 10.1007/s00268-010-0564-7
PUBMED: 20386906
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 20 April 2011" - "CODEN: WJSUD" - "Source: Scopus"
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  1. Murray F Brennan
    1059 Brennan
  2. T Peter Kingham
    609 Kingham