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    320992
    Peer Reviewed

    Surgical services in low-income and middle-income countries.

    Spiegel DA; Gosselin RA

    Lancet. 2007 Sep 22; 370(9592):1013-1015.

    Although substantial progress has been made in addressing the burden of communicable and vaccine-preventable diseases in low-income and middle-income countries, the burden of diseases that are surgically treatable is increasing and has been neglected. Both morbidity and mortality from surgically preventable (eg, elective hernia repair) or treatable (eg, strangulated hernia) disorders can be greatly decreased through simple surgical interventions. Why should a child die from appendicitis, or a mother and child succumb to obstructed labour, when simple surgical procedures can save their lives? Why should patients suffer permanent disability because of congenital abnormalities, fractures, burns, or the sequelae of acute infections such as septic arthritis or osteomyelitis? Many complications of HIV infection (eg, abscesses, fistulas, Kaposi sarcoma) are also amenable to simple surgical interventions. Available epidemiological information and experiential evidence lend support to the conclusion that basic surgical and anaesthetic services should be integrated into primary health-care packages. (excerpt)
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