Reconfiguration of surgical, emergency, and trauma services: Recommendations are useful for configuring emergency services in the developing world

doi:10.1136/bmj.328.7438.523

BMJ 2004;328:523 (28 February), doi:10.1136/bmj.328.7438.523

Letter

Reconfiguration of surgical, emergency, and trauma services

Recommendations are useful for configuring emergency services in the developing world

The first 150 words of the full text of this article appear below.

EDITOR—The editorial by Black on reconfiguration of emergencyservices in the United Kingdom is also important for the developingworld.¹ Emergency services and acute care constitute a majorgap in the focus of the health sector in the developing world,and several issues need to be considered to promote a globaldialogue on how best to configure (rather than reconfigure)such services.

Traditional investments in the health sector in the developingworld have been biased towards urban areas, large tertiary facilities,and specialty services to the detriment of primary and acutecare. This bias needs to be addressed by ministries of healthand finance.

The use of non-doctor personnel is critical for the developingworld. Shortages of skilled staff, lack of training, and poorlydefined career structures plague human resources in the healthsector. It is time to assess the potential contributions ofother health professionals for emergency . . . [Full text of this article]

Adnan A Hyder, assistant professor

Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E-8132, Baltimore, MD 21205, USA ahyder@jhsph.edu