Surgery in South Asia

doi:10.1136/bmj.328.7443.782

BMJ 2004;328:782 (3 April), doi:10.1136/bmj.328.7443.782

Editorial

Surgery in South Asia

A private complication of a public problem

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

It is difficult to write about surgery in South Asia with anysense of pride. In most of the region health care, and especiallysurgical care, is concentrated in major hospitals in big cities.In villages and small towns the health infrastructure existson paper, but even minor procedures are not carried out becauseequipment does not work, and surgeons are reluctant to undertakeoperations for which they are not well trained.

In a community survey of surgical emergencies in the northernareas of Pakistan, the incidences of acute abdominal, trauma,and obstetric emergencies therefore far exceeded the rates ofacute surgical intervention.¹ In rural areas of Pakistan theoverall rate of surgery was 124/100 000 patients per year comparedwith 8253/100 000 in the United States. Death rates were correspondinglyhigh. Even in city hospitals the situation is not much different.The few public hospitals that carry out complex . . . [Full text of this article]

Musthaq Ahmed, associate dean

Aga Khan University, Nairobi, Kenya

Asad Raja, professor

Department of Surgery, Aga Khan University, Nairobi, Kenya

Samiran Nundy, consultant

Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, New Delhi 110060, India (snundy@hotmail.com)

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