International Child Health Care: A Practical Manual for Hospitals Worldwide

BMJ 2003; 326 doi: (Published 26 April 2003) Cite this as: BMJ 2003;326:936
  1. Saw Sian Chin, paediatrician (sianchin{at}
  1. Voluntary Service Overseas

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    Child Advocacy International Eds David Southall, Brian Coulter, Christiane Ronald, Sue Nicholson, Simon Parke BMJ Books, £55, pp 637

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    ISBN 0 7279 1476 6

    Before setting out to the Gambia for a one year paediatric placement, I was looking for the equivalent of an Oxford Handbook of paediatrics in developing countries. However, I could find only a handful of textbooks on tropical paediatrics, which contained detailed pathophysiology and expensive managements, but provided nothing really practical.

    David Southall's book reached me during my time overseas. This book, which is excellently laid out in six main sections, claims to contain guidelines and suggestions about health care “in virtually every setting imaginable—peace and war, emergency and chronic, hospital and clinic.”

    It begins by clearly stating the philosophies of child health care, including a healthcare worker's brief guide to the United Nations Convention on the rights of the child and information about child and baby friendly policies and initiatives. I read this section with interest, but I have some reservations about the lists of “essential” equipment, supplies, and drugs.

    There are two kinds of list: the first of items that are considered necessary to achieve minimum standards, and the second of items considered necessary to improve standards. Our hospital in the Gambia, which will become a teaching hospital by the end of this year, does not even have half the minimum essential drugs or equipment listed. For example, there are seven different anticonvulsant drugs listed, but we just about manage to come up with three different kinds here. Intravenous acyclovir is clearly out of next year's hospital budget.

    The second section of the book, which contains clear diagnostic algorithms, is an excellent reference for teaching health workers. I particularly like the third and fourth sections, as these clearly explain the most common diseases and infections in a no fuss manner and state the minimum requirements for management.

    This book has helped our department develop a policy on caring for children with cancer, especially in terms of providing palliative care. The clinical management that this book recommends mostly parallels World Health Organization guidelines, so it is a great source of reference for those having to write up departmental protocols.

    Although this book still has the feel of Western culture about it, I will strongly recommend it to paediatricians coming to work in a developing country.

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