The current status of international partnerships for child surgery in sub-Saharan Africa.

Disparity still exists in the surgical care between sub-Saharan Africa and developed countries. Several international initiatives have been undertaken in the past decades to address the disparity. This study looks at the impact of these programs in child surgery in Sub-Saharan Africa. Review of electronic databases Medline and African Index Medicus on international partnerships for child surgery in Sub-Saharan Africa was undertaken. Four types of international initiatives were identified and consist of periodic medical missions; partnerships between foreign medical institutions or charities and local institutions; international health electives by surgical residents; and training of individual surgeons from developing countries in foreign institutions. The results of these efforts were variable, but sustainability and self-reliance of host nations were limited. Sociocultural factors, dearth of facilities, and lack of local governments' commitment were main impediments to effective local development or transfer of modern protocols of surgical management and improvement of pediatric surgical care at the host community level. Current initiatives may need improvements with better understanding of the sociocultural dynamics and local politics of the host nation, and improved host nation involvement and commitment. This may engender development of locally controlled viable services and sustainable high level of care.

Pattern of gunshot injuries as seen at the National Orthopaedic Hospital, Enugu: January 1999 December 2004.

BACKGROUND: Civilian gunshot injuries are common in our environment. Hospitalisation for this appears to be on the increase especially around the periods of general elections, but studies on the peri-election pattern are lacking. This report examines the pattern of gunshot injuries seen at an apex trauma centre spanning the periods of two general elections. PATIENTS AND METHODS: This hospital based retrospective study reviewed all admissions into the trauma unit of the National Orthopaedic Hospital, Enugu over six years (January 1999 December 2004). The sources of data were the trauma unit admission registers, nurses' report books, and the case notes of the patients. Simple arithmetic analysis was used. RESULTS: Of 6,765 trauma admissions in the period, gunshot injuries accounted for 306 (4.5%). In 1999 and 2003 they accounted for 6% and 8% of all trauma admissions respectively The overall pattern over the six year period shows the incidence rises from January to a peak in May However in the election year 1999, a progression in incidence immediately following May (the month of hand-over) rising to a peak in August was noted. CONCLUSION: A definite increase in presentation of gunshot injuries exist in the years of general elections.