South African General Surgeon Preparedness for Humanitarian Disasters

Abstract

Background Humanitarian medical organizations provide surgical care for a broad range of conditions including general surgical (GS), obstetric and gynecologic (OBGYN), orthopedic (ORTHO), and urologic (URO) conditions in unstable contexts. The most common humanitarian operation is cesarean section. The objective of this study was to identify the proportion of South African general surgeons who had operative experience and current competency in GS, OBGYN, ORTHO, and URO humanitarian operations in order to evaluate their potential for working in humanitarian disasters. Methods This was a cross-sectional online survey of South African general surgeons administered from November 2017-July 2018. Rotations in OBGYN, ORTHO, and URO were quantified. Experience and competency in eighteen humanitarian operations were queried. Results There were 154 SA general surgeon participants. Prior to starting general surgery (GS) residency, 129 (83%) had OBGYN, 125 (81%) ORTHO, and 84 (54%) URO experience. Experience and competency in humanitarian procedures by specialty included: 96% experience and 95% competency for GS, 71% experience and 51% competency for OBGYN, 77% experience and 66% competency for ORTHO, and 86% experience and 81% competency for URO. 82% reported training, and 51% competency in cesarean section. Conclusions SA general surgeons are potentially well suited for humanitarian surgery. This study has shown that most SA general surgeons received training in OBGYN, ORTHO, and URO prior to residency and many maintain competence in the corresponding humanitarian operations. Other low-to middle-income countries may also have broad-based surgery training, and the potential for their surgeons to offer humanitarian assistance should be further investigated.

Surgical Training Throughout Africa: A Review of Operative Case Volumes at Multiple Training Centers

“…As a diverse set of operative skills is necessary in low‐resource and disaster settings [16], it has been postulated that graduates of programs in high‐resource settings might be unprepared to practice in austere environments [41]. This study, based on the breadth of case volumes, supports that graduates of PAACS programs could be better prepared than graduates from ACGME programs to serve in low‐resource settings or to be deployed in emergency medical teams after sudden‐onset disasters in low‐ and middle‐income countries [17]. However, trainees interested in sub‐specialties, included practicing in resource‐limited settings, may gravitate toward a more diverse or directed case distribution, but the population‐level ACGME data cannot reflect this granularity.…”

“…Yet, little is known about the actual experience of surgical trainees throughout Africa. Operative case volumes for general surgeons have been rarely described within low-resource countries and vary widely in the reported diversity of cases [15][16][17][18][19][20]. A recent study described and compared the ACGME general surgery graduate case logs with case logs from humanitarian surgeons.…”

Situación de la capacitación del personal quirúrgico en Perú y Latinoamérica

“…(Fajardo-Dolci & Santacruz-Varela, 2023;Skinner et al, 2023) En cuanto a Sudáfrica, los cirujanos podrían estar bien preparados para trabajar en entornos humanitarios debido a la amplitud de su capacitación en procedimientos quirúrgicos generales y no generales. (Chu et al, 2019) Por otro lado, en Nigeria existe una experiencia limitada por parte de los cirujanos en formación para ciertas cirugías laparoscópicas básicas que predominantemente se presentan en la práctica. (Ray-Offor & Abdur-Rahman, 2021) En Pakistan, la capacitación en el área traumatológica es mínima e incipiente tanto para pre y post grado a diferencia de otros países asiáticos.…”

Operative Case Volumes and Variation for General Surgery Training in East, Central, and Southern Africa

“…Case volumes have been examined in various general surgery training paradigms [7], with an estimated average of 1366 operative training cases [8]. Most studies are from high-resource settings, but there are reports within low-and middle-income countries [9][10][11][12][13][14]. A recent study examining multiple training programs in countries in Africa described the case volumes of trainees with diverse experience and a high volume of cases [15].…”