Abstract
Delivery of humanitarian global surgical aid to low-middle income countries (LMICs) often occurs as a “fly-in, fly-out” marathon of operations. Unfortunately, the sustainability and efficacy of these missions remain questionable because they are difficult to reproduce and they have limited ability to provide peri-operative care. The goal of this project was to describe the Moore Pediatric Surgery Center (MPSC) in Guatemala City as an alternative model that provides a centralized structure to the interaction between surgical providers and patients in the operative and peri-operative periods. We also describe the Center’s patient population and present feedback from surgical teams visiting the MPSC. A retrospective chart review was performed to quantify the number of patients, procedures, and post-operative complications at the MPSC between January 2011 and December 2014. We also performed a cross-sectional sociodemographic survey of MPSC patients and conducted a satisfaction survey of patients and surgical team members visiting the Center. Since 2011, the MPSC has hosted 42 surgical teams representing 7 different specialties. During its first four years, the surgery center hospital performed 2260 operations with a 1.07 % peri-operative complication rate and 0 % peri-operative mortality rate. All surgeries were performed free-of-charge to children from low-income households. Furthermore, the MPSC was rated highly among visiting team members (range 4.5–6 on a 7-point Likert scale) for quality metrics including organization, physical space, and collaboration with local staff. The MPSC represents a model for delivering multi-specialty surgical aid in low- and middle-income countries by providing modern surgical facilities with quality-assured post-operative care for the treatment of childhood surgical diseases.
Highlights
Medical aid to low- and middle-income countries has focused primarily on infectious diseases, malnutrition, and maternal-neonatal care
In the 5 years preceding construction of the Moore Pediatric Surgery Center (MPSC) (2006– 2010), 7 surgical tours were completed yielding a total of 282 operations (14.3 % and 11.1 % of the total tours and operations between 2006–2014)
In Guatemala, children under 18 years of age represent approximately % of the total population, and % of people live below the international poverty line
Summary
Medical aid to low- and middle-income countries has focused primarily on infectious diseases, malnutrition, and maternal-neonatal care. The most common form of global surgical aid is the short-term medical mission These missions involve a team of physicians, nurses and staff volunteering their time, equipment and services. Partnerships between host and donor countries often arise from interpersonal contacts to coordinate operative space and peri-operative care (Baran and Tiftikcioglu 2007; Mainthia et al 2009; Merrell et al 2007). While these efforts can deliver a Merceron et al SpringerPlus (2015) 4:742 large volume of high quality surgery, they are limited in that they are often the result of non-reproducible ad hoc connections between physicians from different countries. Limited resources and time often lead to restrictions in operative scope and an inability to ensure the post-operative care of the patients
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