Problems facing the visiting anesthesia team in an underdeveloped nation and possible solutions

Abstract

More than 50% of the population in most developing countries is younger than 18 years, and it has been estimated that 85% of these children may require some sort of surgery before their 15th birthday. Common congenital surgical requirements are for cleft lip and palate, inguinal hernia, meningomyelocele, as well as hydrocephalus. In addition, there is a greater incidence of trauma experienced by pediatric patients. Burn and scald injuries are also common because of the proximity of domestic open fires and boiling pots of water. Infectious conditions such as osteomyelitis and skin abscesses are more frequent in developing countries than in the developed world. Given this backdrop, the visiting anesthesiology team is faced with significant logistic issues related to a large and varied set of surgeries. This requires careful planning to ensure there will be enough personnel, equipment, and drugs available for the trip. Anesthesia teams very often have to rely on their own supplies on these excursions. Careful questioning of previous visiting groups is vital in preparation. For example, it is pointless to bring cases of sevoflurane to an operating room where the anesthesia machine only has a halothane vaporizer.