Surgery with Limited Resources in Natural Disasters: What Is the Minimum Standard of Care?

Overview

Journal Curr Trauma Rep

Date 2018 Jun 12

PMID 29888165

Citations 3

Authors

Miguel Trelles Centurion

Rosa Crestani

Lynette Dominguez

An Caluwaerts

Guido Benedetti

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: In a challenging scenario, such as in the aftermath of a natural disaster, minimum standards of care must be in place from the moment surgical care activities are launched.

Recent Findings: Natural disasters cause destruction and human suffering, especially in low- and middle-income countries, which suffer the most when exposed to their consequences. Health systems can quickly get overwhelmed and can collapse under the burden of injured patients during this event, while qualified surgical care remains crucial. Medécins Sans Frontières (MSF) has a vast experience providing surgical care after natural disasters, and quality is assured through the Donabedian model. Minimum structure standards are put in place from the beginning of an emergency response, together with standard operating procedures providing guidance to professionals working in challenging conditions.

Summary: MSF believes that it is always possible to deliver surgical care, ensuring the best possible quality guaranteeing adequate levels of structure and process. The "do no harm" principle must always be respected as adherence to medical ethics is a must in any context, even a challenging one.

Citing Articles

The impact of natural disasters on healthcare and surgical services in low- and middle-income countries.

Salam A, Wireko A, Jiffry R, Ng J, Patel H, Zahid M Ann Med Surg (Lond). 2023; 85(8):3774-3777.

PMID: 37554857 PMC: 10406090. DOI: 10.1097/MS9.0000000000001041.

The role of evaluation in iterative learning and implementation of quality of care interventions.

Shah N, Mathew S, Pereira A, Nakaima A, Sridharan S Glob Health Action. 2021; 14(1):1882182.

PMID: 34148508 PMC: 8216261. DOI: 10.1080/16549716.2021.1882182.

Towards resilient health systems: opportunities to align surgical and disaster planning.

Pyda J, Patterson R, Caddell L, Wurdeman T, Koch R, Polatty D BMJ Glob Health. 2019; 4(3):e001493.

PMID: 31275620 PMC: 6577360. DOI: 10.1136/bmjgh-2019-001493.

References

Wong E, Dominguez L, Trelles M, Ayobi S, Hazraty K, Kasonga C . Operative trauma in low-resource settings: The experience of Médecins Sans Frontières in environments of conflict, postconflict, and disaster. Surgery. 2015; 157(5):850-6. DOI: 10.1016/j.surg.2014.12.021. View

Rose J, Weiser T, Hider P, Wilson L, Gruen R, Bickler S . Estimated need for surgery worldwide based on prevalence of diseases: a modelling strategy for the WHO Global Health Estimate. Lancet Glob Health. 2015; 3 Suppl 2:S13-20. PMC: 5746187. DOI: 10.1016/S2214-109X(15)70087-2. View

Lin Y, Dahm J, Kushner A, Lawrence J, Trelles M, Dominguez L . Are American Surgical Residents Prepared for Humanitarian Deployment?: A Comparative Analysis of Resident and Humanitarian Case Logs. World J Surg. 2017; 42(1):32-39. DOI: 10.1007/s00268-017-4137-x. View

Hsia R, Mbembati N, Macfarlane S, Kruk M . Access to emergency and surgical care in sub-Saharan Africa: the infrastructure gap. Health Policy Plan. 2011; 27(3):234-44. DOI: 10.1093/heapol/czr023. View

Chu K, Stokes C, Trelles M, Ford N . Improving effective surgical delivery in humanitarian disasters: lessons from Haiti. PLoS Med. 2011; 8(4):e1001025. PMC: 3082515. DOI: 10.1371/journal.pmed.1001025. View

Trelles M, Dominguez L, Stewart B . Surgery in low-income countries during crisis: experience at Médecins Sans Frontières facilities in 20 countries between 2008 and 2014. Trop Med Int Health. 2015; 20(8):968-71. DOI: 10.1111/tmi.12523. View

Johnson K, Idzerda L, Baras R, Camburn J, Hein K, Walker P . Competency-based standardized training for humanitarian providers: making humanitarian assistance a professional discipline. Disaster Med Public Health Prep. 2013; 7(4):369-72. DOI: 10.1017/dmp.2013.10. View

Khan F, Amatya B, Gosney J, Rathore F, Burkle Jr F . Medical Rehabilitation in Natural Disasters: A Review. Arch Phys Med Rehabil. 2015; 96(9):1709-27. DOI: 10.1016/j.apmr.2015.02.007. View

Merchant A, Hendel S, Shockley R, Schlesinger J, Vansell H, McQueen K . Evaluating Progress in the Global Surgical Crisis: Contrasting Access to Emergency and Essential Surgery and Safe Anesthesia Around the World. World J Surg. 2015; 39(11):2630-5. DOI: 10.1007/s00268-015-3179-1. View

10.

Forrester J, Boyd N, Fitzgerald J, Wilson I, Bekele A, Weiser T . Impact of Surgical Lighting on Intraoperative Safety in Low-Resource Settings: A Cross-Sectional Survey of Surgical Providers. World J Surg. 2017; 41(12):3055-3065. DOI: 10.1007/s00268-017-4293-z. View

11.

DeMaio A, Jamieson J, Horn R, de Courten M, Tellier S . Non-communicable diseases in emergencies: a call to action. PLoS Curr. 2013; 5. PMC: 3775888. DOI: 10.1371/currents.dis.53e08b951d59ff913ab8b9bb51c4d0de. View

12.

Adair-Rohani H, Zukor K, Bonjour S, Wilburn S, Kuesel A, Hebert R . Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability. Glob Health Sci Pract. 2014; 1(2):249-61. PMC: 4168575. DOI: 10.9745/GHSP-D-13-00037. View

13.

Brolin K, Hawajri O, von Schreeb J . Foreign Medical Teams in the Philippines after Typhoon Haiyan 2013 - Who Were They, When Did They Arrive and What Did They Do?. PLoS Curr. 2015; 7. PMC: 4447417. DOI: 10.1371/currents.dis.0cadd59590724486bffe9a0340b3e718. View

14.

von Schreeb J, Riddez L, Samnegard H, Rosling H . Foreign field hospitals in the recent sudden-onset disasters in Iran, Haiti, Indonesia, and Pakistan. Prehosp Disaster Med. 2008; 23(2):144-51. DOI: 10.1017/s1049023x00005768. View

15.

Djalali A, Ingrassia P, Della Corte F, Foletti M, Ripoll Gallardo A, Ragazzoni L . Identifying deficiencies in national and foreign medical team responses through expert opinion surveys: implications for education and training. Prehosp Disaster Med. 2014; 29(4):364-8. DOI: 10.1017/S1049023X14000600. View

16.

Alvarado O, Trelles M, Tayler-Smith K, Joseph H, Gesline R, Wilna T . Orthopaedic surgery in natural disaster and conflict settings: how can quality care be ensured?. Int Orthop. 2015; 39(10):1901-8. DOI: 10.1007/s00264-015-2781-z. View

17.

Birkmeyer J, Dimick J, Birkmeyer N . Measuring the quality of surgical care: structure, process, or outcomes?. J Am Coll Surg. 2004; 198(4):626-32. DOI: 10.1016/j.jamcollsurg.2003.11.017. View

18.

Gerdin M, Wladis A, von Schreeb J . Foreign field hospitals after the 2010 Haiti earthquake: how good were we?. Emerg Med J. 2012; 30(1):e8. DOI: 10.1136/emermed-2011-200717. View

19.

Wong E, Gupta S, Deckelbaum D, Razek T, Kushner A . Prioritizing injury care: a review of trauma capacity in low and middle-income countries. J Surg Res. 2014; 193(1):217-22. DOI: 10.1016/j.jss.2014.08.055. View

20.

Ariyo P, Trelles M, Helmand R, Amir Y, Hassani G, Mftavyanka J . Providing Anesthesia Care in Resource-limited Settings: A 6-year Analysis of Anesthesia Services Provided at Médecins Sans Frontières Facilities. Anesthesiology. 2016; 124(3):561-9. DOI: 10.1097/ALN.0000000000000985. View