Surgical Needs of Internally Displaced Persons in Kerenik, West Darfur, Sudan
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SURGERY IN LOW AND MIDDLE INCOME COUNTRIES
Surgical Needs of Internally Displaced Persons in Kerenik, West Darfur, Sudan David P. Kuwayama1 • Kathryn M. Chu2 • Zachary Hartman3 • Bashir Idris4 Christopher Wolfgang5 • Hon William H. Frist6
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Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background The burden of surgical disease in refugee and internally displaced person (IDP) populations has not been well defined. Populations fleeing conflict are mobile, limiting the effectiveness of traditional sampling methods. We employed novel sampling and survey techniques to conduct a population-based surgical needs assessment amongst IDPs in Kerenik, West Darfur, Sudan, over 4 weeks in 2008. Methods Satellite imagery was used to identify man-made structures. Ground teams were guided by GPS to randomly selected households. A newly created surgical needs survey was administered by surgeons to household members. One randomly selected individual answered demographic and medical history questions pertaining to themselves and first-degree blood relatives. All household members were offered a physical examination looking for surgical disease. Findings There were 780 study participants; 82% were IDPs. A history since displacement of surgical and potentially surgical conditions was reported in 38% of respondents and by 73% of respondents in first-degree blood relatives. Surgical histories included trauma (gunshots, stabbings, assaults) (5% respondents; 27% relatives), burns (6% respondents; 14% relatives), and obstetrical problems (5% female respondents; 11% relatives). 1485 individuals agreed to physical examinations. Untreated surgical and potentially surgical disease was identified in 25% of participants. Interpretation We identified and characterized a high burden of surgical and potentially surgical disease in an IDP population in West Darfur. Our study is unique in its direct assessment of a traumatized, mobile, vulnerable population. Health officials and agencies charged with the care of IDP and refugee populations should be aware of the high prevalence of surgical and potentially surgical conditions in these communities. This study adds to the growing body of evidence that investment in surgical resources may address a significant portion of the overall burden of disease in marginalized populations.
The abstract of this paper was presented at the 2017 Congress of the World Association for Disaster and Emergency Medicine (WADEM) in Toronto, Ontario, Canada. & David P. Kuwayama [email protected] 1
2
Section of Vascular Surgery, Dartmouth-Hitchcock Medical Center, Unit 3V, 1 Medical Center Drive, Lebanon, NH 03756, USA Department of Global Health, Stellenbosch University, Cape Town, South Africa
3
Alaska Surgical Associates, Palmer, AK, USA
4
Department of Pharmacy, University of Maryland Upper Chesapeake Medical Center, Bel Air, MD, USA
5
Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
6
Department of Thoracic Surgery, Vanderbilt University School of Medicine, Nashville,
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