Specific aspects of trauma in African developing countries. A 20-year Surgical Experience

The 2004 annual WHO report stated that, between 2000 and 2020,decease due to road traffic accidents will decrease by 30% in developedcountries, while they will increase considerably in countrieswith low income and in which, these accidents will constitute, ifappropriate strategies are not taken, the third cause of mortalitybefore year 2020. This represents a challenging situation to allmedical doctors practicing in developing countries and justifies thepresent study.In this presentation, the author, a surgeon who went back to Africaafter his training in France, analyses specific characteristics fromtrauma he and his staff mates had been receiving and managingbetween 1st June, 1986 and 30th June, 2006 at the University Clinicsof Lubumbashi in DRC, at the Kaédi General Hospital, in theIslamic Republic of Mauritania and at the Lusaka University TeachingHospital, in the Republic of ZambiaIt was a descriptive, retrospective study with triangulation. Theauthor’s notes (as direct observer and participant observer) wereadded to the comment from discussion group focus in each hospitalto build up pre-established questionnaire that served for data collection.Inclusion and exclusion criteria were also stated as well asstatistical evaluation tests.Results revealed the following: high annual prevalence, prominenceof road traffic accident as cause of trauma followed by assault,absence of formal public transport to pick up victims to hospital,delayed arrival to hospital of hours, days, weeks, months with highrate of neglected trauma, variety of injuries, poor investigations,management relying mainly on the quality of the staff with regardto trauma management and dexterity of improvisations. The immediateand short outcome relies also on the quality of staff but doesalso require minimal infrastructure.The author concludes that traumas are highly stated public healthproblem, particularly in countries with limited resources where theyare associated with numerous complex factors as: crisis of roadsafety, poverty, inadequate urbanism, lack of human resources andof motivation as well as .official strong policy. The ultimate longterm solution duels in improvement of socio-economical status andbehavioral changes. Meanwhile, in short term, he recommends thattraining of hospital staff and other health care providers in traumamanagement course be regularly undertaken and that minimalinfrastructure and equipment as well as and logistic items stand aspriorities for each of these countries.