Surgery has the potential to address one of the largest, neglected burdens of disease in low- and middle-income countries (LMICs), especially in sub-Saharan Africa (SSA). The Lancet Commission on Global Surgery (LCoGS) has provided a blueprint for a systems approach to making safe emergency and elective surgery accessible and affordable and has started to enable African governments to develop n...

PURPOSE China has among the lowest cataract surgical rates in Asia. This study was conducted to identify barriers to cataract surgery in rural China. METHODS All subjects having undergone cataract surgery and persons with presenting visual acuity or=1 eye due to nonsurgically treated cataract were identified in two population-based studies i...

OBJECTIVE The aim of this study was to quantify and describe a population of patients in rural Cameroon who present with a surgically treatable illness but ultimately decline surgery, and to understand the patient decision-making process and identify key socioeconomic factors that result in barriers to care. BACKGROUND An estimated 5 billion people lack access to safe, affordable surgical car...

PURPOSE To estimate the prevalence and causes of blindness and visual impairment (VI), and report the outcomes of cataract surgery in Chaonan Region, Guangdong Province, southern China. DESIGN Cross-sectional population-based survey. PARTICIPANTS A total of 3484 participants including 1397 men (40.1%) and 2087 women (59.9%) aged ≥50 years were examined (94.2% response rate). METHOD A two-...

PURPOSE To examine differences between patients with cataract detected during screening and presenting to clinic in rural China. METHODS Subjects were recruited from 27 screenings and an eye clinic in the same town. All had pinhole-corrected vision < or =6/18 in > or =1 eye due to ophthalmologist-diagnosed cataract. Subjects were administered a previously validated questionnaire on barriers t...

Laparoscopy, minimally invasive and minimal access surgery with more surgeons performing these advanced procedures. We highlight in the review several key emerging technologies such as the telementoring and virtual reality simulators, that provide a solid ground for delivering surgical education to rural area and allow young surgeons a safety net and confidence while operating on a newly learne...

The reluctance of physicians to stay in remote and rural hospitals has resulted in a shortage of doctors in these settings, and therefore a decline in the quality of care and an intolerable overload on functioning doctors. However, mature paramedics find it difficult to comply with the demands of ambulance work and look for easier tasks that suit their age. The two problems may have a common so...

Critical illness intersects with the workload of rural doctors in Australia, mostly via their on-call responsibilities to rural hospitals. A significant proportion of these are prehospital incidents - vehicle crashes, farming injuries, bushfire etc. Effective care for such patients requires an integration of prehospital ambulance services, retrieval services and tertiary level trauma services a...

In resource-poor countries, substantial sums of money from governments and international donors are used to purchase equipment for health facilities. WHO estimates that 50-80% of such equipment remains non-functional. This article is based on experience from various projects in developing countries in Asia and Africa. The key issues in the purchase, distribution, installation, management and ma...