Browsing by Author "Deckelbaum, L Dan"

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    Augmenting surgical capacity in resource-limited settings
    (Elsevier Science Inc, 2012) Deckelbaum, L Dan; Ntakiyiruta, Georges; Liberman, S Alexander; Razek, Tarek; Kyamanywa, Patrick
    Deficiencies in access to surgical care in low-income and middle-income countries are well recognised. Despite the awareness and benchmarks generated by the Millennium Development Goals, 1 most sub-Saharan African nations have a negative annual growth rate in the number of physicians compared with their population growth rate. 2 In several sub-Saharan African nations, there are only 0·9 physicians per 1000 population, compared with 21 physicians per 1000 population in the UK and 28 per 1000 population in the USA. 3 These trends raise concerns about the morbidity, mortality, and disability-adjusted life-years lost due to injury and diseases requiring surgical treatment (including obstetrics) in sub-Saharan Africa. 4 Policy makers and health-care leaders in Rwanda, a nation with only 0·1 general surgeons per 100 000 population (compared with 6·4 per 100 000 in the USA), have recognised the substantial negative socioeconomic effect caused by such deficiencies and have committed themselves to tackling these challenges. 5 , 6 , 7
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    Strategies to improve clinical research in surgery through international collaboration
    (Elsevier Science Inc , Ste 800, 230 Park Ave, New York, Usa, Ny, 10169, 2013) Søreide, Kjetil; Alderson, Derek; Bergenfelz, Anders; Beynon, John; Connor, Saxon; Deckelbaum, L Dan; Dejong, H Cornelis; Earnshaw, Jonathan J; Kyamanywa, Patrick; Perez, O Rodrigo; Sakai, Yoshiharu; Winter, Desmond C
    More than 235 million patients undergo surgery every year worldwide, but less than 1% are enrolled in surgical clinical trials—few of which are international collaborations. Several levels of action are needed to improve this situation. International research collaborations in surgery between developed and developing countries could encourage capacity building and quality improvement, and mutually enhance care for patients with surgical disorders. Low-income and middle-income countries increasingly report much the same range of surgical diseases as do high-income countries (eg, cancer, cardiovascular disease, and the surgical sequelae of metabolic syndrome); collaboration is therefore of mutual interest. Large multinational trials that cross cultures and levels of socioeconomic development might have faster results and wider applicability than do single-country trials. Surgeons educated in research methods, and aided by research networks and trial centres, are needed to foster these international collaborations. Barriers to collaboration could be overcome by adoption of global strategies for regulation, health insurance, ethical approval, and indemnity coverage for doctors.