Five years as a flying surgeon in Zimbabwe

Abstract

Surgical services in the developing world are often based on a Western model where the patient has to seek out the surgeon. A reverse policy was instituted to overcome severe logistical problems. Funding was obtained for air flights to 10 distant rural hospitals and a program of visits advertised in advance. Patients were selected by the resident doctor and seen either as in- or outpatients. A list was drawn up and patients were operated on that day and if necessary the following day when earlier postoperative cases were reviewed. More than 500 operations were performed of varying complexity, and complications were reported in fewer than 10. A scheme where the surgeon visits the rural patient in his or her home area is cost-effective, popular, and beneficial to the hospital staff. It obviates the need for distant referral where there may be language difficulties and where visits from relatives are precluded. It also reduces the workload of overstretched referral centers. It provides the means to teach the local resident doctor rudiments of surgical practice, and it provides regular contact between the outstation and the referral center.