Role of the medical auxiliary in the control of sexually transmitted disease in a developing country

Abstract

Venereal diseases are becoming a major health problem in many developing countries where the greater part of primary medical care is undertaken by medical auxiliaries. Under these circumstances, the medical auxiliary has an important role to play in the control of these diseases but he can only do this with adequate training, support, and supervision from the professional doctors and specialists. In this paper, the role of the medical auxiliary is outlined and a case is also made for a specially-trained cadre for venereal disease work in busy urban clinics in developing countries.

PIP: The role of the medical auxiliary is outlined and a case is made for a specially trained cadre of medical auxiliaries for venereal disease work in busy urban clinics in developing countries. Evidence exists that all forms of venereal disease are very common in urban and rural areas of several developing nations. Very high rates of gonococcal strains less sensitive to penicillin and other antibiotics have been reported in Uganda, Kenya, Bombay, Ethiopia, and Thailand. The situation in these countries and possibly elsewhere in Africa and The Far East is much worse than in Europe. The fear of the spread of venereal syphilis after mass campaigns against the endemic treponematoses and the consequent loss of cross immunity from yaws is already becoming a reality in some developing countries. In many developing nations venereal diseases are often seen late in the natural history of the condition when complications have set in and the medical auxiliary is called on to treat not merely an irritating symptom but a serious complication or an emergency. Peripheral units in most developing countries are now considered to be the ideal units, offering an integrated service comprising all basic health care. Such health centers are also appropriate for urban communities. These health centers are staffed with trained medical auxiliaries, preferably indigenous to the area concerned. Many countries are unable to provide in every unit the full team of auxiliaries required to run all the basic health services. Dispensaries may be operated by a less well-trained cadre of medical auxiliaries supervised from the Health Center or District Hospital. Where the full range of basic health services are offered there is considerable opportunity for team work. In big cities the medical care in most developing countries is provided by Government Hospitals, Urban Health Centers operated by the City Councils, and private practitioners. Venereal disease clinics form part of the outpatient departments in big hospitals and Urban Health Centers. The overall scarcity of fully qualified professional workers means that tasks which are the strict prerogative of doctors and specialists in the developed countries must be delegated to auxiliaries. If equipped with better knowledge and skills their contribution to venereal disease control can be improved. Where sexually transmitted diseases are most common and the daily number of patients very great, as in urban areas, medical auxiliaries should undergo extra training.