Anesthesia and its allied disciplines in the developing world: a nationwide survey of the Republic of Zambia.
BACKGROUND
Many surgical interventions worldwide are performed in developing countries. To improve survival of acutely and critically ill patients in these countries, basic problems and demands of anesthesia care need to be identified. Using this survey, we evaluated the current status of anesthesia and its allied disciplines (intensive care medicine, emergency medicine, and pain therapy) in the Republic of Zambia.


METHODS
Questionnaires were sent to 87 hospitals registered at the Zambian Ministry of Health as performing minor or major surgery. The questionnaire consisted of 111 questions grouped into five sections: general hospital information, anesthesia, intensive care, emergency medicine, and pain therapy.


RESULTS
Sixty-eight questionnaires could be statistically evaluated (78%). The most common operations were obstetric/gynecological and abdominal surgical procedures. Dissociative ketamine anesthesia was the technique most often used for general anesthesia (50%). Endotracheal intubation was performed in 10% of patients undergoing general anesthesia. In most hospitals (78%), anesthesia was administered by nonphysicians. Only 5 of 68 hospitals (7%) reported having an intensive care unit, with 29 beds to serve the entire country. Anesthesiologists play almost no role in emergency medicine and pain therapy.


CONCLUSIONS
Anesthesia in the Republic of Zambia is a highly under-developed and under-resourced medical specialty.
Jochberger
Stefan
S
Department of Anesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
Ismailova
Feruza
F
Lederer
Wolfgang
W
Mayr
Viktoria D
VD
Luckner
Günter
G
Wenzel
Volker
V
Ulmer
Hanno
H
Hasibeder
Walter R
WR
Dünser
Martin W
MW
D000698:Analgesia / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D000758:Anesthesia / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D003422:Critical Care / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000191:economics / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D017048:Health Care Costs / Q000706:statistics & numerical data; D015276:Health Care Rationing / Q000706:statistics & numerical data; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D012111:Residence Characteristics / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D015024:Zambia