Universal precautions and surgery in Sierra Leone: the unprotected workforce.
BACKGROUND
Surgical patients and healthcare workers in sub-Saharan Africa are at an increased risk of contracting HIV. Sierra Leone is one of the poorest countries in the world and has a documented HIV prevalence rate of 2%. Because surgeons and other healthcare staff in sub-Saharan Africa are at risk for HIV exposure from their patients, an assessment of protective supplies and equipment was considered essential.


METHODS
A Society of International Humanitarian Surgeons team in cooperation with the Sierra Leonean Ministry of Health and Sanitation undertook a survey of HIV-protective supplies and equipment at government hospitals in Sierra Leone. The presence of eye protection, sterile gloves, aprons, functioning suction machines, and sharps containers was recorded and compared with a local mission hospital and a local private hospital.


RESULTS
Only 20% of government hospitals in Sierra Leone have adequate stores of sterile gloves or eye protection. Suction pumps and aprons are available in only 30-40% of facilities, respectively, and only half have functioning sterilizers and sharps containers. The mission and private hospitals were fully stocked.


CONCLUSIONS
Although surgical healthcare workers are at risk for exposure to HIV, resources for their protection at government hospitals in Sierra Leone are severely lacking. The Society of International Humanitarian Surgeons is developing a program to provide protective supplies and equipment to hospitals in Sierra Leone, but additional efforts by other organizations working to decrease the spread of HIV are essential.
Kingham
T Peter
TP
Department of Surgical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. peter@humanitariansurgery.org
Kamara
T B
TB
Daoh
K S
KS
Kabbia
Soccoh
S
Kushner
Adam L
AL
D013502:General Surgery; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006767:Hospitals, District / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D016272:Occupational Health; D011482:Protective Devices / Q000600:supply & distribution*; D012807:Sierra Leone / Q000453:epidemiology; D016635:Universal Precautions / Q000295:instrumentation*