title: Surgical care in the Solomon Islands: a road map for universal surgical care delivery.
abstract: BACKGROUND
  Access to surgical care and emergency obstetrical care is limited in low-income countries. The Solomon Islands is one of the poorest countries in the Pacific region. Access to surgical care in Solomon Islands is limited and severely affected by a country made up of islands. Surgical care is centralized to the National Referral Hospital (NRH) on Guadalcanal, leaving a void of care in the provinces where more than 80% of the people live.
  
  
  METHODS
  To assess the ability to provide surgical care to the people living on outer islands in the Solomon Islands, the provincial hospitals were evaluated using the World Health Organization's Global Initiative for Emergency and Essential Surgical Care Needs Assessment Tool questionnaire. Data on infrastructure, workforce, and equipment available for treating surgical disease was collected at each provincial hospital visited.
  
  
  RESULTS
  Surgical services are centralized to the NRH on Guadalcanal in Solomon Islands. Two provincial hospitals provide surgical care when a surgeon is available. Six of the hospitals evaluated provide only very basic surgical procedures. Infrastructure problems exist at every hospital including lack of running water, electricity, adequate diagnostic equipment, and surgical supplies. The number of surgeons and obstetricians employed by the Ministry of Health is currently inadequate for delivering care at the outer island hospitals.
  
  
  CONCLUSIONS
  Shortages in the surgical workforce can be resolved in Solomon Islands with focused training of new graduates. Training surgeons locally, in the Pacific region, can minimize the "brain drain." Redistribution of surgeons and obstetricians to the provincial hospitals can be accomplished by creating supportive connections between these hospitals, the NRH, and international medical institutions.
authors.affiliation: Loloma Foundation, Encinitas, CA, USA. esnmd@mac.com
authors.forename: Eileen S
authors.initials: ES
authors.lastname: Natuzzi
authors.forename: Adam
authors.initials: A
authors.lastname: Kushner
authors.forename: Rooney
authors.initials: R
authors.lastname: Jagilly
authors.forename: Douglas
authors.initials: D
authors.lastname: Pickacha
authors.forename: Kaeni
authors.initials: K
authors.lastname: Agiomea
authors.forename: Levi
authors.initials: L
authors.lastname: Hou
authors.forename: Patrick
authors.initials: P
authors.lastname: Houasia
authors.forename: Phillip L
authors.initials: PL
authors.lastname: Hendricks
authors.forename: Dudley
authors.initials: D
authors.lastname: Ba'erodo
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D003906:Developing Countries; D005260:Female; D013502:General Surgery / Q000458:organization & administration*; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008542:Melanesia; D013514:Surgical Procedures, Operative / Q000379:methods* / Q000639:trends; D014944:World Health Organization