Measuring global surgical disparities: a survey of surgical and anesthesia infrastructure in Bangladesh.
BACKGROUND
Surgically treatable diseases weigh heavily on the lives of people in resource-poor countries. Though global surgical disparities are increasingly recognized as a public health priority, the extent of these disparities is unknown because of a lack of data. The present study sought to measure surgical and anesthesia infrastructure in Bangladesh as part of an international study assessing surgical and anesthesia capacity in low income nations.


METHODS
A comprehensive survey tool was administered via convenience sampling at one public district hospital and one public tertiary care hospital in each of the seven administrative divisions of Bangladesh.


RESULTS
There are an estimated 1,200 obstetricians, 2,615 general and subspecialist surgeons, and 850 anesthesiologists in Bangladesh. These numbers correspond to 0.24 surgical providers per 10,000 people and 0.05 anesthesiologists per 10,000 people. Surveyed hospitals performed a large number of operations annually despite having minimal clinical human resources and inadequate physical infrastructure. Shortages in equipment and/or essential medicines were reported at all hospitals and these shortages were particularly severe at the district hospital level.


CONCLUSIONS
In order to meet the immense demand for surgical care in Bangladesh, public hospitals must address critical shortages in skilled human resources, inadequate physical infrastructure, and low availability of equipment and essential medications. This study identified numerous areas in which the international community can play a vital role in increasing surgical and anesthesia capacity in Bangladesh and ensuring safe surgery for all in the country.
Thomas J. Watson Foundation, 11 Park Place, New York, NY 10007, USA. drake.lebrun@gmail.com
Drake G
DG
Lebrun
Debashish
D
Dhar
Md Imran H
MI
Sarkar
T M Tanzil A
TM
Imran
Sayadat N
SN
Kazi
K A Kelly
KA
McQueen
D000776:Anesthesiology / Q000458:organization & administration*; D001459:Bangladesh; D003625:Data Collection; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D013043:Specialties, Surgical / Q000458:organization & administration*; D000078329:Workforce