This study analyzes the unmet surgical needs in the african pediatric population. It addresses the indications for paediatric surgery, the problem of septic surgery, some anesthesia issues, the length of hospital stay, mortality incidence and causes. It is retrospective, considering clinical reports from Operating room and Pediatric ward of the Malindi Subcounty Hospital, Kenya, from 1/3/2017 to 24/5/2019. It enrolls 1019 patients. It includes interviews with the hospital staff on: the referring system, the availability of surgical instruments and hygiene conditions, possible improvements, costs to be paid by surgical patients. Our data highlight the deep connection between paediatric surgical pathologies and society, considering that indications that led to surgical treatment are the very first signs of wrong habits and poverty. Moreover, high number of OR accesses are due to septic surgery. Particularly worrying is the far too high number of pregnancies in adolescent girls, often getting a C-section potentially dangerous. Msh staff showed a clear understanding of the possible solutions, according to the interviews. This area deserves a sustainable development strategy: starting from childrens’ health may be the key for understanding how to get the best improvement not only in the health issues, but also in the whole society.
Titolo in italiano: Chirurgia pediatrica e Cooperazione internazionale: caso di studio presso il Malindi Subcounty Hospital, Kenya Il presente studio analizza le caratteristiche e le necessità della pratica chirurgica nella popolazione pediatrica del Malindi Subcounty Hospital, in Kenya. In particolare, quesiti specifici sono la distribuzione delle diagnosi chirurgiche, la percentuale di chirurgia settica, l’utilizzo dell’anestesia, la durata delle degenze, la mortalità e le sue cause. Lo studio è retrospettivo e considera 1019 pazienti raccolti dal 1/3/2017 al 24/5/2019. Esso include inoltre i risultati di interviste con lo staff dell’ospedale in merito al sistema di referring, alla disponibilità di strumentazione chirurgica, alle condizioni igieniche, ai possibili miglioramenti, ai costi sostenuti dai pazienti. I dati evidenziano una profonda connessione tra la chirurgia pediatrica e la società, in quanto molte indicazioni chirurgiche sono i primissimi segnali di povertà e di scorrette abitudini. In più, tanti accessi in sala operatoria sono dovuti a chirurgia settica. Emerge ancora un numero troppo alto di tagli cesarei in adolescenti, che denuncia gravidanze indesiderate e pratiche ostetriche obsolete. Lo staff, nelle interviste, dimostra una buona comprensione delle possibili soluzioni. L’Africa merita una strategia di sviluppo sostenibile. In questa area la salute dei bambini potrebbe essere una chiave perché, con il suo miglioramento, creerebbe un impatto positivo in tutta la società.
Pediatric Surgery and International Cooperation: case study at Malindi Subcounty Hospital, Kenya
TUNDO, ELEONORA
2018/2019
Abstract
This study analyzes the unmet surgical needs in the african pediatric population. It addresses the indications for paediatric surgery, the problem of septic surgery, some anesthesia issues, the length of hospital stay, mortality incidence and causes. It is retrospective, considering clinical reports from Operating room and Pediatric ward of the Malindi Subcounty Hospital, Kenya, from 1/3/2017 to 24/5/2019. It enrolls 1019 patients. It includes interviews with the hospital staff on: the referring system, the availability of surgical instruments and hygiene conditions, possible improvements, costs to be paid by surgical patients. Our data highlight the deep connection between paediatric surgical pathologies and society, considering that indications that led to surgical treatment are the very first signs of wrong habits and poverty. Moreover, high number of OR accesses are due to septic surgery. Particularly worrying is the far too high number of pregnancies in adolescent girls, often getting a C-section potentially dangerous. Msh staff showed a clear understanding of the possible solutions, according to the interviews. This area deserves a sustainable development strategy: starting from childrens’ health may be the key for understanding how to get the best improvement not only in the health issues, but also in the whole society.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/19192