Anaesthesia is in crisis in the developing world because of lack of investment in trained personnel, drugs and equipment, according to His Royal Highness The Duke of York, Patron of the Association of Anaesthetists of Great Britain and Ireland.
In the foreword to a special supplement on anaesthesia in the developing world, published by Anaesthesia, The Duke of York says that this situation is in stark contrast to the UK where patients undergoing surgery “receive a first-class anaesthesia service from highly trained and motivated physician anaesthetists.”
He points out that anaesthesia has fallen behind other medical specialities in the developing world and that this has had a major impact on mother and child deaths and on overall health care.
“Effective, reliable anaesthesia, relief from pain and safe childbirth should be universal human rights, but these aims cannot be achieved without considerable commitment from anaesthetists everywhere” stresses The Duke of York.
He has urged anaesthetists worldwide to “spend time thinking about how they might be able to influence the improvement of anaesthesia services for patients in the developing world.”
The Duke of York maintains that investment in anaesthesia is essential in striving towards the Millennium Development Goals of the World Health Organization – “without it, these far–sighted aims may be largely unachievable” he says.
“Anaesthetists live in a global village” adds Anaesthesia Editor Dr David Bogod, Consultant Anaesthetist at Nottingham City Hospital.
In an editorial, co-written with Dr Iain Wilson (Royal Devon and Exeter NHS Foundation Trust) and Dr Isabeau Walker (Great Ormond Street Hospital, London) he says that: “The knowledge that our colleagues struggle in such basic situations should encourage us to support the development of our specialty worldwide”.
Anaesthetists have a low status in many developing countries, says the editorial.
“Emigration of medical staff is partly to blame, leaving few models to encourage the development of the specialty and subsequently very low numbers of medical graduates entering anaesthesia training.
“The consequence in many countries is a technician-based specialty with poor image, low wages, inadequate equipment and conditions that limit professional development.”
The consequences for patients are also very serious, especially in sub-Saharan Africa.
A recent study published in Anaesthesia showed that in Uganda there were only sufficient supplies to carry out six per cent of caesareans and 13 per cent of child surgery with safe anaesthesia.
Elsewhere in the developing world, mothers have a one in 16 chance of dying in childbirth and an even higher chance of their baby dying or being injured during childbirth.
Even in India, a country with high physician rates and some first rate services, lack of anaesthesia in rural areas is a major contributing factor to high maternal mortality rates.
“Action is needed, not just at a personal level but at institutional, national and international levels” according to Drs Bogod, Wilson and Walker.
“Overseas development agencies need to recognise the place of anaesthesia in patient care.”
The supplement has been produced as part of an international initiative by the Council of Science Editors to draw attention to the global issues of poverty and human development.
“I was delighted to write the foreword for this very important supplement and hope that it will highlight the need for international action to tackle this essential area of healthcare in developing countries” says The Duke of York.
Free online access to all the articles in this special Anaesthesia supplement is available at http://www.blackwell-synergy.com/toc/ana/62/s1
Notes to Editors
- Anaesthesia in developing countries is a special supplement produced by Anaesthesia (vol 62, S1 – December 2007) with a foreword by HRH The Duke of York, (p1) and Editorial by Walker, Wilson and Bogod (p 2-3). For free online access to all papers visit: http://www.blackwell-synergy.com/toc/ana/62/s1
- The eight Millennium Development Goals (MDGs) – which range from halving extreme poverty to halting the spread of HIV/AIDS and providing universal primary education, all by the target date of 2015 – form a blueprint agreed to by all the world’s countries and all the world’s leading development institutions. They have galvanized unprecedented efforts to meet the needs of the world’s poorest. (source: www.un.org/millennium)
- Anaesthesia, which was established in 1945, is the official journal of the Association of Anaesthetists of Great Britain and Ireland. It publishes original, peer-reviewed articles to an international audience on all aspects of general and regional anaesthesia, intensive care and pain therapy, including research on equipment. Consultant Anaesthetist Dr David Bogod of Nottingham City Hospital, UK, is Editor in Chief of the journal, which is published by Wiley-Blackwell. www.blackwellpublishing.com/ana
- About Wiley-Blackwell. Wiley-Blackwell was formed in February 2007 as a result of the acquisition of Blackwell Publishing Ltd. by John Wiley & Sons, Inc., and its merger with Wiley’s Scientific, Technical, and Medical business. Together, the companies have created a global publishing business with deep strength in every major academic and professional field. Wiley-Blackwell publishes approximately 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal. For more information on Wiley-Blackwell, please visit www.blackwellpublishing.com or http://interscience.wiley.com.
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