[Emergency care in tropical areas: status report based on surgical emergencies in Senegal]

Management of surgical emergencies in Senegal is characterized by a mismatch between supply of facilities and demand for care. The situation has been complicated by runaway urban growth. Two situations can be distinguished in rural zones and in the major city of Dakar. The common features in both locations are chronic underfunding, absence of pre-hospital emergency and rescue services, and inadequacy of health care facilities to manage emergency situations. In urban and rural areas, hospital are oversollicited, poorly designed and managed in terms of infrastructure and equipment, and understaffed in terms of surgeons and qualified paramedical personnel. The main differences between urban and rural areas involve the volume and type of surgical emergencies with a constantly increasing number of trauma emergencies in cities. Solving these problems will require a specific national plan to develop emergency care services in general. This plan will require coordination of funding, re-organisation of hospital facilities, and hiring and training of qualified personnel (surgeons and paramedical staff).