[Does tropical environment influence morbidity and mortality?]

Despite enormous progress in medical science, health care coverage in poor countries remains incomplete, uncertain and minimal. The probability of death is higher in Africa. Life expectancy is only from 50 to 55 on the African continent in comparison with over 70 years in North America and Europe. The African population is predominantly young but malnutrition, deficiencies, anemia, parasitism and genetic defects (drepanocytemia) are widespread. In general treatment of acute trauma and illness is straightforward and vital or functional prognosis is good provided that proper elementary care is administered rapidly. However due to difficult field conditions and limited medical facilities, care is often delayed. Most patients are admitted with advanced, complicated disease to facilities that are often poorly equipped, undersupplied and lacking in qualified personnel, basic medication and blood products. This combination of factors accounts in part for the fact that prognosis of the same disease is poorer in tropical areas than in other areas of the world. Rational use of human resources and better organization of international cooperation would allow short-term improvement in health care in tropical areas. It is only at this price that people in the Northern and Southern hemisphere in this time of globalization can have the same chance of survival for the same disease.