Universal precautions and surgery in Sierra Leone: the unprotected workforce

Area of Science:

• Global health
• Infectious disease epidemiology
• Surgical safety

Background:

• Sub-Saharan Africa, including Sierra Leone, faces high Human Immunodeficiency Virus (HIV) prevalence, posing risks to surgical patients and healthcare workers.
• Sierra Leone's status as one of the world's poorest nations exacerbates challenges in healthcare provision and infection control.
• Healthcare workers in surgical settings are particularly vulnerable to occupational HIV exposure from patients.

Purpose of the Study:

• To assess the availability and adequacy of essential HIV-protective supplies and equipment in government hospitals in Sierra Leone.
• To compare the stock levels of protective gear in government facilities with those in mission and private hospitals within Sierra Leone.

Main Methods:

• A survey was conducted by the Society of International Humanitarian Surgeons in collaboration with the Sierra Leonean Ministry of Health and Sanitation.
• The survey documented the presence of specific protective items: eye protection, sterile gloves, aprons, functioning suction machines, and sharps containers.
• Data from government hospitals were compared with findings from a local mission hospital and a private hospital.

Main Results:

• Government hospitals in Sierra Leone demonstrate critical shortages of sterile gloves and eye protection, with only 20% adequately stocked.
• Availability of suction pumps and aprons is limited to 30-40% of facilities, and functioning sterilizers and sharps containers are present in only 50%.
• In stark contrast, the local mission and private hospitals were found to be fully equipped with necessary protective supplies.

Conclusions:

• Despite the recognized occupational risks of HIV exposure for surgical staff, government hospitals in Sierra Leone are severely deficient in essential protective resources.
• The Society of International Humanitarian Surgeons is initiating a program to supply protective gear, but broader support is crucial.
• Additional collaborative efforts from diverse organizations are essential to mitigate HIV transmission risks in Sierra Leone's healthcare system.