Care of the injured in the Third World--what can we learn?

There is a need to put more emphasis on primary surgical care centred on provincial and district hospitals in the developing world using simple equipment which needs little maintenance and low running costs. The general duty doctors and paramedicals who are at the first point of contact with the patient, need practical on-site instruction in dealing with common surgical emergencies, of which injury forms a large part. To achieve this change in emphasis, provision should be made for surgical trainees and experienced surgeons from the United Kingdom or else where to work in selected provincial and district hospitals where support services can be adequately provided. The experience they would gain, would in turn benefit their patients in the National Health Service. If this activity is to have any chance of success, the training and research potential must be recognized by the Royal Colleges as valid experience in higher surgical training programmes. The National Health Service and the Health Authorities must accept these periods overseas as integral parts of a career in the National Health Service. This would include provision for superannuation, encouraging proleptic appointments to consultant posts, and secondment or early retirement of Consultants. Funding should be sought from international and national agencies for a pilot project based on a direct link between a district hospital in this country and a selected district or provincial hospital in a developing country.(ABSTRACT TRUNCATED AT 250 WORDS)