An appropriate approach to orthopaedics in developing countries

Gifts of high technology and expensive buildings can constitute a disservice to a poor country when not accompanied by funding for the maintenance and running costs, since they will divert limited resources from more essential needs. The orthopaedic surgery that should be practised in many developing countries differs greatly from that in the contemporary Western world because of a different spectrum of disease, the consequences of uncontrolled disease processes and the less satisfactory conditions in which to function. Training in the home country is therefore essential and circumvents frustration and the brain drain from these countries. Poverty in material resources is not matched by poverty of intellect or resourcefulness, and we have much to learn from developing countries. Different cultures result in the needs of patients being quite different. Orthoses and prostheses need to be based on local crafts and resources, and some of these are illustrated. The Western world can best assist by having surgeons working, teaching and learning in the Developing World, using inexpensive means to treat the many and not to pamper the few.