Major and minor surgery at a rural African hospital

Surgical operations performed at Ombo Hospital in Western Kenya from January to December 1989 were studied and annual surgical rates were calculated based on the estimated catchment area population. The total annual rate of major surgery at this church-supported hospital was 207 operations per 100,000 people. This rate is similar to those at other East African hospitals while rates in industrialized countries are 20-35 times higher. The most common major procedures were Caesarean section, laparotomy, hernia repair and salpingectomy. The 1989 rate of minor operations at the hospital was 1286 per 100,000 people with tooth extraction, wound suture, incision and drainage, evacuation of the uterine cavity and closed reduction of fracture as the most frequent procedures. Major operations were performed exclusively by doctors while minor surgery was carried out mainly by clinical officers, nurses and other auxiliary staff.