Anaesthesia is in crisis in the developing world because of lack of investment in trained personnel, drugs and equipment, according to His Royal Highness The Duke of York, Patron of the Association of Anaesthetists of Great Britain and Ireland.
In the foreword to a special supplement on anaesthesia in the developing world, published by Anaesthesia, The Duke of York says that this situation is in stark contrast to the UK where patients undergoing surgery receive a first-class anaesthesia service from highly trained and motivated physician anaesthetists.
He points out that anaesthesia has fallen behind other medical specialities in the developing world and that this has had a major impact on mother and child deaths and on overall health care.
Effective, reliable anaesthesia, relief from pain and safe childbirth should be universal human rights, but these aims cannot be achieved without considerable commitment from anaesthetists everywhere stresses The Duke of York.
He has urged anaesthetists worldwide to spend time thinking about how they might be able to influence the improvement of anaesthesia services for patients in the developing world.
The Duke of York maintains that investment in anaesthesia is essential in striving towards the Millennium Development Goals of the World Health Organization without it, these farsighted aims may be largely unachievable he says.
Anaesthetists live in a global village adds Anaesthesia Editor Dr David Bogod, Consultant Anaesthetist at Nottingham City Hospital.
In an editorial, co-written with Dr Iain Wilson (Royal Devon and Exeter NHS Foundation Trust) and Dr Isabeau Walker (Great Ormond Street Hospital, London) he says that: The knowledge that our colleagues struggle in such basic situations should encourage us to support the development of our specialty worldwide.
Anaesthetists have a low status in many developing countries, says the editorial.
Emigration of medical staff is partly to blame, leaving few models to encourage the development of the specialty and subsequently very low numbers of medical graduates entering anaesthesia training.
The consequence in many countries is a technician-based specialty with poor image, low wages, inadequate equipment and conditions that limit professional development.
The consequences for patients are also very serious, especially in sub-Saharan Africa.
A recent study published in Anaesthesia showed that in Uganda there were only sufficient supplies to carry out six per cent of caesareans and 13 per cent of child surgery with safe anaesthesia.
Elsewhere in the developing world, mothers have a one in 16 chance of dying in childbirth and an even higher chance of their baby dying or being injured during childbirth.
Even in India, a country with high physician rates and some first rate services, lack of anaesthesia in rural areas is a major contributing factor to high maternal mortality rates.
Action is needed, not just at a personal level but at institutional, national and international levels according to Drs Bogod, Wilson and Walker.
Overseas development agencies need to recognise the place of anaesthesia in patient care.
The supplement has been produced as part of an international initiative by the Council of Science Editors to draw attention to the global issues of poverty and human development.
I was delighted to write the foreword for this very important supplement and hope that it will highlight the need for international action to tackle this essential area of healthcare in developing countries says The Duke of York.
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