Contents

 

The goal of the DTC is to enable access to a qualitatively acceptable surgical care to all human beings in little and medium income countries (LMIC´s) regardless of their social background. Amongst others the following concepts and activities serve this purpose:

  • Direct and project-based support of healthcare facilities
  • Training of personnel
  • Realization of tropical surgery oriented workshops and symposia
  • Development of appropriate surgical technologies
  • Cooperation with national and international organizations
  • Encouragement of North-South-partnerships between colleagues and clinics

 

Every fourth human being worldwide has no access to basic surgical or emergency care.  This number has barely changed after many years of „developmental aid“ and millions worth of healthcare programs. The surgical care in developing countries is always a reflection of their economic situation. The latter bears the only solution in the long run. Meanwhile the countries can be supported with the improvement of medical care. This assistance should be sustained for a longer duration and realized in the framework of direct partnerships with hospitals or doctors (preferably in rural areas). It is particularly effective when both material assistance as well as training of medical personnel are accounted for. The German Association for Tropical Surgery has dedicated itself to these matters.

 

Surgery  under acceptance of local circumstances

 

The „German Association for Tropical Surgery“ (DTC) was founded in 1990 initially under the name of „Association for the promotion of surgery in developing countries” and two years later it received its current name after many colleagues from other surgical specialities and anesthesiology had joined in. Today it has around 300 members; 60 amongst these are from Africa, Asia or Latin America.

Its original name points towards the main concern of the DTC – namely to partake actively  in  making access to qualitatively acceptable surgical care reachable for the whole population (regardless of socio-economic status) in the countries of the Third World.

 

Female surgical ward at Zomba Central Hospital in Malawi: very high bed occupancy rate (180%) and no separation of septic and aseptic patients

 

 

What to do?

The idea of surgery in developing countries stands for surgical care of people in LMIC´s considering local and regional particularities. From the surgical point of view there is a particular spectrum of diseases to be considered. Also the socio-economic conditions and the (often lacking) psychosocial acceptance of rational shaped medicine have to be considered. All concepts planning to improve the essential surgical care in LMIC´s should take these into account.

According to our experiences, the starting point and emphasis of all projects should be decentralized and begin with patient care. Over time it should be continued as a concrete partnership of few persons or institutions, integrating governmental health authorities, implementing infrastructures and including material support as well as further education of medical personnel.

 

 

DTC activities in Germany

We are conducting an annual national symposium and a biannual international symposium. Special topics of surgical and neighboring medical fields are discussed. The symposia are supplemented by regular courses where basic surgical techniques, such as suture techniques, trepanation of the skull, obstetric procedures, ultrasound, external fixation of bones and conservative fracture-treatment, are taught „hands-on“.

 

Teaching nutrition for mothers of malnourished children at Zomba Central Hospital, Malawi

 

 

Henning Mothes