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Glenn Geelhoed
George Washington University

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There are increasingly numerous and more impoverished people in the majority part of the world’s south euphemistically referred to in the hopeful economic term developing. These people suffer lack of almost everything which is found in such redundancy in the neighboring north. Most of the globe’s citizens live and die without benefit of a physicians attention. More than 90% of the world’s surgical needs exist outside Europe and North America. Yet all our training and technology are geared to service a minority representation of the world’s needs, while the vast majority of these needs are comfortably outside our view. This book assists in narrowing the divide between the labor and equipment intensive practice of medicine and surgery in Europe and North America (first world) and the third world of constrained resources where ingenuity is not only rewarded, but is a requirement in medical/surgical care. It reviews tricks of ancillary trades which add to the resourcefulness that can be brought to the field in laboratory, anesthesia, nursing services, and even such taken-for-granted supply of one’s own utility services such as water, electricity and basic materials like IV fluids and suture. Specific surgical treatments can be adapted to resource constraints. An important component of the medical mission is the sustainability of it through the training and continuing encouragement and assistance to those who will carry on at the field site, passing on and indigenizing hope. In addition, the author believes that the improvisations and techniques reviewed in this text can be carried back as skills learned—a gift from the third to the first world—and adapted to the care of increasingly diverse populations of patients closer to home. The intention is that lives should be enhanced on either side of the exchange. These goals are outlined in the intent and content of this book.

Table of contents

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Foreword Preface

1. Preparation Time
Harvey Bratt

2.Surgery in Developing Countries
John E. Woods

3.A Commitment to Voluntary Health Care Service
Donald C. Mullen

4.International Surgical Education: The Perspective from Several Continents
Glenn W. Geelhoed

5.Medicine Writ Large in the Raw, without Power or Plumbing
Glenn W. Geelhoed

6.To My Son, the Urologist
Douglas Walter Soderdahl and Douglas Wayne Soderdahl

7.Medicine and Surgery in the Third World
Lawrence Levy

8.Lab in a Suitcase
Christine A. King and James Kerr

9.Lab in a Suitcase: Saving Lives in Remote Corners of the Globe
Hollee D. Van der Veen and Milton B. Amanyun

10.Establishing Electrical Power in Remote Facilities for Health Care
Jeffrey A. Mazer

11.Tropical Nursing
Diana Downing

12.Communication in the Third World: A One Way Street
Jim Bascom

13.Anesthesia in the Third World
John F. Williams

14.Outpatient Assessment of the Pregnant Patient: Dilatation and Curettage
Kedrick D. Pickering

15.Basic Obstetrics and Obstetric Surgery in a Mission Setting
F. L. Dutton and Glenn W. Geelhoed

16.Pointers for American Surgeons Going to the Developing World
Donald E. Meier and John L. Tarpley

17.Training to Serve the Unmet Surgical Needs Worldwide
Robert J. W. Blanchard, Ronald C. Merrell, Glenn W. Geelhoed, Olajide O. Ajayi, Donald R. Laub and Edgar Rodas

18.Guide to the Operating Theater on $25 a Patient
Glenn P. Verbrugge

19.Orthopedic Surgery
Richard C. Fisher

20.Chronic Pyogenic Osteomyelitis in a Rural Area: The Aggravating Factor
of Underdevelopment
Ahuka Ona Longombe

21.Study of the Epidemiology and Treatment of Fractures in Rural North East
of Democratic Republic of Congo
Ahuka Ona Longombe, M. Mbusa, K. Diyo, M. Kakule, K. Kasindi and M. Duani

22.The Prevention and Treatment of Landmine Injuries in the Developing World
James C. Cobey

23.Cleft Lip and Palate Surgery in Developing Countries
William P. Magee

24.Outreach Dentistry: A World of Wonder Awaits in the Golden Anniversary
of General Dentistry
Glenn W. Geelhoed

25.Dentistry
David Foskett and Anthony M. Vandersteen

26.Reconstructive Surgery in the Tropics
Harold P. Adolph

27.Factors Influencing Geographic Distribution and Incidence of Tropical
Surgical Diseases
Ricardo Cohen, Frederico Aun and Glenn W. Geelhoed

28.Population Dynamics of Surgical Tropical Diseases
Ricardo Cohen, Frederico Aun, Glenn W. Geelhoed and Eric L. Sarin

29.Metabolic Maladaptation
Glenn W. Geelhoed

30.Nutrition and Development in Africa Risk: Factors on Either Side
of the Fulcrum Balance
Glenn W. Geelhoed

31.Uterine Ruptures in Rural Zaire
Ahuka Ona Longombe, K.M. Lusi and P. Nickson

32.Vesicovaginal Fistula of Obstetrical Origin in Northeast Democratic Republic
of Congo (DRC): The Experience of the CME Nyankunde
Ahuka Ona Longombe

33.Ophthalmology
James Kerr and Christine A. King

34.Accommodating Deficits in Material and Assistance
William L. Barrett, Laji Varghese and Malini Anand

35.Abscesses and Other Infections Treated by Surgery
Robert J. W. Blanchard

36.Surgical Training of Nurses for Rural Areas: Necessity or Aberration?
Ahuka Ona Longombe

37.Training of Medical Assitants in Mozambique for Surgery in a Rural Setting
Ivo Paulo Garrido

38.Training Surgeons in the Developing World
David C. Thompson

39.Mobile Surgery
Edgar Rodas and Edgar B. Rodas

40.Public Health Problems on Burma Frontiers: A Window into a Nation in Crisis
Myaing Nyunt

41.Medical Adventures in the Nigerian Bush
Glenn W. Geelhoed and Sally E. Geelhoed

42.Infectious Disease Mortality
Glenn Geelhoed

43.World Health
Glenn W. Geelhoed

44.Treating Others: Human Sciences in Theory and Practice
Glenn W. Geelhoed

45.The Impact of a Volunteer Medical Mission on the Attitudes, Knowledge
Base, and Reported Humanitarian Motivations of a Group of Medical and Public
Health Students
Glenn W. Geelhoed

46.Field Notes on the Clinical, Public Health, Geographic,
and Political Features of a Typical Day in a Himalayan Medical Mission
Glenn W. Geelhoed