Surgical Care at the District Hospital

Many patients who present to district (first-referral) level hospitals require surgical treatment for trauma, obstetric, abdominal or orthopaedic emergencies. Often surgery cannot be safely postponed to allow their transfer to a secondary or tertiary-level hospital, but many district hospitals in developing countries have no specialist surgical teams and are staffed by medical, nursing and paramedical personnel who perform a wide range of surgical procedures, often with inadequate training. The quality of surgical and acute care is often further constrained by poor facilities, inadequate low-technology apparatus and limited supplies of drugs, materials and other essentials.

The mission of the team responsible for Devices and Clinical Technology in the World Health Organization Department of Blood Safety and Clinical Technology (WHO/BCT) is to promote the quality of clinical care through the identification, promotion and standardization of appropriate procedures, equipment and materials, particularly at district hospital level. WHO/BCT has identified education and training as a particular priority, especially for non-specialist practitioners who practise surgery and anaesthesia. It has therefore developed Surgical Care at the District Hospital as a practical resource for individual practitioners and for use in undergraduate and postgraduate programmes, in-service training and continuing medical education programmes. The manual is a successor of three earlier publications that are widely used throughout the world and that remain important reference
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