The Scope and Challenges of Rural Surgical Practice in Nigeria

Abstract

Background: Rural surgical practice is the practice of Surgery under conditions of limited resources which brings surgical services to the doorsteps of the rural Populace, majority of whom are poor.
Aims: The aim of this paper is to highlight rural surgical practice in Nigeria.
Materials and Methods: A review of personal experiences in rural surgery and interaction with other practitioners in the field as well information gathered at Rural Surgery conferences in Nigeria and abroad.
Results: Scope of surgery performed is commonly usually limited by infrastructure, manpower and funding. Procedures include fields as Obstetrics and Gynaecology, Urology, Orthopaedics, Ear Nose and throat, Anaesthesia as well as General Surgery. A high proportion is contributed by emergencies especially Caesarian Sections, removal of foreign bodies from the ear, nose and throat, initial management of simple fractures, Hip-pinning, appendectomies, relief of intestinal obstruction, suprapubiccystostomies, catheterization and management of ruptured ectopic tubal pregnancies. The procedures are carried out by General Duty doctors with only a few surgeons in established self-owned practices. Challenges include poor living conditions, poor accessibility, lack of infrastructure and equipment, lack of suitably trained assistants, inadequate schools for their children, lack of suitable jobs for spouses. In spite of difficulties Rural Surgery in Nigeria has come to stay and is growing especially with formation of Rural Surgical Practitioners in Nigeria.
Conclusion: Rural surgical practice is feasible in Nigeria and should be encouraged by the Government as it forms an important arm of Healthcare delivery in Nigeria.

Key Words: Rural, Surgery, Scope, Challenges, Limited resources, Poverty