Surgical outreach program in poor rural Nigerian communities.

INTRODUCTION The majority of the world's population resides in rural areas without access to basic surgical care. Taraba State in North-Eastern Nigeria consists of rural communities where approximately 90% of the State's population resides. METHODS This was a prospective study of patients whose surgical conditions were treated during surgical outreach program in rural North-Eastern Nigeria communities between February 2008 and July 2009. RESULTS A total of 802 patients had 903 procedures due to the co-existence of multiple pathologies in 97 patients (12.1%). There were 506 males (63.1%) providing a male to female ratio of 1.7:1. Ages ranged between one month and 91 years (mean 35.2±18.8 SD). Hernia repair 404 (44.7%), hydrocelectomy±orchidectomy 133 (14.7%), lumps excision 143 (15.8%) and appendicectomy 66 (7.3%) were the most frequent procedures. The surgical conditions were frequently long in duration and huge in size. The duration of goitres ranged from 2 to 28 years (10.3±7.4) and 4 to 42 years (15±13.9) in patients with cleft lip and palate. The procedures were performed under spinal, general and local anaesthesia in 7.6%, 34.3% and 58.2% of patients, respectively. No mortality was recorded but the complications encountered included: surgical site infection 46 (5.1%), scrotal haematoma and oedema 6 (0.7%), haemorrhage 3 (0.3%) and partial wound dehiscence 3 (0.3%). CONCLUSION Surgical pathologies in rural communities are often multiple, wide ranging and of long duration. Such conditions can be successfully managed under local or spinal anaesthesia. Based on the authors' experience, a remarkable reduction in surgical disease burden is feasible in these communities using available, simple but effective options.