Global Surgery and Anesthesia Manual Providing Care in Resource-limited Settings

Highly Commended, BMA Medical Book Awards 2015 In 2008, Paul Farmer and Jim Yong Kim described global surgery as the "neglected stepchild" of healthcare, and now leaders from around the world are working to redefine it as a human right through the Lancet Commission on Global Surgery. In order to help advance global surgery and anesthesia as a public health intervention, providers require a practical, hands-on manual to train and educate them to provide safe and effective surgery and anesthesia in resource-limited settings. In an effort to respond to that need, over 140 clinicians from high-, low-, and middle-income countries collaborated to create the Global Surgery and Anesthesia Manual: Providing Care in Resource-Limited Settings. This guide provides in-depth instruction on epidemiology and ethics surrounding surgical services, and on anesthesia, perioperative care, trauma surgery, and non-trauma surgery. With contributions from a group of culturally and academically diverse clinicians, each chapter is enriched by at least one commentary from a surgeon or anesthesia provider in a low- or middle-income country (LMIC) who shares first-hand perspectives on the realities and complexities of providing surgical care in these settings with limited resources. The book will serve as a core reference for surgeons and anesthesiologists at all levels interested in global surgery. It will assist those working in LMICs who are confronted with surgical problems that they are not routinely exposed to in their traditional practice. Filled with expert guidance, decision-making algorithms, and treatment options, it will also serve as an invaluable text for trainees in LMICs as it covers the majority of surgical disease processes that would be encountered in such settings.

Introduction The Global Burden of Surgical Disease; K. A. Kelly McQueen Commentator: Zipporah Gathuya Ethical Considerations; David B. Waisel and Caris Grimes Commentator: Wangari Nyaga Developing Surgical Capacity: Models of Implementation; Regan Bergmark, Wendy Williams, Johanna N. Riesel, Doreen Nakku, and Mack Cheney Commentators: Nobhojit Roy, Nakul Raykar Anesthesia Preparing for a Trip: OR Management; Craig D. McClain Commentator: Clover Ann Lee Pharmacology of Commonly Used Drugs; Leal G. Segura Commentators: Edouard Uwamahoro, Denise M. Chan Regional Anesthesia; Christopher S. Lee and Navil F. Sethna Commentator: Alexandra Torborg Preoperative Evaluation; Cynthia S. Tung Commentators: Francoise Nizeyimana, Denise M. Chan Intraoperative Management; Terrance A. Yemen Commentators: Francoise Nizeyimana, Denise M. Chan Postoperative Care: PACU and ICU; Traci A. Wolbrink and Martin Zammert Commentators: Francoise Nizeyimana, Denise M. Chan Resuscitation and Approach to Crisis Situations; Ann T. Hau and Craig D. McClain Commentators: Edouard Uwamahoro, Denise M. Chan Non-Trauma Chest; Abraham Lebenthal and Alexi C. Matousek Commentator: Koffi Herve Yangni-Angate Acute Abdomen; Reinou S. Groen and Adam L. Kushner Commentators: Okao Patrick, Louis-Franck Telemaque, Ntakiyiruta Georges Stomach; David S. Shapiro Commentator: Ntakiyiruta Georges Liver, Pancreas and Gall Bladder; Kelly Hewitt and Raymond R. Price Commentators: Jigjidsuren Chinburen, Tsiiregzen Enkh-Amgalan Spleen; Mallory Williams, Quyen D. Chu, and Selwyn O. Rogers Commentators: Ndukauba Eleweke, Ntakiyiruta Georges, Okao Patrick Appendicitis; Ibrahim M. Daoud and Vladimir P. Daoud Commentators: Edgar Rodas, Edgar B. Rodas Hernia; Joaquim M. Havens Commentators: Edgar Rodas, Edgar B. Rodas Colon and Rectum; Allison F. Linden and Kathryn Chu Commentator: Thandinkosi E. Madiba Anus and Rectum; Joel E. Goldberg Commentator: Thandinkosi E. Madiba, Ntakiyiruta Georges Laparoscopy; Gabriela M. Vargas and Raymond R. Price Commentator: Sergelen Orgoi Breast Cancer; Lisa A. Newman, Marcel Bayor, Evelyn Jiagge, Der Muonir Edmund, and Mawuli Gyakobo Commentators: Ouyang Lizhi, Ruth Damuse Obstetrics; Reinou S. Groen and Adam L. Kushner Commentator: Bomi Ogedengbe Gynecology; Felicia Lester and Sierra Washington Commentator: Tarek Meguid Genitourinary Surgery; Marc D. Manganiello and Jill Buckley Commentators: E. Oluwabunmi Olapade-Olaopa, Thaim Buya Kamara Neurosurgery; Benjamin C. Warf Commentator: John Mugamba Otorhinolaryngology; Robert M. Boucher Commentator: Wakisa Mulwafu Thyroidectomy; Robert M. Boucher Commentator: Emmanuel R. Ezeome Ophthalmology; Matthew C. Bujak and Geoffrey Tabin Commentator: John Nkurikiye Dentistry; Joel S. Reynolds and Robert P. Horne Commentator: Rose Dina Premier Orthopedic Surgery; George S.M. Dyer Commentator: Ankur B. Bamne Pediatric Surgery; Doruk Ozgediz and Emmanuel A. Ameh Commentator: Milliard Derbew Oncology; T. Peter Kingham and Olusegun Alatise Commentator: Ruth Damuse Infectious Diseases; Gita N. Mody, Sachita Shah, and Robert Riviello Commentators: Samuel Abimerech Luboga, Peter M. Nthumba Soft-Tissue Coverage and Flaps; Christopher D. Hughes and Nadine Semer Commentators: Jorge Palacios, Chona Thomas, Charles Furaha, Christian Paletta Skin Grafts; Ingrid Ganske and Jennifer Wall Commentators: Jorge Palacios, Charles Furaha, Christian Paletta Wound Care; Helena O.B. Taylor and Stephen R. Sullivan Commentators: Ntakiyiruta Georges, Sterman Toussaint, Okao Patrick, Okechukwu O. Onumaegbu Trauma Disaster Management; Susan Miller Briggs and Guy Lin Commentator: Emmanuel Kayibanda Initial Evaluation of the Trauma Patient; William P. Schecter Commentator: Sebastian O. Ekenze Amputation; Samuel C. Schecter and Nikolaj Wolfson Commentators: L.O.A. Thanni, Michael O. Ogirima Burns; Jennifer Wall, Gita N. Mody, and Robert Riviello Commentators: Nivaldo Alonso, Daniel Chimutu, David Morton Thoracic Trauma; Abraham Lebenthal and Alexi Matousek Commentators: Koffi Herve Yangni-Angate, Ikechukwu A. Nwafor Abdominal Trauma; Alexi Matousek, Thomas G. Weiser, and Selwyn O. Rogers Commentators: Rodolphe R. Eisenhower Jean-Louis, Emmanuel Kayibanda Urologic Trauma; Kristen R. Scarpato, Hiep T. Nguyen, and Richard N. Yu Commentators: Demberelnyambuu Batsukh, E. Oluwabunmi Olapade-Olaopa, Emile Rwamasirabo Neurosurgical Trauma; Benjamin C. Warf Commentator: John Mugamba Maxillofacial Trauma; Daniel J. Meara Commentators: Bin Song and C.C. Uguru Ophthalmic Trauma; Matthew C. Bujak, Geoffrey C. Tabin, and Benjamin J. Thomas Commentators: Ifeoma Ezegwui, John Nkurikiye Soft-Tissue Injuries of the Face; Christopher D. Hughes and Julian J. Pribaz Commentator: Nivaldo Alonso Spinal Trauma; Andrew K. Simpson and Mitchel B. Harris Commentator: Ankur B. Bamne Upper Extremity Trauma; Paul T. Appleton and Joseph P. DeAngelis Commentator: Ankur B. Bamne Hand Trauma; Simon G. Talbot and Amir H. Taghinia Commentator: Nyengo Mkandawire Lower Extremity Trauma; Paul T. Appleton, J. Kent Ellington, and John Y. Kwon Commentator: Ankur B. Bamne References Appendix: Safety, Security, and Survival Considerations for Healthcare Providers in Remote, Hostile, and Disaster Areas; Mykel Hawke Index

John G. Meara, MD, DMD, MBA, FACS, FRACS is Director of the Program in Global Surgery and Social Change at Harvard Medical School, Chairman of the Executive Committee of the Harvard Plastic Surgery Training Program, and Plastic Surgeon-in-Chief at Boston Children’s Hospital. Since 2008, he has Co-Directed the Paul Farmer Global Surgery Fellowship program in collaboration with Partners in Health. His clinical interests and innovation activities are in the areas of craniofacial anomalies, and cleft lip and cleft palate. Dr. Meara is particularly interested in augmenting the delivery of quality surgical care in low-resource settings, and serves as chair for the Lancet Commission on Global Surgery. Craig D. McClain, MD, MPH is an anesthesiologist at Boston Children’s Hospital, an Assistant Professor of Anesthesia, and Affiliate Faculty in the Department of Global Health and Social Medicine at Harvard Medical School. He has spent time working in multiple low-resource countries in Asia, Africa, South America, and the Caribbean. He currently serves as the lead anesthesiologist for Harvard Medical School for the Human Resources for Health project in Rwanda. He is the founder and Director of the Global Pediatric Anesthesiology Fellowship at Boston Children’s Hospital. His academic interests include improving the perioperative care of children undergoing neurosurgical procedures, as well as improving the safe delivery of anesthesia and perioperative care in low-resource countries. Selwyn Rogers, Jr., MD, MPH, FACS has served as Division Chief of Trauma, Burn, and Surgical Critical Care at Brigham and Women’s Hospital. In 2005, Dr. Rogers helped launch the Center for Surgery and Public Health, whose mission is to understand the nature, quality, and utilization of surgical care globally. His research includes examining processes to improve quality of care and improving the understanding surgical disparities to close the quality chasm for underserved populations nationally and globally. Dr. Rogers served as Surgeon-in-Chief of Temple University Health System from 2012 to 2014. He now serves as Chief Medical Officer at the University of Texas Medical Branch. David P. Mooney, MD, MPH, FACS is Director of the Trauma Center at Boston Children’s Hospital, an Associate Professor in Surgery, and Affiliate Faculty in the Department of Global Health and Social Medicine at Harvard Medical School. He has been active in Partners in Health and was a part of the U.S. National Disaster Medical System response to the 2010 Haitian earthquake. He is one of the founders of the Pediatric Trauma Society. His interests include the development of trauma care and trauma systems for children in a variety of resource settings.