Dormans J P, Fisher R C, Pill S G
Orthopaedic Surgery, Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104-4399, USA.
J Am Acad Orthop Surg. 2001 Sep-Oct;9(5):289-96. doi: 10.5435/00124635-200109000-00002.
Half of the world's population lack access to adequate primary health care, and two thirds lack access to orthopaedic care. Globally, the need for health care outstrips the available resources. This problem is compounded in the developing world by a lack of trained medical personnel, a lack of medical facilities, and, in many regions, an inability to access existing facilities. There is little specific epidemiologic data about the exact burden of musculoskeletal disease in these countries, but most agree that it is reasonable to assume that it will increase. In the least developed and developing nations, problems with access are related to fundamental issues such as infrastructure, physical facilities, equipment, and trained personnel. There are a number of ways in which the orthopaedic community can become involved in ameliorating the burden. Education is the most effective method of providing a sustainable solution. The objective of educational organizations should be to train local health-care workers at all levels in their own environment to provide sustainable and appropriate care so that the programs become self-sufficient and ensure a continued supply of competent medical personnel.
世界上一半的人口无法获得足够的初级卫生保健，三分之二的人口无法获得骨科护理。在全球范围内，医疗保健需求超过了可用资源。在发展中国家，由于缺乏训练有素的医务人员、医疗设施，而且在许多地区无法使用现有设施，这一问题更加复杂。关于这些国家肌肉骨骼疾病的确切负担，几乎没有具体的流行病学数据，但大多数人都认为，有理由假定其负担将会增加。在最不发达国家和发展中国家，获得医疗服务的问题与基础设施、物理设施、设备和训练有素的人员等基本问题有关。骨科界可以通过多种方式参与减轻这一负担。教育是提供可持续解决方案的最有效方法。教育组织的目标应该是在当地环境中培训各级当地卫生保健工作者，以提供可持续和适当的护理，使这些项目能够自给自足，并确保有持续的合格医务人员供应。
