Loloma Foundation, Encinitas, CA, USA.
World J Surg. 2011 Jun;35(6):1183-93. doi: 10.1007/s00268-011-1097-4.
Access to surgical care and emergency obstetrical care is limited in low-income countries. The Solomon Islands is one of the poorest countries in the Pacific region. Access to surgical care in Solomon Islands is limited and severely affected by a country made up of islands. Surgical care is centralized to the National Referral Hospital (NRH) on Guadalcanal, leaving a void of care in the provinces where more than 80% of the people live.
To assess the ability to provide surgical care to the people living on outer islands in the Solomon Islands, the provincial hospitals were evaluated using the World Health Organization's Global Initiative for Emergency and Essential Surgical Care Needs Assessment Tool questionnaire. Data on infrastructure, workforce, and equipment available for treating surgical disease was collected at each provincial hospital visited.
Surgical services are centralized to the NRH on Guadalcanal in Solomon Islands. Two provincial hospitals provide surgical care when a surgeon is available. Six of the hospitals evaluated provide only very basic surgical procedures. Infrastructure problems exist at every hospital including lack of running water, electricity, adequate diagnostic equipment, and surgical supplies. The number of surgeons and obstetricians employed by the Ministry of Health is currently inadequate for delivering care at the outer island hospitals.
Shortages in the surgical workforce can be resolved in Solomon Islands with focused training of new graduates. Training surgeons locally, in the Pacific region, can minimize the "brain drain." Redistribution of surgeons and obstetricians to the provincial hospitals can be accomplished by creating supportive connections between these hospitals, the NRH, and international medical institutions.
在低收入国家，获得外科护理和紧急产科护理的机会有限。所罗门群岛是太平洋地区最贫穷的国家之一。所罗门群岛的外科护理服务有限，并且受到岛国的严重影响。外科护理集中在瓜达尔卡纳尔的国家转诊医院（NRH），而在超过 80%的人口居住的省份则存在护理空白。
为了评估向所罗门群岛外岛居民提供外科护理的能力，使用世界卫生组织全球紧急和基本外科护理需求评估工具问卷对省级医院进行了评估。在访问的每个省级医院都收集了有关基础设施、劳动力和用于治疗外科疾病的设备的数据。
所罗门群岛的外科服务集中在瓜达尔卡纳尔的 NRH。当有外科医生时，有两家省级医院提供外科护理。评估的六家医院仅提供非常基本的外科手术。每家医院都存在基础设施问题，包括缺乏自来水、电力、足够的诊断设备和外科用品。卫生部雇用的外科医生和妇产科医生人数目前不足以在外岛医院提供护理。
所罗门群岛可以通过对新毕业生进行有针对性的培训来解决外科劳动力短缺问题。在太平洋地区对当地外科医生进行培训可以最大限度地减少“人才流失”。通过在这些医院、NRH 和国际医疗机构之间建立支持性联系，可以将外科医生和妇产科医生重新分配到省级医院。
