Derenoncourt Max Herby, Carré Roselaine, Condé-Green Alexandra, Rodnez Alain, Sifri Ziad C, Baltazar Gerard A
Hospital Bernard-Mevs, Blvd Toussaint Louverture, Village Solidarite #2, Port-au-Prince, Haiti.
Division of Plastic Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
World J Surg. 2016 Apr;40(4):801-5. doi: 10.1007/s00268-015-3302-3.
The 2010 Haiti earthquake severely strained local healthcare infrastructure. In the wake of this healthcare crisis, international organizations provided volunteer support. Studies demonstrate that this support improved short-term recovery; however, it is unclear how long-term surgical capacity has changed and what role volunteer surgical relief efforts have played. Our goal was to investigate the role of international surgical volunteers in the increase of surgical capacity following the 2010 Haiti earthquake.
We retrospectively analyzed the operative reports of 3208 patients at a general, trauma and critical care hospital in Port-au-Prince from June 2010 through December 2013. We collected data on patient demographics and operation subspecialty. Surgeons and anesthesiologists were categorized by subspecialty training and as local healthcare providers or international volunteers. We performed analysis of variance to detect changes in surgical capacity over time and to estimate the role volunteers play in these changes.
Overall number of monthly operations increased over the 2.5 years post-earthquake. The percentage of orthopedic operations declined while the percentage of other subspecialty operations increased (p = 0.0003). The percentage of operations performed by international volunteer surgeons did not change (p = 0.51); however, the percentage of operations staffed by volunteer anesthesiologists declined (p = 0.058). The percentage of operations performed by matching specialty- and subspecialty-trained international volunteers has not changed (p = 0.54).
Haitian post-earthquake local and overall surgical capacity has steadily increased, particularly for provision of subspecialty operations. Surgical volunteers have played a consistent role in the recovery of surgical capacity. An increased focus on access to surgical services and resource-allocation for long-term surgical efforts particularly in the realm of subspecialty surgery may lead to full recovery of surgical capacity after a large and devastating natural disaster.
2010年海地地震严重破坏了当地的医疗基础设施。在这场医疗危机之后，国际组织提供了志愿者支持。研究表明，这种支持促进了短期恢复；然而，长期手术能力如何变化以及志愿手术救援工作发挥了什么作用尚不清楚。我们的目标是调查国际手术志愿者在2010年海地地震后手术能力提升中所起的作用。
我们回顾性分析了2010年6月至2013年12月在太子港一家综合、创伤和重症监护医院的3208例患者的手术报告。我们收集了患者人口统计学和手术亚专业的数据。外科医生和麻醉师根据亚专业培训情况以及是当地医疗服务提供者还是国际志愿者进行分类。我们进行方差分析以检测手术能力随时间的变化，并估计志愿者在这些变化中所起的作用。
地震后的2.5年里，每月手术总数有所增加。骨科手术的比例下降，而其他亚专业手术的比例上升（p = 0.0003）。国际志愿外科医生进行的手术比例没有变化（p = 0.51）；然而，志愿麻醉师参与的手术比例下降（p = 0.058）。由经过匹配的专业和亚专业培训的国际志愿者进行的手术比例没有变化（p = 0.54）。
海地地震后当地和整体手术能力稳步提高，特别是在提供亚专业手术方面。手术志愿者在手术能力恢复中发挥了持续作用。更加关注手术服务的可及性以及长期手术工作的资源分配，尤其是在亚专业手术领域，可能会在重大灾难性自然灾害后实现手术能力的完全恢复。
