Pediatric surgery in Bangladesh.

Bangladesh, although a small country of only 55,000 square miles, is the world's eighth most populous nation, and its 90 million inhabitants occupy a land of harsh economic conditions. One half of this dense population is children, 90% of whom suffer from parasitic infestations, 10% are affected with neonatal tetanus, and one half are severely malnourished. Health care resources are scarce with one physician and hospital bed for about every 10,000 persons. A 1-month stay in Bangladesh at the Dhaka Shishu Hospital, made possible by the Canadian Association of Paediatric Surgeons, afforded an invaluable opportunity to be involved in Pediatric Surgery in such a setting. During the month, over 40 major pediatric surgical procedures were performed, including sequestrectomy, drainage of parietal wall abscess, and resection of massive neoplasms. Many unusual pathologic conditions, not commonly seen in Western countries, were encountered including canker otis, tuberculous ileitis, and ascaris-induced small bowel obstruction. In the setting of widespread malnutrition and limited diagnostic aids, appropriate surgical treatment remains crucial in many serious childhood conditions. Awareness of some of the more unusual infections and parasites seen in Third World nations is of great importance to Western surgeons due to increased travel and immigration and for a perspective on diseases rarely seen in more affluent countries.