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Invited Critique
May 16, 2011

Teaching a New Dog Old Tricks: Comment on “The World Health Organization Program for Emergency Surgical, Obstetric, and Anesthetic Care”

Author Affiliations

Author Affiliations: Division of Trauma and Burn, Maine Medical Center, Portland.

Arch Surg. 2011;146(5):624. doi:10.1001/archsurg.2011.87

To paraphrase Dickens, we live in the best of times, and we live in the worst of times. The cultural and technological advances of the past century have vastly improved the length and quality of life for some, while the gap between the most advantaged and the least advantaged has widened into an abyss. This is strikingly evident in the area of emergency and essential surgical care.

The developed world must be part of the solution to this problem; the question is how best to help. We are capable of bringing trained medical personnel and state-of-the-art equipment to areas that lack these resources, transplanting a fully functioning modern surgical hospital anywhere in the world, but such a facility can rarely be sustained by local resources. Individual patients benefit, but the effect is inherently limited. On a different tack, the EESC program of the WHO, as described by Abdullah et al, does not provide direct patient care but aims instead to deliver tools to assist with the development of local resources and capabilities, thus creating lasting change.

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