Rural General surgical care in a remote area of Nepal: Our experience at Karnali Academy of Health Sciences, Jumla
Abstract
Background: Karnali is one of the remote area of Nepal with just a 388,713 populations. The access to the hospital from the entire region is very challenging as not all the places have road access yet. Karnali Academy of Health Sciences which is located in Jumla district was established for the propose of providing health services in these areas plus four other district as well. It has provided various services including surgical services from the very beginning.
Objective: The objective of this study was to evaluate the general surgical cases in the resource limited as well as rural setting.
Method: A hospital based retrospective study was conducted among 640 patients with various surgical procedures performed. Data was collected entered in Microsoft excel and analysis was done with different headings.
Results: Of the total 640 patients comprised male 54.22 %( n=374) and female 45.78 %( n=266). Most of the cases were from 20-30 years with 23.33%(n=150) followed by 30-40 yrs 15.32%(n=98) , then 10-20 yrs 14.06% (n=90)and so on with Elderly people >70yr comprised the lowest with 2.03%(n=13).The emergency procedure were 44.06%(n=282) and elective procedure 55.96%(n=358). Minor procedures consist of 40.47 %( n=259) followed by intermediate 32.97 % (n=211) and then major 26.56% (n=170).Out of the surgery Incision and Drainage performed for abscess (n=90) was the main emergency performed followed by appendectomy (n=78) then debridement (n=40), then exploratory laparotomy (n=30) and so on. Whereas perianal surgeries (n=60) were the most often performed elective surgeries followed by excision of soft tissue mass (n=50), vasectomy (n=42), repair of hernia (n=34), cholecystectomy (n=23) and so on.
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