Open AccessHumanitarian Surgical Missions in Times of COVID‐19: Recommendations to Safely Return to a Sub‐Saharan Africa Low‐Resource Setting
Author(s) -
LopezLopez Víctor,
Morales Ana,
GarcíaVazquez Elisa,
González Miguel,
Hernandez Quiteria,
BarojaMazo Alberto,
Palazon Dolores,
Tortosa Jose A.,
Rodriguez Maria A.,
Torregrosa Nuria M.,
Kanyi Winnie,
Ndungu J. K.,
Martinez José Gil,
Rodriguez José M.
Publication year - 2021
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-021-06001-x
Subject(s) - medicine , context (archaeology) , humanitarian crisis , pandemic , health care , life expectancy , multidisciplinary approach , medical emergency , global health , covid-19 , public health , nursing , environmental health , disease , population , economic growth , political science , infectious disease (medical specialty) , paleontology , refugee , pathology , law , economics , biology
Background Since the declaration of the pandemic, humanitarian medicine has been discontinued. Until now, there have been no general recommendations on how humanitarian surgical missions should be organized. Methods Based on our experience in the field of humanitarian surgical missions to Sub‐Saharan Africa, a panel of recommendations in times of COVID‐19 was developed. The fields under study were as follows: (1) Planning of a multidisciplinary project; (2) Organization of the infrastructure; (3) Screening, management and treatment of SARS‐COV‐2; (4) Diagnostic tests for SARS‐COV‐2; (5) Surgical priorization and (6) Context of patients during health‐care assistance. We applied a risk bias measurement to obtain a consensus among humanitarian health‐care providers with experience in this field. Results A total of 94.36% of agreement were reached for the approval of the recommendations. Emergency surgery must be a priority, and elective surgery adapted. For emergency surgery, we established a priority level 1a (< 24 h) and 1b (< 72 h). For an elective procedure, according our American College of Surgeon adaptation score, process with more than 60 points should be reconsidered. Due to the low life expectancy in many African countries, we consider 45–50 years as age of risk. In case of SARS‐COV‐2 active infection or high clinical suspicion, the screening, management and treatment should be following the international guidelines adapted to duration of the stay, available infrastructure, size of the cooperation team and medical resources. Conclusions Humanitarian surgical mission in times of COVID‐19 is a challenge that must extrapolate the established recommendations to the local cooperation environment.