Paediatric surgery in the rural setting: prospect and feasibility.

This report is based on a 6-year experience with surgery in children in a rural hospital in Northern Nigeria. Paediatric surgery represents 6.6% of all paediatric work-load and 9.6% of all operative surgery. Majority of the operations were performed for congenital problems (40%) and less frequently infections (22%) and trauma (21%). Most of the infective and trauma problems were preventable. The mortality was 7.3%, due mostly to septic complications. Overall, 95% of the operations were not of complex nature and could be performed by general duty doctors with general surgical experience. These doctors who are more readily available in rural areas should be encouraged to perform these operations to reduce the economic and emotional burden on rural families. However, the more complex congenital conditions should always be referred early to specialist hospitals. Surgical conditions cause significant morbidity and mortality in children and should not be overlooked in the planning of child health care services in rural areas.