The spectrum of surgery in Ethiopia.

Ethiopia's need for surgical services is assessed from on-site reviews of operating-room records in various hospitals and compared with data from other countries. Information on surgical manpower and total operations for the country were obtained from the Ministry of Health of Ethiopia. In Ethiopia the ratio of surgeons to population is very low (0.32 surgeons per 100,000 population) and inadequate numbers of essential operations (e.g., cesarean section and inguinal-hernia repair) are performed. The average age of the surgical patient is young (37 years), and men are operated on twice as frequently as women. Of the 9422 operations performed during 6 months in the central, regional and rural hospitals surveyed, 7037 (75%) could be performed by a general practitioner or a paramedic specially trained for the procedure and would not require a fully trained general surgeon. The implications for surgical manpower training are discussed.