Surgery in a rural hospital: experience from northern Nigeria.

Over a 5-year period in a rural hospital in Northern Nigeria, 949 patients were operated on, constituting 84.7% of all surgical admissions. Nearly one half were emergency procedures. The majority of the patients were young (mean age 36.0 years) and predominantly male (M:F = 1.5:1). A wide variety of surgical procedures were performed but overall 85% were not of a complex nature. Mortality was 4.8%, due mostly to septic complications. It is suggested that most of the surgical procedures in rural Africa can be performed by general duty doctors with surgical experience and they should be taught and encouraged to perform these operations. The importance of relevant research to solve local problems is highlighted and the planning of primary health care to include more primary surgery emphasised.