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East and Central African Journal of Surgery, Vol. 9, No. 2, Dec, 2004, pp. 110 Book ReviewWorld Health Organization 2003. Price Not Available. ISBN 9241545755 Code Number: js04051This is a paperback book updating three earlier WHO publications namely:
It is a compact, however detailed book with extensive information written by authors with experience in surgical education, training and first hand experience in the provision of clinical care in developing countries. The book is divided into 6 parts plus annex on “trauma management in district and remote locations”. Each part is subdivided into chapters with specific educational goals and objectives, highlighting important messages as key points. These key points are and will be very helpful as a quick reference for the consulting and busy practitioner at the District Hospital. Part one addresses the importance of establishing good infrastructure at the District Hospital. The information is too detailed as it covers a wide range of issues. It needs to be looked at as a reference to be consulted in specific situations, for example, how to keep good records or how to establish a trauma team. The chapter on surgical domain is well done. It gives detailed information with practical tips and illustrations on the basis of creating the proper environment for surgery. In Part two, the authors succeeded in highlighting the differences between the adult and the pediatric surgical patients. The description/illustration of basic surgical techniques is well done, easy to understand and to follow. It should be very helpful to the reader/practicing doctor as he/she learns the basics before proceeding with more complex procedures as detailed in the subsequent parts of the book. The rest of the book is divided by organ specific/subspecialties sections. The section under the heading of “the abdomen” teaches the reader how to assess and surgically treat general surgical and urological diseases. Except for abdominal wall hernias, the emphasis is placed on the management of surgical emergencies such as intestinal obstruction, appendicitis, and bleeding ulcer, which is very appropriate, and could be life saving at the District Hospital. The reader is presented with information on how to assess a condition, make a diagnosis, establish the urgency of the situation and prepare the patient for surgery. Then the procedure is well presented with easy steps to follow. This model of care is repeated throughout the book (emergency obstetric care, resuscitation and anesthesia, traumatology and orthopedics), which is very appropriate as the goal is to teach nonspecialists how to deal with surgical conditions at the District Hospital. However, some of the procedures described in the book will be difficult to do at the District Hospital because of lack of training of the practitioner and the unavailability of equipment and supply such as the use of external fixation to immobilize fractures. In summary, the information provided is too detailed and comprehensive. The chapters are well written, easy to read with good illustration of the procedures. The “key points” are well done and very helpful in highlighting important messages. It is however a “big book” to consult on a regular basis. It may be more useful if it is subdivided into 3 volumes for easier use. The first can include: Part 1 & 2, the second: Part 3, 4, 5 and the annex and the third: part 5, which is resuscitation and anesthesia.Given the importance of appropriate training and continuing medical education of health care workers, this book will be an excellent addition, helping them to provide good care to their patients. As noted in the introduction “the WHO would be pleased to receive comments and suggestions regarding the manual and experience in its use”, therefore the best review/comments regarding the appropriateness and the usefulness of this book should come from the practitioners themselves as they use it in their daily work. The WHO should establish a mechanism to gather such feedback.. Antoine Loutfi MD Associate Professor of Surgery and Oncology © 2004 East and Central African Journal of Surgery |
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