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News Middle East & Africa

According to a new study, many refugees and asylum seekers do not receive the surgical care they need—particularly in the Middle Eastern and North African region. (Photograph: Fotosr52/Shutterstock)
0 Comments Jun 3, 2016 | News Middle East & Africa

Unmet surgical needs of refugees high in Middle East and North Africa

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BALTIMORE, USA: By the end of 2014, about 60 million people worldwide were displaced from their homes owing to conflict, persecution or human rights violations—and the number is continuing to rise. The largest number of forcibly displaced persons can be found in the Middle Eastern and North African region, with about 22.6 million people. According to a new study, refugees and asylum seekers all over the world are in urgent need of health care and surgery, but this need often remains unmet, as many host countries only have inadequate surgical care capacity.

For their study, US researchers collected data from United Nations’ databases, analysing the number and demographics of refugees, internally displaced persons and asylum seekers around the world. In order to estimate the number of surgical procedures needed per year, they used a rate of a minimum of 4,669 annual procedures per 100,000 population, a number similar to the target minimum surgical rate of 5,000 per 100,000 published by the Lancet Commission on Global Surgery.

Based on these figures, they estimated the number of surgeries needed for all displaced persons worldwide at 2.78 million procedures per year. Of these, 1.06 million procedures were required in the Middle East and North Africa. “Host countries with the highest surgical burden for the displaced included Syria (388,000 procedures), Colombia (282,000 procedures), and Iraq (187,000 procedures),” the researchers said in their study.

According to the findings, 85 per cent of the world has surgical volumes that fail to meet the minimum target of 5,000 per 100,000—particularly in the regions of Africa, the Middle East and Asia, which host 78 per cent of all forcibly displaced persons globally.

“We are facing the largest forced migration crisis since World War II,” said lead author Dr Adam Kushner, a general surgeon and an associate in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health in Baltimore. “And while surgery is a critical component of health care, it is often neglected in times of crisis. Without access to timely and safe surgery, many people will become disabled and many will die—outcomes that could have been prevented. What many people also do not realise is that many types of surgical care are easy to do and very cost-effective.”

The types of necessary surgeries include the repair of hernias and broken limbs, C-sections, cleft lip repair and gallbladder removals, as well as stitching up of wounds and burn care. In times of war, surgeries related to trauma, violence and burns might be particularly needed, the researchers stated. Moreover, there is a high need for paediatric and obstetric care, Kushner explained.

The researchers concluded that their findings shed light on something that few governments and humanitarian aid organisations take into account when preparing for a large influx of displaced persons. “When planning to take care of refugees, much thought is put into how to house and feed and clothe people who are far from home for circumstances often beyond their control,” Kushner said. “But surgery is a basic need and nobody talks about this.” He and his colleagues hope that their findings will be taken into consideration by those planning humanitarian assistance and targeted surgical capacity improvements.

The study, titled “Global estimation of surgical procedures needed for forcibly displaced persons”, was published online in the World Journal of Surgery on 25 May.

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