Sociopolitical, clinical, and ethical challenges of sustainable fracture care in Haiti.

Autor: Charles AJ; Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Bethell MA; Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA., Pean MA; Department of Orthopedics and Traumatology, La Paix University Hospital, Port-au-Prince, Haiti., Ochoa B; Department of General Surgery, Medical University of South Carolina, Charleston, South Carolina, USA., Nau B; Department of Orthopedics and Traumatology, La Paix University Hospital, Port-au-Prince, Haiti., Pean CA; Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
Jazyk: angličtina
Zdroj: World journal of surgery [World J Surg] 2024 Oct; Vol. 48 (10), pp. 2327-2332. Date of Electronic Publication: 2024 Sep 15.
DOI: 10.1002/wjs.12323
Abstrakt: Introduction: In low- and middle-income countries such as Haiti, musculoskeletal injuries are the leading cause of morbidity and mortality. Untreated injuries can contribute to decreased mobility, leading to disability and reduced productivity for individuals. The accessibility of timely fracture care poses a substantial challenge in Haiti, where socioeconomic instability and recent surges in gang violence exacerbate an already strained healthcare infrastructure. This manuscript delves into the intricate barriers to sustainable fracture care in Haiti, shedding light on the sociopolitical landscape and clinical challenges that influence the delivery of orthopedic services.
Ethical Discussion: The ethical considerations in providing fracture care in Haiti are multifaceted, including classic medical principles, self-preservation in the face of violence, issues of justice in resource and service allocation, and concerns of nonmaleficence in the context of international volunteers. These ethical dilemmas arise from the complex interplay of limited resources, the dangers posed by the current sociopolitical climate, and the involvement of international aid in a vulnerable healthcare system.
Conclusion: To address the clinical and ethical conflicts of providing fracture care in Haiti, solutions include education and training of Haitian orthopedic surgeons, capacity building of healthcare facilities, and establishing ethical standards for international volunteers. This comprehensive approach is vital for advancing sustainable fracture care in Haiti and other resource-limited settings.
(© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)
Databáze: MEDLINE
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