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Surgery in Malawi – a national survey of activity in rural and urban hospitals

Authors: Lavy, Chris; Tindall, Alistair; Steinlechner, Colin; Mkandawire, Nyengo; Chimangeni, Sandy

Source: Annals of The Royal College of Surgeons of England, Volume 89, Number 7, October 2007 , pp. 722-724(3)

Publisher: The Royal College of Surgeons of England

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INTRODUCTION: Malawi is a poor country with few doctors. It has 21 district hospitals all of which have operating theatres but none of which has a permanent surgeon. It also has 4 central hospitals, each with one or more surgeons. Most district hospitals are manned by a single doctor and two or more paramedical clinical officers.

PATIENTS AND METHODS: All district and central hospitals were visited, and theatre logbooks analysed. All cases performed in 2003 were recorded.

RESULTS: In 2003, a total of 48,696 surgical operations were recorded, of which 25,053 were performed in 21 district hospitals and 23,643 in 4 central hospitals. Caesarean section is the commonest major surgical procedure in district hospitals and is performed in approximately 2.8% of all births, compared to 22% in the UK. Very few major general surgical or orthopaedic procedures are carried out in district hospitals.

CONCLUSION: This study underlines Malawi's need for more surgeons to be trained and retained.


Document Type: Research Article


Affiliations: Beit Cure Orthopaedic Hospital, Blantyre, Malawi

Publication date: October 1, 2007

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  • The Annals of The Royal College of Surgeons of England is the official journal of the College and is published eight times a year in January, March, April, May, July, September, October and November. The main aim of the journal is to publish high quality, peer-reviewed papers that relate to all branches of surgery.

    The Annals also includes letters and comments, a regular technical section, NICE news, controversial topics, CORESS feedback, book reviews and the best trainee presentations from England and Wales. The editorial board is composed of members of the College Council and experts from across the surgical specialties.

    Archive issues of the Annals of The Royal College of Surgeons of England are available via the PubMed Central database

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