ORCID Profile
0000-0002-1372-6068
Current Organisations
University of Amsterdam
,
University of Groningen
,
Vrije Universiteit Amsterdam
,
Johns Hopkins School of Medicine
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Publications
Teaching Emergency and Essential Surgical Care in Sierra Leone: A Model for Low Income Countries
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.JSURG.2011.05.012
Abstract: Surgeons OverSeas (SOS), a New York-based organization with a mission to save lives in developing countries, conducted a surgical needs assessment in Sierra Leone in 2008 which identified a large gap in surgical knowledge. We hypothesized that knowledge transfer could be improved by conducting workshops with significant local faculty participation. Description of emergency and essential surgical care workshops (EESC) workshops and follow-up. Freetown and Bo, Sierra Leone. International and local health providers in Sierra Leone. SOS organized EESC workshops in collaboration with significant local surgeons' support. Data on subsequent workshops were recorded. Fifteen instructors were identified and assisted with teaching. Nine of the instructors were specialists from Sierra Leone. Each workshop lasted 3 days. Feedback was gathered after these workshops Subsequent to the SOS workshops, 8 other workshops were undertaken by local surgeons in Sierra Leone, 5 of which were organized and taught solely by local surgeons working for the Sierra Leone Ministry of Health and Sanitation. Three other workshops were organized with external support. EESC workshops organized with significant local input are useful for knowledge transfer and empower local surgeons to conduct subsequent workshops on their own.
An overview of renal replacement therapy and health care personnel deficiencies in sub-Saharan Africa
Publisher: Frontiers Media SA
Date: 28-03-2012
DOI: 10.1111/J.1432-2277.2012.01468.X
Abstract: Chronic kidney disease (CKD) is a public health problem in sub-Saharan Africa (SSA) but there is limited data to guide programs or plan interventions. To help set priorities and understand the needs for renal replacement therapy a baseline assessment is required. World Health Organization (WHO) databases and Medline were searched to determine the number of physicians, nephrologists, and dialysis centers and patients in SSA. Data on renal transplant (RTx) programs were collected from the WHO Global Observatory on Donation & Transplantation database for deceased-donor and living-donor RTx. Of the 47 countries in SSA only 15 had recent data with most rates of physicians per 10,000 population under 2.0. Nigeria and South Africa had the greatest absolute numbers of physicians and nephrologists but Mauritius had the greatest proportion to population. South Africa had the most dialysis patients. Kenya, Nigeria and South Africa were the only countries with RTx programs and reported rates per million population of 0.60, 0.23 and 5.12, respectively. Treatment for patients with CKD in SSA is limited by a lack of physicians, nephrologists, and dialysis centers. Few countries are performing RTx. Resources are needed to increase the health workforce and increase RTx programs in SSA.
Ratio of Cesarean Deliveries to Total Operations and Surgeon Nationality Are Potential Proxies for Surgical Capacity in Central Haiti
Publisher: Springer Science and Business Media LLC
Date: 18-09-2012
DOI: 10.1007/S00268-012-1794-7
Abstract: The World Health Organization has a standardized tool to assess surgical capacity in low- and middle-income countries (LMICs), but it is often resource- and time-intensive. There currently exists no simple, evidence-based measure of surgical capacity in these settings. The proportion of cesarean deliveries in regard to the total operations (C/O ratio) has been suggested as a way to assess quickly the capacity for emergency and essential surgery in LMICs. This ratio has been estimated to be between 23.3 and 41.5 % in LMICs, but the tool's utility has not been replicated. We reviewed operative logbooks for the Partners In Health/Zanmi Lasante hospital in Cange, Haiti. We recorded data on all consecutive surgical patients from July 2008 to 2010 and calculated the C/O ratio by iding the number of cesarean deliveries by the total number of operations performed. We also analyzed surgical data by surgeon nationality to provide additional information about local surgical capacity. A total of 3,641 operations were performed between 2008 and 2010. The C/O ratio decreased significantly between 2008-2009 and 2009-2010 (13.4 vs. 10.7 %, p = 0.001) as the surgical volume and resources increased. Nationality analysis demonstrated that Haitian surgeons were able to provide a spectrum of general and specialist surgical care. In its inherent relation to essential surgical procedures and to the overall rate of cesarean deliveries in the region, the C/O ratio can provide an accessible assessment of regional surgical resources. In Haiti, the change in the C/O ratio demonstrated a relative increase in surgical capacity from 2008 to 2010. An additional analysis of surgeon nationality ensured that C/O ratio estimates more accurately reflect local practitioner activity, but deficiencies in the regional capacity to address the local burden of surgical disease may still exist.
Social media in low-resource settings: A role for Twitter and Facebook in global surgery?
Publisher: Elsevier BV
Date: 06-2012
Non-communicable diseases and surgery at the UN? “Fugetaboutit!”
Publisher: Elsevier BV
Date: 11-2011
Review: indications for ultrasound use in low‐ and middle‐income countries
Publisher: Wiley
Date: 09-2011
DOI: 10.1111/J.1365-3156.2011.02868.X
Abstract: To determine the indications for using ultrasound, in low- and middle-income countries (LMICs) and to assess whether its use alters clinical management. Literature review. We conducted a Pubmed search on the clinical use of ultrasound in LMIC for articles published between January 2000 and December 2010, recording country of origin, speciality and whether ultrasound use led to a change in management. Fifty-eight articles were identified from 32 countries and represented nine specialties. Ultrasound was most commonly used for assisting with the diagnosis of obstetrical conditions, followed by intra-abdominal conditions such as liver abscesses and intussusceptions. Clinical management was altered in >30% of cases. Ultrasound is a highly valuable diagnostic tool in LMICs and its use should be considered essential for all district medical facilities. The use could be applied more widely, eg., for tropical and non-communicable diseases. Additional research is needed to further characterize the impact of task shifting on ultrasound use in LMICs.
A preparation guide for surgical resident and student rotations to underserved regions
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.SURG.2012.03.002
Abstract: Interest in global health among surgical residents and medical students is growing. There are numerous opportunities worldwide for both short- and long-term experiences. In order to maximize the learning potential, the authors present a practical guide for residents and students to prepare for a surgical visit, elective, rotation, or mission to an underserved region. The following steps will be outlined:
Scarcity of healthcare worker protection in eight low‐ and middle‐income countries: surgery and the risk of HIV and other bloodborne pathogens
Publisher: Wiley
Date: 31-10-2011
DOI: 10.1111/J.1365-3156.2011.02909.X
Abstract: In view of the substantial incidence of bloodborne diseases and risk to surgical healthcare workers in low- and middle-income countries (LMICs), we evaluated the availability of eye protection, aprons, sterile gloves, sterilizers and suction pumps. Review of studies using the WHO Tool for the Situational Analysis of Access to Emergency and Essential Surgical Care. Eight papers documented data from 164 hospitals: Afghanistan (17), Gambia (18), Ghana (17), Liberia (16), Mongolia (44), Sierra Leone (12), Solomon Islands (9) and Sri Lanka (31). No country had a 100% supply of any item. Eye protection was available in only one hospital in Sri Lanka (4%) and most abundant in Liberia (56%). The availability of sterile gloves ranged from 24% in Afghanistan to 94% in Ghana. Substantial deficiencies of basic protective supplies exist in low- and middle-income countries.
A quantitative analysis of surgical capacity in Santa Cruz, Bolivia
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.JSS.2013.05.051
Abstract: This investigation aimed to document surgical capacity at public medical centers in a middle-income Latin American country using the Surgeons OverSeas (SOS) Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) survey tool. We applied the PIPES tool at six urban and 25 rural facilities in Santa Cruz, Bolivia. Outcome measures included the availability of items in five domains (Personnel, Infrastructure, Procedures, Equipment, and Supplies) and the PIPES index. PIPES indices were calculated by summing scores from each domain, iding by the total number of survey items, and multiplying by 10. Thirty-one of the 32 public facilities that provide surgical care in Santa Cruz were assessed. Santa Cruz had at least 7.8 surgeons and 2.8 anesthesiologists per 100,000 population. However, these providers were unequally distributed, such that nine rural sites had no anesthesiologist. Few rural facilities had blood banking (4/25), anesthesia machines (11/25), postoperative care (11/25), or intensive care units (1/25). PIPES indices ranged from 5.7-13.2, and were significantly higher in urban (median 12.6) than rural (median 7.8) areas (P < 0.01). This investigation is novel in its application of a Spanish-language version of the PIPES tool in a middle-income Latin American country. These data document substantially greater surgical capacity in Santa Cruz than has been reported for Sierra Leone or Rwanda, consistent with Bolivia's development status. Unfortunately, surgeons are limited in rural areas by deficits in anesthesia and perioperative services. These results are currently being used to target local quality improvement initiatives.
Related Organisations
Related Funding Activities
No related grants have been discovered for Reinou Groen.