Imagine a family of four dangerously perched upon a dilapidated motorbike, winding through narrow streets and negotiating congested traffic made up of cars, trucks, buses, pedestrians, and animals of all kinds. This scenario is a common one in many developing countries and often leads to death and injury. The level of permanent disability and disease that can result from commonplace injuries due to a lack of adequate health care in developing countries is under-appreciated says a U of T researcher.
“Falls are the leading cause of disease burden among children between ages five and 14 in low and middle-income countries, followed by road traffic injuries,” says Dr. Massey Beveridge, a U of T professor in the Department of Surgery. Dr. Beveridge noted in the Journal of Bone and Joint Surgery that a significant proportion of deaths in developing countries could be avoided with simple surgical and obstetrical techniques. In the absence of such procedures, what would be an easily rectifiable injury for someone living in Canada can cause life-long disability for a person living in a low-income country.
Yet the vast majority of public attention and financial relief given to such countries is directed at prevention and treatment of communicable diseases, such as HIV, even though injury is among the leading causes of death in low- and middle-income countries worldwide.
Dr. Beveridge noted that “injury is amenable to both prevention and treatment, and opportunities to improve both are greatly underexploited. International research expenditures have trivialized the burden of disease attributable to injury.”
The burden of injury recently received attention as one of many themes of World Health Day in April 2004. This provided an opportunity to initiate partnerships between orthopedic surgeons in developed countries with doctors in underdeveloped countries. Such partnerships improve the level of clinical care and alleviate some of the global burden of injury and related diseases. Improvements in health care should, however, prove to be very difficult, especially in light of the extreme shortage of doctors. According to Dr. Beveridge, East Africa currently has only 400 surgeons-only 40 of which are orthopedists-to treat 200 million people.
