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Gepubliceerd in: Nederlands Tijdschrift voor Traumachirurgie 2/2012

01-04-2012 | origineel artikel

Fractuurbehandeling in ontwikkelingslanden

Auteur: P. Kloen

Gepubliceerd in: Nederlands Tijdschrift voor Traumachirurgie | Uitgave 2/2012

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Samenvatting

Het aantal traumatische letsels neemt in de ontwikkelingslanden epidemische vormen aan. De voornaamste oorzaak is een combinatie van verstedelijking met toename van gemotoriseerd verkeer en achterblijven van de verkeersveiligheid. Het is de verwachting van de Wereldgezondheidsorganisatie dat in 2020 de wereldwijde ziektelast op basis van trauma 20% zal bedragen. Er is in ontwikkelingslanden nagenoeg geen prehospitale zorg, en het merendeel van de bevolking heeft geen toegang tot medische en operatieve zorg. Grote aanpassingen in de medische voorzieningen zijn noodzakelijk.
Het merendeel van de fractuurzorg wordt door de zogenoemde traditionele botgenezers (TBG) gedaan. Dit is een traditie die meestal van vader op zoon wordt overgeleverd zonder certificering of peer review. Voor simpele fracturen en bij gebrek aan medisch gekwalificeerde zorg een adequate oplossing, maar voor complexe traumatische letsels onacceptabel met een hoog risico op complicaties. Een beter verwijspatroon van TBG naar orthodoxe genezers is nodig.
Vrijwilligers die om humanitaire redenen naar ontwikkelingslanden gaan om daar voor kortere of langere tijd te werken, zullen indrukwekkende en ongewone pathologie tegenkomen. Het armamentarium van de bezoekende arts zal dan ook voorbereid moeten zijn op ongewone casuïstiek en ongewone werkomstandigheden. Het doel is om het beste te doen voor zo veel mogelijk patiënten, en niet om de ernstigste patiënt als eerste te behandelen.
Om goede zorg te kunnen leveren, zijn grote investeringen in infrastructuur, materialen en opleiding nodig. Vrijwilligers kunnen hierin zeker een belangrijke rol spelen, mits hun missies goed voorbereid zijn en bovenal vanuit de juiste beweegredenen worden ondernomen.
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Metagegevens
Titel
Fractuurbehandeling in ontwikkelingslanden
Auteur
P. Kloen
Publicatiedatum
01-04-2012
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Nederlands Tijdschrift voor Traumachirurgie / Uitgave 2/2012
Print ISSN: 2214-8736
Elektronisch ISSN: 2214-8744
DOI
https://doi.org/10.1007/s12506-012-0010-6

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