As African populations grow older, the rise in hip fractures among the elderly in The Gambia and Zimbabwe reveals significant shortcomings in healthcare systems. Both countries struggle with inadequate medical infrastructure and a shortage of specialized healthcare professionals, posing serious challenges to effective fracture management.
Service Availability Concerns
The study found that hospital facilities in both nations are insufficient and often lack essential resources such as consistent electricity, reliable oxygen supplies, and proper disposal systems for sharps and infectious waste. In The Gambia, a majority of public hospitals and other healthcare facilities operate without doctors, severely limiting access to necessary medical care for patients with fractures.
Readiness for Fracture Care
Both countries exhibit a critical shortage of orthopedic surgeons, with fewer than one per 100,000 adults. Additionally, the availability of trained nurses, physiotherapists, and occupational therapists is minimal, complicating comprehensive fracture treatment. Diagnostic capabilities are hindered by the limited presence of functional X-ray machines, and essential equipment for fracture immobilization is largely unavailable, impacting the quality and timeliness of care.
Insights from the survey indicate:
- Severe shortage of orthopedic specialists limits effective treatment options.
- Inconsistent utility services disrupt continuous patient care.
- Limited access to diagnostic and immobilization equipment delays diagnosis and treatment.
- Traditional bone-setters rarely refer hip fracture cases to hospitals, affecting patient outcomes.
The readiness to manage hip fractures remains low, with only a small number of facilities capable of performing surgeries. Delays in surgical intervention are prevalent, particularly in Zimbabwe, leading to a reliance on non-operative treatments. In The Gambia, traditional bone-setters manage fractures using methods like splinting and manipulation, but seldom refer cases to medical hospitals, potentially compromising patient recovery.
Improving fracture care in these regions necessitates a multi-faceted approach. Increasing the number of trained orthopedic surgeons and allied healthcare professionals is crucial. Enhancing infrastructure by ensuring reliable electricity and oxygen supply can significantly improve patient care standards. Expanding access to diagnostic tools like X-ray machines and providing necessary immobilization equipment will facilitate timely and effective treatment. Additionally, integrating traditional bone-setters into the formal healthcare system through training and referral protocols could bridge the gap between traditional and medical fracture management, ensuring better patient outcomes.
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