There are many reasons why many people in Africa embark on health tourism outside Africa especially when it comes to surgical procedures. The common reason usually tendered is lack of well equipped and up-to-date healthcare facilities.
Recent research reveal patients undergoing surgery in Africa are more than twice as likely to die after an operation than the global average, despite generally being younger, healthier and the surgery they are undergoing being more minor.
Globally, an average of 1% of patients die after surgery, but researchers say this number rises to 2.1% for patients in Africa.
Prof Bruce Biccard, a co-author of the latest study from the University of Cape Town told The Guardian that one of the major problems is likely to be an insufficient number of medical staff and facilities to spot complications after the surgery.
“[The reason] that people do so terribly in Africa from a surgical point of view is that there are just no human resources,” he said.
The survey published in the Lancet Medical Journal, is the largest study of its kind ever undertaken in Africa, analysing data of 11,422 adult patients at 247 hospitals across 25 countries – including Ethiopia, Nigeria, Egypt, Zambia and South Africa
The results reveal that 2.1% of those who underwent any surgery, and 1% of those who had elective surgery, died in hospital within 30 days of their operation. Only a minority of deaths occurred on the day of the operation itself.
Meanwhile, caesarean deliveries accounted for 33% of surgeries across Africa – a remarkably high proportion.
The researchers say infection was the most common post-surgery complication.
The authors suggest that the findings are probably a reflection of a scanty workforce, limited numbers of hospital beds, and poor systems to check up on patients following surgery, noting that there are only about 0.7 specialist surgeons, obstetricians and anaesthesiologists per 100,000 population.
The recommended figure to decrease the risk of death following surgery is 20–40 such specialists per 100,000 population.
“There is no way we are going to be able to train enough physicians to fill this deficit in human resources,” said Biccard, suggesting that either systems for focusing care on high-risk patients need to be developed, or non-physicians would need to be helped to identify patients who might be at risk.
This study builds on the work of the Lancet Commission on Global Surgery which last year found 5 billion people around the world don’t have access to safe surgery.
In sub-Saharan Africa, fewer than 1 in 10 people can get basic surgical care. But even when they do, complication rates are much higher than other parts of the world.
This all comes down to weaker health systems, fewer medical staff, and patients not having access to the full care they need. Having surgery isn’t just about the medical procedure, it’s about aftercare.