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MSF

MSF. NGO since 40 years Provide assistance to populations victim of crisis : Conflicts , natural disasters Epidemic Exclusion from health care Chart: humanity, impartiality, independance,professionalism… 5 sections: France, Belgium, NL, Switz, Spain 63 countries

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MSF

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  1. MSF • NGO since 40 years • Provide assistance to populations victim of crisis : • Conflicts , natural disasters • Epidemic • Exclusion from health care • Chart: humanity, impartiality, independance,professionalism… • 5 sections: France, Belgium, NL, Switz, Spain • 63 countries • 2000 volunteers + 30 000 nat staff • Epidemiologic dpt : epicentre • Logistic center : Bordeaux

  2. Surgical activity MSF OCPsept2011 • Haiti : Port au prince (631) • Nigeria : Port Harcourt , Jahun (262) (85) • RDC : Nyanzale, Rushuru (422) • Congo : Bétou (60) • RCA : Paoua (137) • Jordanie : Amman (77) • Pakistan : Hangu, Peshawar (69) (15) • Soudan : Aweil (250) • Sri-Lanka : Point-Pedro, Mullaitivu (175) (200) • Yemen : Khameer, Althal, Saana stand by (80) • Palestine : Gaza ( 33) • Cote d’ivoire : Abidjan, Doueque (178) • Lybie : Misrata (150) • Somalia : Mogadiscio remote control (?)

  3. Surgical activityMSFF jan-dec 2010 25 516 procedures 2126 /month(2009 : 23.417 p )

  4. Surgical indications MSF OCP jan-dec 2010 61% Accidents 51% 20% 18% Violence 10% 2009 : 15% obst ; 24% med ; 61 % trauma 43 % acct 18 % violence

  5. Types of surgery MSF OCP 2010 Ortho 15% Soft tissues: 20% 24% 18% 6% 4%

  6. Surgical emergenciesMSFF jan-dec 2010 Acute (35%) & delayable (51%) emergencies 86% Planned & elective surgery 14% 2009 : emergency 70% planned 30%

  7. Peri operative mortality MSFF jan-sept 2009 • 10 813 procedure records evaluated (62%) • 132 deaths

  8. Causes of perioperative mortality MSFF jan-sep 2009 • Shock (88%) • hemo 33% (43) trauma, obst… • Septic 17% (22) acute abdomen.. • X organ failure 38% (50) burns, trauma… • Pulmonary embolism suspected 5% (7) • Head injury 3% (4) • Unclear, anesthesia … 4% (6)

  9. Factors contributing to mortality • : Lack of post op surveillance • No recovery room • Haemorragic shock associated with inadequate monitoring • Poor surveillance by nurses (ICU) • : No or suboptimal prophylaxis : pulm.embolism • : Hypovolemic shock associated with difficulties of veinous acces • : Lack of anaesth pre op assessment • : Complications of elective surgery

  10. Objective 2012 • Implementation ICU units of level 1 in each MSF hospital

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