MAJOR AND MINOR SURGERY AT A RURAL AFRICAN HOSPITAL

Surgical operations performed at Ombo Hospital in Western Kenya from J anuary to December 1989 were studied and annual surgical rates were ca lculated based on the estimated catchment area population. The total a nnual rate of major surgery at this church-supported hospital was 207 operations per 100 000 people. This rate is similar to those at other East African hospitals while rates in industrialized countries are 20- 35 times higher. The most common major procedures were Caesarean secti on, laparotomy, hernia repair and salpingectomy. The 1989 rate of mino r operations at the hospital was 1286 per 100 000 people with tooth ex traction, wound suture, incision and drainage, evacuation of the uteri ne cavity and closed reduction of fracture as the most frequent proced ures. Major operations were performed exclusively by doctors while min or surgery was carried out mainly by clinical officers, nurses and oth er auxiliary staff.