Original Research Dienye et al. 48 TURKISH JOURNAL OF FAMILY MEDICINE AND PRIMARY CARE (TJFMPC) ▪ www.tjfmpc.com ▪ VOL.8, NO.2 ▪ JULY 2014 ABSTRACT Practice of Anaesthesia and Surgery in a Rural Clinic: Meeting the Challenge This is a descriptive prospective study aimed at describing the scope of surgery and anaesthetic practice in a rural clinic in Ngo, Nigeria. All the medical records of patients that fulfilled the inclusion criteria and managed in the clinic were retrieved and analysed. Out of 6911 patients who attended the clinic within the period, 575 (8.32%) medical records of surgical patients were retrieved. Fifteen (2.60%) were referred to tertiary health centres for expert management of their surgical conditions. Of the remaining 560 medical records that were retrieved 551(98.4%) met the criteria for inclusion and had their surgical pathology treated in 583 procedures. The most common surgical problem encountered in the rural clinic was hernias(39.75%) done mainly using 1% xylocaine local anaesthesia (63.64%). The most commontype of anaesthesia used in the clinic was ketamine anaesthesia(53.90%). Mortality recorded within the period was in two (0.4%) women who had eclampsia and severe post partum haemorhage. The result suggests that adequately trained family physicians can meet the challenge of scarcity of surgeons and anaesthesiologists in the rural areas satisfactorily. Key Words: Rural clinic, Nigeria, Anaesthesia, Surgery, Personnel Dienye P, Diete-Spiff K, Chukwuma N. Extending Practice of Anaesthesia and Surgery in a Rural Clinic: Meeting the Challenge. TJFMPC 2014;8(2): 48-54DOI:10.5455/tjfmpc.149707 Introduction The word 'Anaesthesia' was derived from the Greek word 'Anaistheto,' meaning insensibility. Several approaches were used by surgeons to administer anaesthesia but the most successful was diethyl ether. Its use was successfully demonstrated in the induction of general anaesthesia by William Morton, a surgeon. 1 With advances in technology, refinements in anaesthetic equipment and drugs, and a focus on education and training, there have been major improvements in quality and safety in anaesthesia. 2 These made surgery much easier, safer and of course painless. Even with this development, anaesthetists working in some developing countries in sub-Saharan Africaand in overseas medical missions have described the poor state of anaesthesia and other medical services in these countries. 3 The rural areas, characterized by inadequate infrastructure, communication and essential public utilities such as potable water, electricity supply and access roads 4 are the worst hit by this inadequacy. Unfortunately, about 70% of the Nigerian population live in the rural areas and suffer from this shortfall. Trained and quality staffs are often difficult to hire and retain. Regrettably, most of the surgical problems such as hernia, hydrocele, septic wounds, and emergencies like obstructed labour, acute appendicitis, duodenal ulcer perforations, blunt trauma to the abdomen or the thorax, minor and simple fractures 5 are common in these areas. To contain the challenge created by lack of staff, reliance on non-physicians who are trained to provide surgical services in rural hospitals has become imperative in some African countries. 6 Although they may be able to discharge such functions, they cannot be compared with the professionals in efficiency. The ideal doctor in such locations must be competent enough to handle most of the health problems, including the technique of administering anaesthetic agents as well as inducing regional analgesia. This article aims to highlight our experience having performed a large number of surgical operations under different types of anaesthesia at the Bethesda Clinic, Ngo town in Andoni Local Government Area of Rivers State over a period of Practice of Anaesthesia and Surgery in a Rural Clinic: Meeting the Challenge Paul Dienye, Kaine Diete-Spiff, Nkemdilim Chukwuma Department of Family Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria Corresponding author: Paul Dienye, Department of Family Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. E-mail: pdienye@yahoo.com Received Date: January 5, 2014 Accepted Date: March 4, 2014