Measuring Global Surgical Disparities: A Survey of Surgical and Anesthesia Infrastructure in Bangladesh Drake G. LeBrun • Debashish Dhar • Md. Imran H. Sarkar • T. M. Tanzil A. Imran • Sayadat N. Kazi • K. A. Kelly McQueen Published online: 2 October 2012 Ó Socie ´te ´ Internationale de Chirurgie 2012 Abstract Background Surgically treatable diseases weigh heavily on the lives of people in resource-poor countries. Though global surgical disparities are increasingly recognized as a public health priority, the extent of these disparities is unknown because of a lack of data. The present study sought to measure surgical and anesthesia infrastructure in Bangladesh as part of an international study assessing surgical and anesthesia capacity in low income nations. Methods A comprehensive survey tool was administered via convenience sampling at one public district hospital and one public tertiary care hospital in each of the seven administrative divisions of Bangladesh. Results There are an estimated 1,200 obstetricians, 2,615 general and subspecialist surgeons, and 850 anesthesiolo- gists in Bangladesh. These numbers correspond to 0.24 surgical providers per 10,000 people and 0.05 anesthesi- ologists per 10,000 people. Surveyed hospitals performed a large number of operations annually despite having mini- mal clinical human resources and inadequate physical infrastructure. Shortages in equipment and/or essential medicines were reported at all hospitals and these shortages were particularly severe at the district hospital level. Conclusions In order to meet the immense demand for surgical care in Bangladesh, public hospitals must address critical shortages in skilled human resources, inadequate physical infrastructure, and low availability of equipment and essential medications. This study identified numerous areas in which the international community can play a vital role in increasing surgical and anesthesia capacity in Bangladesh and ensuring safe surgery for all in the country. Introduction Surgically treatable conditions are a primary contributor to preventable morbidity and mortality in low income nations. Yet, because of a lack of surgical human resources, phys- ical infrastructure, equipment, and essential medicines, approximately 2 billion people in these countries lack access to surgical services [1]. Surgical disability adjusted life years (DALYs) constitute approximately 11 % of all DALYs worldwide [2], with nearly half being found in Southeast Asia [3]. Because of the dearth of data on surgical resources in developing regions, the true extent of global surgical D. G. LeBrun Thomas J. Watson Foundation, 11 Park Place, New York, NY 10007, USA D. G. LeBrun (&) 3725 Kimble Dr, Plano, TX 75025, USA e-mail: drake.lebrun@gmail.com D. Dhar North South University, 15 Ariful Haque Chowdhury Road, Dhaka, Bangladesh Md. I. H. Sarkar Dhaka Medical College Hospital, Ramna, Dhaka, Bangladesh T. M. T. A. Imran Shahid Suhrawardi Medical College, Shar-e-Bangla Nagar, Dhaka, Bangladesh S. N. Kazi Tejgaon College, 16 Indira Road, Farmgate, Dhaka, Bangladesh K. A. K. McQueen Department of Anesthesiology, Vanderbilt University, 1301 Medical Center Drive, #4648 TVC, Nashville, TN 37232, USA e-mail: kelly.mcqueen@vanderbilt.edu 123 World J Surg (2013) 37:24–31 DOI 10.1007/s00268-012-1806-7