Morbidity and mortality with nephroblastoma is high in our environment. Late presentation, poverty, ignorance and poor compliance to treatment constitute a great challenge to the paediatric oncologist in a developing country. Solutions may lie in improving health funding and health information in the health care delivery system. Free health care for children with malignancy is advocated. Collaboration with institutions in the privileged parts of the world may help.

A significant number of colostomies for large bowel anomalies are constructed late in our setting. This is largely due to delayed presentation in Hirschsprung's disease and may be associated with increased morbidity. Loop colostomy is associated with higher rate of complication and as much as possible should be performed less often.

There is a wide spectrum of DSD in our setting. Time to diagnosis, evaluation, and outcome may be improved by public enlightenment initiative, focused education of healthcare personnel and provision of relevant diagnostic facilities through enhanced funding and collaboration.

No abstract