In developing countries, sciatic nerve injury following gluteal intramuscular injection is a persistent problem. A study over 6 months involving 133 children seen in Mulago hospital with acute flaccid paralysis revealed 124 (93%) children with injection-induced sciatic nerve injury. The identity of the drug in 79 cases (59.4%) was quinine. It is recommended that the gluteal region should not be used as an intramuscular injection site in children.
Limited infrastructure, trained personnel, and surgical supplies rations access to surgical care. In this environment, participants with advantageous social connections were able to self-advocate for surgery where demand for these services greatly exceeded available resources.
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