Critically Assessing the Haiti Earthquake Response and the Barriers to Quality Orthopaedic Care

Sonshine, Daniel B.; Caldwell, Amber; Gosselin, Richard A.; Born, Christopher T.; Coughlin, R. Richard

doi:10.1007/s11999-012-2333-4

Cited by 57 publications

(15 citation statements)

References 45 publications

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“…The number of interview subjects and the proportion who discussed the barriers and drivers at least once were calculated with 95% CIs for each of the identified domains [36]. Atlas.ti 1 6.2 (Scientific Software Development, Berlin, Germany), a qualitative research software package, provided a conceptual framework based on grounded theory to assist with our transcript analysis and data output.…”

Section: Methodsmentioning

confidence: 99%

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Elliott

Sonshine

Akhavan

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Research addressing the burden of musculoskeletal disease in low-and middle-income countries does not reflect the magnitude of the epidemic in these countries as only 9% of the world's biomedical resources are devoted to addressing problems that affect the health of 90% of the world's population. Little is known regarding the barriers to and drivers of orthopaedic surgery research in such resource-poor settings, the knowledge of which would help direct specific interventions for increasing research capacity and help surgeons from high-income countries support the efforts of our colleagues in low-and middle-income countries. Purpose We sought to identify through surveying academic orthopaedic surgeons in East Africa: (1) barriers impeding research, (2) factors that support or drive research, and (3) factors that were identified by some surgeons as barriers and others as drivers (what we term barrier-driver overlap) as they considered the production of clinical research in resource-poor environments. Materials Semistructured interviews were conducted with 21 orthopaedic surgeon faculty members at four academic medical centers in Ethiopia, Kenya, Tanzania, and Uganda. Qualitative content analysis of the interviews was conducted using methods based in grounded theory. Grounded theory begins with qualitative data, such as interview transcripts, and analyzes the data for repeated ideas or concepts which then are coded and grouped into categories which allow for identification of subjects or problems that may not have been apparent previously to the interviewer. Results We identified and quantified 19 barriers to and 21 drivers of orthopaedic surgery research (mentioned n = 1688 and n = 1729, respectively). Resource, research process, and institutional domains were identified to This study was supported by private donations to the Institute for Global Orthopaedics and Traumatology (IGOT, San Francisco, CA, USA). No authors received payment or in-kind benefit for this study, nor are any authors members of a company that provided funding to IGOT. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. categorize the barriers (n = 7, n = 5, n = 7, respectively) and drivers (n = 7, n = 8, n = 6, respectively). Resource barriers (46%) were discussed more often by interview subjects compared with the research process (26%) and institutional barriers (28%). Drivers of research discussed at least once were proportionally similar across the three domains. Some themes such as research ethics boards, technology, and literature access occurred with similar frequency as barriers to and drivers of orthopaedic surgery research. Conclusions The barriers we identified most often among East African academic orthopaedic faculty members focused on resources to accomplish research, followed by institutional barriers, and method or process ba...

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Section: Methodsmentioning

confidence: 99%

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Elliott

Sonshine

Akhavan

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Gosselin emphasized that nearly two-thirds of surgeons who responded to the Haiti earthquake had no previous disaster training or experience (6). As a result of disorganization, a lack of training, and inexperience, critics have questioned whether many of the amputations performed after the earthquake might have been unnecessary or otherwise avoidable (7).…”

Section: Discussionmentioning

confidence: 99%

Mass Casualty Disasters: Who Should Run the Show?

Russo

Galante

Jacoby

et al. 2015

The Journal of Emergency Medicine

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“…Among all human tragedies and injustices, specific circumstances, such as natural disasters, require immediate worldwide aid mobilisation due to their rarity, damage intensity and human resources and logistics needed [22]. More than 500,000 earthquakes are reported each year worldwide, with three million lives claimed over the past 20 years.…”

Section: Discussionmentioning

confidence: 99%

Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake

Awais

Saeed

2014

International Orthopaedics (SICOT)

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Purpose In the 2005 Pakistan earthquake, the great many injured with multiple fractures and open wounds provided a unique opportunity to practice damage-control orthopaedics. External fixators remain a time-tested tools for operating surgeons on such occasions. The locally manufactured, readily available Naseer-Awais (NA) external fixator filled such needs of this disaster with good outcome. Methods This is a retrospective descriptive study of 19,700 patients that presented over seven months to the two centres established by the lead author (SMA) in Muzaffarabad and Mansehra just one night after the 2005 earthquake. A series of local and foreign orthopaedic surgeon teams operated in succession. The computerised patient data collection of 1,145 operations was retrospectively analysed. Results Of the 19,700 patients presenting to the SMA centres, 50 % had limb injuries. Total fracture fixations were 1,145, of which 295 were external fixations: 185 were applied on the lower limb and 90 on upper limb, the majority were applied on tibia. Conclusion External fixators are valuable damage-control tools in natural disasters and warfare injuries. The locally manufactured NA external fixator served the needs of the many limb injuries during the 2005 Pakistan earthquake.

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Critically Assessing the Haiti Earthquake Response and the Barriers to Quality Orthopaedic Care

Cited by 57 publications

References 45 publications

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

What Factors Influence the Production of Orthopaedic Research in East Africa? A Qualitative Analysis of Interviews

Mass Casualty Disasters: Who Should Run the Show?

Use of external fixators for damage-control orthopaedics in natural disasters like the 2005 Pakistan earthquake

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