Surgical Needs of Internally Displaced Persons in Kerenik, West Darfur, Sudan

Abstract

Background The burden of surgical disease in refugee and internally displaced person (IDP) populations has not been well defined. Populations fleeing conflict are mobile, limiting the effectiveness of traditional sampling methods. We employed novel sampling and survey techniques to conduct a population-based surgical needs assessment amongst IDPs in Kerenik, West Darfur, Sudan, over 4 weeks in 2008. Methods Satellite imagery was used to identify man-made structures. Ground teams were guided by GPS to randomly selected households. A newly created surgical needs survey was administered by surgeons to household members. One randomly selected individual answered demographic and medical history questions pertaining to themselves and first-degree blood relatives. All household members were offered a physical examination looking for surgical disease. Findings There were 780 study participants; 82% were IDPs. A history since displacement of surgical and potentially surgical conditions was reported in 38% of respondents and by 73% of respondents in first-degree blood relatives. Surgical histories included trauma (gunshots, stabbings, assaults) (5% respondents; 27% relatives), burns (6% respondents; 14% relatives), and obstetrical problems (5% female respondents; 11% relatives). 1485 individuals agreed to physical examinations. Untreated surgical and potentially surgical disease was identified in 25% of participants. Interpretation We identified and characterized a high burden of surgical and potentially surgical disease in an IDP population in West Darfur. Our study is unique in its direct assessment of a traumatized, mobile, vulnerable population. Health officials and agencies charged with the care of IDP and refugee populations should be aware of the high prevalence of surgical and potentially surgical conditions in these communities. This study adds to the growing body of evidence that investment in surgical resources may address a significant portion of the overall burden of disease in marginalized populations.

Untreated Surgical Problems Among East African Refugees: A Cluster Randomized, Cross‐Sectional Study

“…al have reported on surgical need among forced migrant populations in Sudan and Lebanon, respectively, our study adds to this nascent body of literature by performing, to the best of our knowledge, the first and largest study of prevalence of surgical disease in a refugee population in sub‐Saharan Africa using cluster random design sampling and population‐based, household survey methods. [12, 13].…”

“…Despite the alarming and growing number of refugees globally, little empirical attention has been paid to forced migrant populations. To our knowledge, only few studies have attempted to characterize the burden of surgical disease in forced migrant populations, and no household‐based study has been done in sub‐Saharan Africa to estimate the prevalence of surgical disease among refugees [12, 13].…”

The unmet surgical needs of global refugee populations: A perspective review

“…16,17 Several studies have underscored the unmet obstetric surgical needs among forcibly displaced individuals. 10,19 Estimates indicate approximately 196,000 emergency obstetric procedures were potentially required for forcibly displaced women of reproductive age. 20 Similarly, obstetric complications, such as caesarean deliveries for maternal indications, postpartum haemorrhage and ectopic pregnancies, accounted for approximately 10% of the total minimum surgical need among this population, all of which remained unaddressed (Figure 2).…”

“…Refugees are disproportionately affected by trauma-related injuries, resulting in substantial unmet surgical needs. 8,19,21 This vulnerable population often faces an elevated risk of sustaining severe injuries, including gunshot wounds, shrapnel injuries, burns, fractures, amputations and soft tissue injuries (Figure 2). 19 Recent studies have demonstrated the extent of unmet surgical needs among trauma patients in refugee populations.…”

Misconceptions and associated factors of COVID-19 infection among internally displaced persons in Sudan

“…However, the war peaked in 2004, which has ended over 300,000 lives, left around 3 million Internally Displaced Persons (IDPs) from their homes, and suffered from poor health care services. 23 Moreover, their limiting access to health services may prevent them from diagnostics and medical management in the event of an outbreak and make them at the highest risk of COVID-19 infection. To date, however, little is known about COVID-19 myths among the IDPs in Sudan.…”