Surgery refers to the treatment of disease, injury and deformity by operation or manipulation.
Normally, the basic surgical services for NTDs are available in district hospitals, whereas more specialized surgery is performed at tertiary level facilities. However, approximately two billion people worldwide have no access to basic surgical care at all.
For which NTDs is this relevant?
Surgery treatment of disease complications is needed in several NTDs, for example for men with hydrocele in lymphatic filariasis, for patients with trachoma-related trichiasis (i.e. turned in eyelashes), for people with muscle paralysis due to leprosy, for people with onchocerciasis for removal of the worms (nodulectomy) and for people suffering from severe open wounds or severe scars due to buruli ulcer.
Surgery should be performed by appropriately trained health care providers. Affected people in rural and impoverished areas have limited access to such trained health staff and often the complex surgery treatment may be too expensive. They are therefore, more prone to develop severe complications and disabilities. Today, high priority should be given to strengthen surgical health services in the impoverished areas by improving access to surgical services, scaling-up the trained health staff who perform surgery and building more surgical services. An example of a recent successful study on surgery for trachoma in endemic villages in Egypt can be found here.
The Morbidity Management and Disability Prevention (MMDP) Project was a five-year, global project funded by the USAID. The project helped countries provide high-quality treatment and care for people suffering from the debilitating effects of trachoma and lymphatic filariasis. The project was led by Helen Keller International and ended in July, 2019.Lessons learned were documented, and the project devoted considerable effort to developing useful tools and resources, such as a surgical simulator for hydrocele surgery, a manual for training trichiasis surgeons, a resource package for photo taking during trichiasis surgery, and a training package for filaricele surgery.