ADF Health Vol 3 April 2002Book ReviewMaking a difference
Obstetrics and gynaecological surgery in the Third World. Ian Jones, Jeremy Oats and Roger Likeman. Brisbane: Mater Misericordiae Health Services, 2001. WHEN NON-OBSTETRICALLY TRAINED DOCTORS venture into the Third World for humanitarian work, one of their greatest fears is the need to confront an obstetric emergency. This new primer has been written with this nervous audience in mind. The authors have all had experience in humanitarian aid work as surgeons and two have had extensive experience in military operations when civilian services have broken down. In a short text intended as an aide memoire, it is inevitable that some subjects receive less than exhaustive treatment and others are omitted. The decision to avoid any mention of operative vaginal delivery other than asssisted breech delivery has been justified on grounds that inexperienced operators are more likely to cause harm. If the alternative is a difficult caesarean with the presenting part deep in the pelvis, I doubt that abdominal delivery is necessarily the "soft option". The book is written in keeping with sound educational principles. The illustrations are easily understood and relevant. Where a diagnosis is required, there is emphasis on the fundamentals - ie, a good history and physical examination - principles that are often given scant attention in nations with ready access to computer-aided imaging and sophisticated pathology services. The value of freshly donated whole blood for obstetric haemorrhage is emphasised. In accordance with the original reasons for production of this book, the ADF may distribute it to non-obstetric medical officers before deployment. The concluding chapter has some excellent advice for the "crusader": not all your patients will survive, and debriefing is necessary for all team members when critical incidents occur. Standards of care will inevitably differ from those in the First
World - but what is important is that you can still make a |
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