Abstract
With the relentless advance of technology in surgery, old methods are being forgotten in rich centres. These are the places that dictate what is taught and this is often copied in the rest of the world, despite the fact that the technological resources implicated are often missing, non-functional or simply too expensive for the vast majority of patients.
It is, however, dawning on the powers that be that surgery is cost-effective; at least basic essential surgery is. However, if much technology that is used in rich centres is deemed mandatory, the cost-effectiveness of such surgery may easily vanish. This would be a great pity, because much is possible (and often better done) with simple methods. A prime case in point is symphysiotomy, a simple operation which, in the right situation and for the right indication can save the life of baby and mother, and also prevent complications of subsequent pregnancies. Yet, who in rich countries knows how to perform a symphysiotomy safely, let alone has actually done one? Who teaches this procedure? How many obstetricians promote this small intervention actively to save the lives of thousands? How many women must suffer simply because prejudices and a blind subservience to tradition blinds their birth attendants to a simple and effective practice?
The same applies to a number of other surgical operations that have disappeared from the armamentarium of the modern Western surgeon. Tropical Doctor intends to highlight these and discuss their proper and relevant usage in forthcoming editions. We welcome articles to complement this drive.