A personal reflection about surgery and HIV from Operation Health: Surgical care in the developing world.
“Doctor, we have none” was the terse response to the question, “Why are you not wearing eye protection?” The nurse had seemed so cheery and helpful, but her attitude had instantly changed. Suddenly my attempt to assist at a hospital in Africa was not going well.
Having taken it for granted that all operating room personal would follow universal precautions: double gloving, gowns, careful treatment of sharp instruments and eye protection — seeing a scrub nurse without eye protection was a shock. In the United States entering an operating room without proper eye protection: glasses, goggles or a visor – is not only unthinkable, it is illegal. The U.S. Occupational Safety and Health Administration (OSHA) mandates wearing eye protection – and that is in a country with a relatively low prevalence of HIV. In a country with a high HIV prevalence, not using full protection was inconceivable.
It was from that moment the realization set in that despite all the resources devoted to HIV prevention and treatment, one group was neglected and at risk of exposure to HIV – surgical healthcare workers. Why was that? Why was there not sufficient protective gear in operating rooms? Also, if surgical health care workers were neglected, were there other conditions involving HIV and surgical care that were not receiving the attention they needed?
To read the chapter on Surgical care and HIV: A case study from Malawi, get a copy of Operation Health: Surgical care in the developing world from JHU Press or on Amazon.
Operation Health: A series of books on surgery and global health from Johns Hopkins University Press 