Critical care resources in the Solomon Islands: a cross-sectional survey
1 Bachelor of Medicine Candidate (2012), University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
2 George Institute for Global Health, PO Box M201, Missenden Road Sydney, NSW 2050, Australia
3 Faculty of Medicine, University of Sydney, Sydney, NSW 2006, Australia
4 Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada
5 Trauma, Emergency and Critical Care Programme, Sunnybrook Health Sciences Centre, Room D1.08 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
6 Interdepartmental Division of Critical Care, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada
7 Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Room D1.08 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
8 Director of Public Health and Primary Health Care, Solomon Islands Ministry of Health and Medical Services, PO Box 349 Honiara, Solomon Islands, USA
BMC International Health and Human Rights 2012, 12:1 doi:10.1186/1472-698X-12-1Published: 1 March 2012
There are minimal data available on critical care case-mix, care processes and outcomes in lower and middle income countries (LMICs). The objectives of this paper were to gather data in the Solomon Islands in order to gain a better understanding of common presentations of critical illness, available hospital resources, and what resources would be helpful in improving the care of these patients in the future.
This study used a mixed methods approach, including a cross sectional survey of respondents' opinions regarding critical care needs, ethnographic information and qualitative data.
The four most common conditions leading to critical illness in the Solomon Islands are malaria, diseases of the respiratory system including pneumonia and influenza, diabetes mellitus and tuberculosis. Complications of surgery and trauma less frequently result in critical illness. Respondents emphasised the need for basic critical care resources in LMICs, including equipment such as oximeters and oxygen concentrators; greater access to medications and blood products; laboratory services; staff education; and the need for at least one national critical care facility.
A large degree of critical illness in LMICs is likely due to inadequate resources for primary prevention and healthcare; however, for patients who fall through the net of prevention, there may be simple therapies and context-appropriate resources to mitigate the high burden of morbidity and mortality. Emphasis should be on the development and acquisition of simple and inexpensive tools rather than complicated equipment, to prevent critical care from unduly diverting resources away from other important parts of the health system.