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Sunday, Sep. 20, 2009

New surgeries a SIGN of the times

By Dr. Lewis G. Zirkle, In Focus

Health care issues are a subject of much debate in the United States. People in developing countries do not have the luxury of care that we have, nor the chance to debate the aspects of this care. The following is an example of one such patient whose story is repeated many times in developing countries.

Imagine that you live in Phnom Penh, Cambodia, and are able to buy a new $500 motorcycle after years of hard work, saving from your meager salary. This motorcycle becomes the family vehicle. You, your wife and your three children often ride to the market together.

Imagine that on the last trip you are sideswiped by a truck and your family is thrown to the ground. One child is killed and you have two broken bones in your leg. You're taken to a local hospital and two SIGN nails are inserted into these broken bones to hold them in the proper position while they heal (a SIGN nail is an intramedullary stainless steel nail designed and manufactured at our headquarters in Richland). A local orthopedic surgeon has been trained in the SIGN technique and the nails have been donated for the treatment of poor patients. You're able to bear a little more weight each day and you can walk without a crutch in six weeks.

If this accident happened five years ago, you likely would have been treated by a bonesetter. A bonesetter is a practitioner who places herbs on the fracture and immobilizes the limb with bamboo splints. The result would have been either a crooked leg or a fracture that did not heal. You would be unable to stand on your leg without a great deal of discomfort and, therefore, could not continue your job. Your family would have to supply your meals and your children would be forced to drop out of school because you could not afford to send them.

This injury would be an economic catastrophe for your family. Studies have shown that a severe injury to the breadwinner in developing countries causes the family to spiral into poverty impacting three generations.

In Cambodia, as well as in other developing countries, the injured must purchase all the supplies for their surgery prior to the operation. Many times choice possessions must be sold to purchase surgical supplies.

This never would happen in the United States, where even the poorest citizen would receive care based on the latest technology. There would certainly be a cost and many underinsured people have gone bankrupt because of medical bills. The surgical result, however, would not be dependent on the ability to pay for the latest care.

Since its inception in 1999, SIGN has trained 2,000 surgeons and started 200 programs in 41 countries around the world. More than 50,000 SIGN surgeries have been done.

The reports and X-rays on the SIGN surgical database indicate the results are as good as surgeries done in the United States. The surgeons are able to implement the training they have received. Hospital beds no longer are filled with patients in traction for up to three months waiting for a recovery that may never come. Instead, patients receiving a SIGN nail are able to leave the hospital within three or four days, clearing the beds for other patients in need of care.

SIGN's dedicated and talented staff manufacture these instruments and implants in Richland. There is a rising demand for SIGN systems, and at least one request to start a new program is received every week. To continue and expand this important work, SIGN is dependent on the generosity of donors.

If you are interested in learning more about SIGN, please visit the website at www.sign-post.org. You may also learn about SIGN by attending the annual benefit at 7 p.m. Oct. 17 at SIGN headquarters at 451 Hills Street, Richland. Contact Jennifer at jennifer@sign-post.org to receive your invitation.

* Dr. Lewis G. Zirkle Jr. is the founder and president of SIGN.

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