Dr. José Roberto Nociti (Comité Ejecutivo de la WFSA).

This presentation was prepared after a wide consult with local colleagues and CLASA officers
BACKGROUND

TABLE I shows some numbers on anesthetic manpower in Central and South America countries. For comparison, the number of patients per anesthetist in Brazil, Argentina and Uruguay is close to that in developed countries like USA (11,700* and Japan (30,000*). On the other hand, the number of patients per anesthetist in Guatemala, Haiti, Ecuador, Nicaragua and Honduras, is similar to that in other parts of the developing world like Nepal (287,000*). Vietnam (197,000*), Thailand (124,000*).
Tritrakam T - Challenges in the Developing World, World Anesthesia News, 2001 ; 4 (2): 2-4.

TABLE I
ANESTHETIC MANPOWER IN CENTRAL AND SOUTH AMERICA
COUNTRY
POPULATION
(Million)
Nº ANESTHETISTS
PT PER ANESTHETIST
SOUTH AMERICA
     
BRAZIL
158,200
11,870
13,300
COLOMBIA
39,300
1,000
39,300
ARGENTINA
36,700
3,080
11,900
PERU
26,600
320
83,100
VENEZUELA
23,200
260
89,200
CHILE
14,900
250
59,600
ECUADOR
12,500
80
156,200
BOLIVIA
7,900
107
73,800
PARAGUAY
5,400
63
85,770
URUGUAY
3,300
200
16,550
CENTRAL AMERICA
 
 
 
MEXICO
100,200
1,823
54,990
GUATEMALA
12,300
50
246,000
CUBA
11,090
107
103,600
DOMINICAN REPUBLIC
8,100
110
73,600
HAITI
6,800
45
151,000
HONDURAS
5,900
46
128,000
NICARAGUA
4,700
33
142,000
COSTA RICA
3,600
40
90,000
PANAMA
2,700
50
54,000
JAMAICA
2,400
25
96,000
Sources: Brazilian Society of Anesthesiology ; WFSA Annual Report 2000/2001.

1.
In Brazil, as well as in the other countries in Central and South America, THERE ARE NOT NURSE ANESTHETISTS.
2.
CLASA Member Societies support the resolution approved by the General Assembly in La Habana, 1995, stating that ANESTHESIA IS A MEDICAL ACT, and should be practised by specialized doctors in order to preserve the highest standards of safety and quality.
3.
The number of SPECIALIZED DOCTORS is adequate to the needs of the population in many countries, but still inadequate in others. These regional differences are being managed by local governments, CLASA and the National Societies.
4.
EDUCATIONAL PROGRAMS for doctors coming from those less developed regions are in course in countries like Brazil and Argentina. These programs as a rule are not avaiable to nurses or other paramedical people, just to medical doctors. The great number of doctors arising each year from the Universities supports this policy.

ACTION

How wfsa can best help the development of anesthesiology in central and south america area:
1.
Supporting always as possible, particularly within the ambit of WHO,the statement that ANESTHESIA IS A MEDICAL ACT, and should be practised by specialized doctors.
2.
WFSA should not encourage the development of Training Centers for paramedical personnel, as well as should encourage the development of TRAINING CENTERS FOR MEDICAL DOCTORS.
3.
WFSA should provide to National Societies (through the Committee on Education), the assistance of VISITING PROFESSORS as well as of LECTURERS IN THEIR NATIONAL EVENTS, with airfares paid by the Federation, and hotel / other local costs provided by the National Society.


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