February 2007 issue of the SICOT newsletter (No. 103)

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Orthopaedic Surgeryin VenezuelaIn Venezuela, medicalstudies can be undertakenin the followingofficial universities:Central University ofCaracas (UCV) with 2 medical campuses,one at the Razzetti school locatedin the University City and theother at the Vargas School locatedin the north-west of Caracas;OrientUniversity, situated in the easternpart of the country, with differentcampuses in Barcelona, Cumana,Maturin and Ciudad Bolivar;AndesUniversity (ULA) in Merida and SanCristobal; Carabobo University(CU) in Valencia and Maracay; Center-OccidentalUniversity (UCO-LA) (Lisandro Alvarado) in Barquisimeto;Zulia University (LUZ) in Maracaibo,the second most populatedcity; Francisco de Miranda University(FMU) located in Coro. All ofthem are government-owned universities.After medical studies have beencompleted, the graduate must doone year of rural medicine and thengo to an accredited hospital to receivetrauma training. A specialtymust be done in an accredited certifiedhospital and lasts for threeyears.These hospitals either belongto universities, the Social SecurityInstitute (IVSS), the Government, orthe Municipalities.Very few are private.Trainingconsists mainly of traumaand adult orthopaedics withlittle paediatric orthopaedics.Afterending the three-year training, thegraduate can either apply for a certifiedsubspecialty in Hand Surgeryor Paediatric Orthopaedics or do aone- or two-year Fellowship in,among other things,Arthroscopy,Foot and Ankle, Spine, or EmergencyTrauma. Due to its proximity,most graduate orthopaedic surgeonsgo to the United States forFellowships and a smaller numbergo to Europe.Thus, in terms of specialisttraining, the influence of theUnited States is more importantthan that of Europe.The number of orthopaedic surgeonsregistered at the “SociedadVenezolana de Cirugía Ortopédicay Traumatología” (SVCOT), thenational Trauma and OrthopaedicSociety, is 1,606, according to lastyear’s records. SVCOT has differentgrades of membership.There areAn Andean valley387 Adherent members, who areresidents or starting to practise;1073 Effective members, who havehad less than six years in practice;276 Associate members, with morethan six years in practice; 93 Titularmembers, with more than 12 yearsin practice and after having presentedwork in a General Assembly; 36Honorary members, who are awardedthis membership according totheir curriculum after outstandingpractice; and finally 70 Jubilee members,who are retired orthopaedicsurgeons and traumatologists.In 1997, the population withsome form of insurance reached15,665,235 (65% of the total population).57% of them belonged tothe IVSS.The National Health Ministry(MSDS) takes care of about80% of the population. Despite thefact that public hospitals shouldtheoretically be capable of offeringsufficient health services, part ofthe population relies on being treatedat private hospitals or clinicsfor reasons such as long waitinglists, unsatisfactory treatments,overcrowded hospitals, lack of certainmedication and surgical items,inoperative X-ray machines, laboratories,etc.These are problems outsidedoctors’ control.Thus, qualifiedspecialist work can be found in boththe public and private health sectoror only in private practice.page 4
Prof Federico Fernandez-Palazzi |First Vice President of SICOT and National Delegate of VenezuelaCountrytocountryseriesColonial style Catholic church in Falcon stateAccidents and violence caused12.5% of the total number of deathsin 1999. In the same year, accidentsoccupied fourth place in causes ofdeath (7.5%), with a mortality rateof 32.8 per 100,000 inhabitants.Thesex ratio of mortality due to accidentswas 320 males per 100 females.In 1989, the rate was 39.5 per100,000.Traffic accidents, which represented60% of all causes of death,were the third cause of death formales and sixth for females. In 1999,suicides and homicides represented5% of all deaths, ranking seventh incauses of death and fourth in causesof male mortality (78.4%).The mortalityrate for homicides and suicideswas 11.7 per 100,000 inhabitantsin 1998 and 16.9 in 1999.Thepopulation most at risk was menfrom 15 to 44 years of age (430.2per 100,000). In the first trimesterof 2000,homicides and suicides werethe fifth cause of death, 83% (7,908)being homicide cases. In 1999, it was76% (5,860 cases).When there is a trauma of anykind, multiple fractures, accidents,firearm wounds – which occurs veryoften on weekends – fires, road accidents,etc., the patient is broughtto an emergency hospital that isusually overcrowded. If possible, thepatient will receive an initial medicalevaluation. If surgery is required butcan possibly be postponed, the patientis admitted to a hospital warduntil the surgery can be performed.Thus, emergency hospitals, but alsothe referral hospitals, are mostlyfilled with patients needing urgentsurgery that has been delayed.As aresult, less elective surgery is performedand creates a long waitinglist.This is the main reason why peopleat present choose to attend privatepractice… but what the futurewill offer… we do not know!!■u Country name: Venezuelau Capital: Caracas (over 5,000,000 people)u Location: north coast of South Americau Population: 26,128,898 (13,127,351 males and13,001,547 females; 93% urban and 7% rural)u Age structure: under 14: 34.04%; 15-64: 61.51%; above 65: 4.44%)u Size of country: 916,446 km 2 ; formed of 23 states, one Capital Districtand one Federal Dependency consisting of 311 islandsu Population density: 28.93 inhabitants per km 2u Growth rate: 17.22 per 1,000 populationu Birth rate: 22.31 per 1,000 populationu Death rate: 5.89 per 1,000 populationu Infant mortality rate: 16.82 per 1,000 live birthsCaracasu Ethnic features: 67% mixed origin, 21% white,10% black, and 2% Indianu Religion: 92% Catholicu Official language: Spanishu No. of doctors: 48,000u No. of orthopaedic surgeons registeredat SVCOT: 1,606u No. of hospital beds: 9 per 10,000 populationu No. of medical schools: 12u SICOT active members: 8page 5
Page 1 and 2: SICOTSOCIÉTÉ INTERNATIONALE de CH
Page 3: The SICOT Newsletter:a steady commu
Page 7 and 8: On the Webinformation technologists
Page 9 and 10: Hospital under fire: the experience
Page 11 and 12: Worldwidenewsa visiting faculty, 13

February 2007 issue of the SICOT newsletter (No. 103)

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