What can we Expect from the ORTOJ?

Abstract

Indeed ORTOJ, with its wide vision, will be able to address all aspects of orthopedics and trauma, satisfying the interest of readers around the globe. We are aware that, different areas of the globe differ in their disease makeup, health care levels and systems. Although these differences apply for health disciplines in general, they are more obvious in orthopedics and trauma in particular. For instance in many areas in the developing world, Sudan as an example, seeing and managing neglected late presenting cases or cases seen by bone setters first is the rule. Even children disabilities are taken care of soon after birth by untrained personnel. Compared to other developed areas with good health system and people awareness were even tertiary care is available in a location accessible for almost all population. Thus researches addressing neglected cases although of little value at some parts of the developed world, is highly appreciated in the developing world. Indeed this difference in levels of the first care will affect publications and research topics. In most of European, American and other developed countries, a trained orthopedic and trauma surgeon will see the patient first, whereas a pediatric orthopedic unit will be usually the second if not the first level of health care, compared to developing countries where either a native bone setter or a general medical assistant is the first level of health care. Thus our training in such setup should be directed towards health personnel (paramedical staff), so that people will opt going to health centers and not to native bone setters
if better service is offered by the available health personnel. In a study previously conducted in Sudan,1 it was shown that clubfoot can be scored to comparable results when it is done by a pediatric orthopedic surgeon or an assistant physiotherapist (a nurse who had only on job training in physiotherapy). So we can trust these health personnel to deliver an acceptable quality service, because it will not be possible for the health system to make a trained orthopedic or pediatric orthopedic surgeon as it is in the developed part of the world. In such underdeveloped areas, even patient’s follow up is a challenge due to lack of awareness and cultural issues related to how disability is looked at in such communities and poor health system setups, leave alone financial constraints.