Preface Keith MacLcllan, MD: -The modest country doctor may furnish you the vital link in your chain, and the simple rural practitioner is often a very wise man.- - Sir William Osier, in Thayer, W. S. "Osier, the Teacher," Johns Hopkins Hospital Bulletin, 30:198, 1919. -A rural doctor is someone chewing more than can be bitten off- - anonymous, possibly from ancient Mesopotamia A Manual of widely varying rural medical procedures, such as burr holes, casting, breech deliveries, skin grafts and so on, springs from needs specific to rural life. Rural populations are older, sicker, poorer and more prone to accidents than their urban counterparts, no matter what part of the world they live in. The generic challenges of health care delivery to rural populations are identical whether it's in Nepal or Ghana, Canada or Australia - widely dispersed patients, a dearth of specialists, and, as urban centres aspirate most funding, chronically meager budgets for the job on hand. Transport of patients to urban centres has been one of the answers to counter these challenges, but, in the absence of expensive all-weather dedicated transport crews, this solution is limited. Information technology is a newer solution holding promise in certain cases, but not at the expense of degrading local capabilities.
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