La pratique de l'anesthésie en situation précaire

The practice of surgery and anesthesia in a precarious situation, apart from any hospital structure, is common in the developing countries. The authors wanted to transmit the experience gained with the Non-Governmental Organization Interplast-France Chirurgie Sans Frontières for 20 years, during 40 surgical missions carried out in sub-Saharan Africa and Madagascar, during which more than 2000 patients were operated. The constraints and limitations of this surgical practice, outside the beaten path, are exposed and practical solutions are proposed. Professionalism, anticipation and autonomy are essential to the success of this type of mission. The surgical procedure is not a be-all and end-all, and must necessarily be included into a broader therapeutic framework where the sacred dimension often plays a preponderant role.