SIGN Fracture Care International

Creating Equality of Fracture Care for the World’s Poor

Lead Organization

SIGN Fracture Care International

Richland, Washington, United States

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

More than 20 million people are injured in traffic accidents every year. Surgeons in low- and middle-income countries (LMICs) often lack proper equipment to care for the injured, and patients are often unable to afford treatment.SIGN is building sustainable orthopaedic capacity in LMICs by providing educational resources to local surgeons and manufacturing and donating implants and instruments. To meet the need, SIGN must scale current operations. We must provide education to expand the range of fractures surgeons are able to treat and give SIGN implants to more surgeons. Our goal is to treat 1 million patients by 2030. Access to the right tools and knowledge empowers surgeons to provide necessary health services to their local communities. Affordable orthopaedic treatment enables patients to return to work or school, keeps families on the path out of poverty, and improves the lives of future generations.

Problem Statement

Tens of millions of people are injured or disabled in road traffic accidents (RTAs) every year. The working poor of LMICs are most often the victims of RTAs and RTA injuries. Proper orthopaedic care is frequently inaccessible to these patients due to the lack of skilled surgeons, orthopaedic equipment, or inability to afford treatment.Other organizations are working to improve road safety, but little is being done to ensure that those injured in RTAs receive proper care and treatment.Orthopaedic surgeons in LMICs lack access to the equipment needed to treat RTA injuries. This can stem from a hospital lacking the funds to purchase necessary equipment or funds being diverted to other urgent problems, such as malaria prevention or prenatal care. Without the ability or funds to treat patients, hospital wards become overcrowded, scores of patients receive poor treatment, and hospital staff become demoralized. Care is also costly to patients, most of whom earn less than $5.50 per day. Some patients go years without seeking treatment for a broken bone because they cannot afford the implant needed. They may seek help from a traditional healer, causing further complications, or even resort to amputation.The most influential way to effect change is supplying appropriate orthopaedic education, implants, and instruments to LMIC surgeons. Orthopaedic care in LMICs must also be affordable. To be accessible to the poor, implants must be provided at little to no cost.

Solution Overview

SIGN will expand our model of education plus donation of orthopaedic implants. The problem will not be solved in five years, but by providing a reliable supply of training and implants, SIGN is helping local surgeons build sustainable orthopaedic capacity in LMICs.Our goal is to treat 1 million patients by 2030. We will monitor our progress via the SIGN Surgical Database, where SIGN Surgeons record each fracture they treat. Surgical mentors review the database each day and provide feedback to help build the surgeons’ skills.To achieve our goal, SIGN will create new educational opportunities to help SIGN Surgeons treat a wider variety of fractures. Online training modules will teach surgeons about the SIGN Technique and the treatment of long bone fractures. SIGN will expand our current pelvic fracture fellowship in Ethiopia and develop a spinal fellowship to train more surgeons in the management of these complex injuries. We will provide further support for overseas SIGN conferences.To complement the expansion of SIGN’s education, we will produce more implants and instruments for donation. We will identify new partner hospitals, expanding into new regions and countries. SIGN will also send more implants to our current partner hospitals, enabling them to increase the number of patients they are able to treat.Finally, SIGN will help create trauma centers in LMICs, which will provide training to hospital staff and surgeons and allow for the efficient treatment of many patients.Patients, surgeons, and hospitals will all benefit from optimum care of all patients.

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