LAUSR

The Lancet Commission’s landmark 2015 report highlighted the importance of anesthesia in the role of surgical care in low and middleincome countries (LMICs). Indeed, without safe anesthesia, the goal of providing the necessary care for surgical patients cannot be achieved. Although an impressive number of initiatives exist to increase the provision of safe surgery, the same attention to inclusion of anesthesia requirements is lagging behind. An evaluation of the state of anesthesia in Ethiopia, a large country in sub-Saharan Africa, provides a case study and a framework with which to evaluate some of the unique challenges for women in anesthesiology in low-income countries (LIC). Physician density is highly varied throughout the world. Estimates by the World Health Organization show the disparity between high-income countries (HIC) and LIC. For example, the United States has a density of 2.568 physicians per 1000 population, whereas Ethiopia has 0.025. With a population of over 100 million, Ethiopia, like many other countries in sub-Saharan Africa, has a crisis in anesthesiology. Although the Lancet Commission suggests a minimum number of surgical, anesthesia, and obstetric physicians per 100,000 population, there are orders of magnitudes of fewer providers than this in LICs. With a population of over 100 million, Ethiopia ideally should have 10 to 20,000 surgical, anesthesia, and obstetric physicians, but examination of the true state shows a different picture.