Know thy neighbors: The status of cardiac surgery in the South Asian countries around India

OBJECTIVES: The South Asian neighboring countries of India include Bangladesh, Bhutan, Nepal, The Maldives, Pakistan and Sri Lanka. Interestingly all these countries possess either a land or a sea border with India and no border among themselves. These countries have historic, cultural, ethnic and genetic links with India. The paper describes the developmental history and current status of cardiac surgery in these countries. METHODS: Thorough search of the printed and electronic materials has been made. The authors visited all these countries and contacted the eminent surgeons personally or through mails. All the information is cross-checked and compiled. Record keeping is not well organized in most of these countries. Best information often came from unusual sources like Anesthetists’ society or the corporate houses. RESULTS: Four of these countries Bangladesh, Nepal, Pakistan and Sri Lanka have their cardiac surgical programs. Collectively they perform around 38000 cardiac operations a year which is a quarter of the cases performed in India. These countries are important sources of medical tourism in India which is worth 3 billion US$ of business annually. CONCLUSION: When the number of operations per million populations is considered, Bangladesh and Nepal are lagging behind India where as Pakistan has a comparable figure. Sri Lanka with 265 cardiac operations/million populations has the best figures in the region. However when compared with the Western countries even the Lankan figures also look quite inadequate.