The Orthopaedic National Programme aims to co-ordinate the provision of efficient orthopaedic and trauma service to central, provincial and rural hospitals. The country is divided into southern, central and northern regions, each with a central hospital with orthopaedic surgeons. The 1 500-bed Central Hospital in Maputo is the national referral centre and the teaching hospital for Eduardo Mondlane University. The orthopaedic department has 200 beds and 12 orthopaedic surgeons. In each provincial hospital an orthopaedic surgeon provides specialist care and supports and supervises the surgical paramedical staff at district and rural hospitals.

The referring hospitals have been equipped to provide conservative treatment. The types of fractures that should be treated surgically have been clearly defined. In some rural hospitals with surgical facilities, there are well-trained surgical paramedics, but where possible patients are treated conservatively. We guarantee the supply of equipment and material and provide regular refresher training.

In Mozambique fractures constitute more than 70% of the orthopaedic pathology. In adults the most common are fractures of the femur, tibia, forearm and arm. In children under 16 years, 60% of hospital admissions are for trauma, usually sustained in falls from trees or vehicle accidents. Infections account for 30% of admissions, and other causes for the remainder. In contrast with developed countries, we have few patients with fractures due to osteoporosis.