Hello @ebingo
There is a big difference in costs if we see what it costs in Nigeria and what it costs in the US for surgery, it is impressive.
But that's the way it is, and it's hardly going to change.
I think you have been explicit on the costs, what I see in general is that protocol there are some things that are not done and that must be evaluated by each treating physician based on the reality of the patient himself and the conditions of the surgery. In the case of an acute Entero Entero Fistula surgery, due to the type of surgery, I think that antibiotics must be used afterwards, because the surgical area is generally contaminated. But in a clean surgery it is generally not necessary to use antibiotics. It is necessary to individualize each case, that is what I think.
By the way, a salary of 11 dollars for a doctor is very low, it is almost what anyone earns in these parts of the world (Colombia), but in Venezuela the salary of a doctor can be 10 dollars a month, for example.