According to the WHO and The Lancet Commission, most of the
preventable deaths are secondary due to non-compressible bleeding
and lack of access to emergency surgery. In other words, in some
areas of the world, patients are dying from the lack of resources
that are regarded as basic necessities in high-income countries.
the community and optimize surgical care. This
cache includes the equipment and tools necessary
not only during the operation, but also in the ongoing management of surgical diseases.
Surgeons who provide care in austere environments need to use cost-effective techniques and be
capable of providing a range of clinical services that
extend beyond the operating room, such as taking
and documenting vital signs, triaging patients,
transporting patients, and obtaining lab tests and
In summary, when planning to participate in a
global surgery opportunity, prepare to act in the
•Functioning in a team-based setting with health care
professionals who bring a wide range of skill sets.
•Understanding the local environment and potential
limitations of resources.
•Maintaining an open mind to how dynamic situations may arise in LMICs. Be flexible. Teaching
and learning may happen on the go, in many busy
When engaging in global outreach, surgeons should
maintain the same patient safety standards they
follow in their home institutions and ensure that
all team members practice within their scope of
training. Although it might seem easy to uphold
these values regardless of the setting, the reality
is that working within one’s scope of practice in
LMICs can often be difficult. The spectrum of surgical pathology in these countries is broad, whereas
the number of local clinicians and specialists is limited. The desire of wanting to meet patients’ needs
must be balanced with our pledge to “above all,
do no harm.” While trainees can be of significant