World Journal of Surgery

, Volume 37, Issue 6, pp 1203–1207 | Cite as

Guidelines for Surgeons on Establishing Projects in Low-Income Countries

  • Caris E. Grimes
  • Jane Maraka
  • Andrew N. Kingsnorth
  • Rudolph Darko
  • Christopher A. Samkange
  • Robert H. S. Lane



There is increasing interest by surgeons in high-income countries to support colleagues in low-income countries to improve the provision of surgical care, particularly in rural areas. Such interest may be demonstrated by single individuals, short-term surgical missions, or establishment of partnerships. Such altruistic efforts may cause problems unless properly planned and carried out.


We reviewed the available literature and consulted widely to establish consensus guidelines for any surgeon considering participating in an initiative to improve surgical care in low-income countries.


A series of recommendations is presented. These include ensuring that projects are appropriate, that there is an emphasis on training local healthcare providers in all aspects of perioperative care, that outcomes are monitored, and that initiatives work with local and regional training programs.


With adherence to these recommendations, we hope that future partnerships and missions can maximize their effectiveness and minimize the risks of potential harm done.



We thank the following for their review of these recommendations: Professor Bomi Ogedengbe, President, West African College of Surgeons, Professor Clement Nwawolo, Secretary-General, West African College of Surgeons; Professor Mohamed Labib, Committee Member, College of Surgeons of East Central and Southern Africa; Professor Krikor Erzingatsian, Registrar and Committee Member, College of Surgeons of East, Central and Southern Africa.

Conflict of interest

RHSL is the Honorary Surgical Advisor to the Tropical Health and Education Trust. There are no other competing interests.


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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • Caris E. Grimes
    • 1
  • Jane Maraka
    • 2
  • Andrew N. Kingsnorth
    • 3
  • Rudolph Darko
    • 4
  • Christopher A. Samkange
    • 5
  • Robert H. S. Lane
    • 1
  1. 1.International Development Committee, Association of Surgeons of Great Britain and Ireland (ASGBI)LondonUK
  2. 2.Papworth HospitalCambridgeUK
  3. 3.Operation Hernia FoundationPeninsula College of MedicinePlymouthUK
  4. 4.West African College of SurgeonsLagosNigeria
  5. 5.College of Surgeons of East Central and Southern AfricaArushaTanzania

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