Skip to main content


Log in

The Provision of Surgical Care by International Organizations in Developing Countries: A Preliminary Report

  • Published:
World Journal of Surgery Aims and scope Submit manuscript



Emerging data demonstrate that a large fraction of the global burden of disease is amenable to surgical intervention. There is a paucity of data related to delivery of surgical care in low- and middle-income countries, and no aggregate data describe the efforts of international organizations to provide surgical care in these settings. This study was designed to describe the roles and practices of international organizations delivering surgical care in developing nations with regard to surgical types and volume, outcomes tracking, and degree of integration with local health systems.


Between October 2008 and December 2008, an Internet-based confidential questionnaire was distributed to 99 international organizations providing humanitarian surgical care to determine their size, scope, involvement in surgical data collection, and integration into local systems.


Forty-six international organizations responded (response rate 46%). Findings reveal that a majority of organizations that provide surgery track numbers of cases performed and immediate outcomes, such as mortality. In general, these groups have mechanisms in place to track volume and outcomes, provide for postintervention follow-up, are committed to providing education, and work in conjunction with local health organizations and providers. Whereas most organizations surveyed provided fewer than 500 surgical procedures annually, more than half had the capacity to provide emergency services. In addition, a great diversity of specialized surgical care was provided, including obstetrics, orthopedic, plastic, and ophthalmologic surgery.


International organizations providing surgical services are diverse in size and breadth of surgical services provided yet, with consistency, provide rudimentary analysis, postoperative follow-up care, and both education and integration of health services at the local level. The role of international organizations in the delivery of surgery is an important index, worthy of further evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others


  1. Debas H, Gosselin R, McCord C, Thind A (2006) Surgery. In: Jamison D (ed) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York

    Google Scholar 

  2. Ozdegiz D, Jamison D, Cherian M, McQueen K (2008) The burden of surgical conditions and access to surgical care in low and middle income countries. Bull World Health Organ (86)8:646–647

    Article  Google Scholar 

  3. Farmer PE, Kim JY (2008) Surgery and global health: a view from beyond the OR. World J Surg 32:533–536

    Article  PubMed  Google Scholar 

  4. WHO. World Health Report 2005. Make every mother and child count. Accessed 21 Aug 2008

  5. Gosselin RA, Thind A, Bellardinelli A (2006) Cost/DALY averted in a small hospital in Sierra Leone: what is the relative contribution of different services? World J Surg 30:505–511

    Article  PubMed  Google Scholar 

  6. Spiegel DA, Gosselin RA (2007) Surgical services in low-income and middle-income countries. Lancet 370(9592):1013–1015

    Article  PubMed  Google Scholar 

  7. McQueen KAK, Magee B, Crabtree TG, Romano C, Burkle FM (2009) Application of outcome measures in international humanitarian aid: comparing indices through retrospective analysis of corrective surgical care cases. Prehopital Disaster Med 1(24):39–46

    Google Scholar 

  8. Maki J, Qualls M, White B, Kleefield S, Crone R (2008) Health impact assessment and short-term medical missions: a methods study to evaluate quality of care. BMC Health Serv Res 8:121

    Article  PubMed  Google Scholar 

  9. Operation Giving Back. Accessed 21 Aug 2008

  10. Society for Pediatric Anesthesia. Accessed 21 Aug 2008

  11. International Committee for the Red Cross. 2007 Annual Report. Accessed 12 Feb 2009

  12. Medicines Sans Frontieres. Annual Reports 2007, 2008. Accessed 12 Feb 2009

  13. Operation Smile. Accessed Feb 12, 2009

  14. Interplast. Accessed 9 April 2009

  15. Taira BR, Kelly McQueen AK, Burkle FM Jr (2009) Burden of surgical disease: does the literature reflect the scope of the international crisis? World J Surg 33:893–898

    Article  PubMed  Google Scholar 

  16. Burden of Surgical Disease Working Group. Accessed 29 March 2009

  17. US State Department. Private Volunteer Organization Registry. Accessed 21 Aug 2008

  18. Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, Gawande AA (2008) An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 372(9633):139–144

    Article  PubMed  Google Scholar 

  19. Del Rossi C, Fontechiari S, Casolari E, Fainardi V, Caravaggi F, Lombardi L (2008) Treatment of congenital anomalies in a missionary hospital in Bangladesh: results of 17 paediatric surgical missions. ACTA Biomed 79:260–263

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to K. A. Kelly McQueen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

McQueen, K.A.K., Hyder, J.A., Taira, B.R. et al. The Provision of Surgical Care by International Organizations in Developing Countries: A Preliminary Report. World J Surg 34, 397–402 (2010).

Download citation

  • Published:

  • Issue Date:

  • DOI: