We appreciate the response to our article from Dr. Emmanual Monjok and heartily concur that especially in limited-resource settings, it is neither practical nor helpful to the communities that seek care to follow models that have been developed in other contexts with a different set of available resources. We have devised this program in Niger with the idea that this is a provisional solution until there are enough formally trained surgeons to live in rural areas. We have been able to implement this program with the help of financial partners collaborating with our Ministry of Health, and wholeheartedly agree that a comprehensive approach—one that involves a department of higher education and health—is required for addressing the problem of coverage of essential surgical care.