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Invited Critique
February 16, 2009

Quantifying Surgical Capacity in Sierra Leone—Invited Critique

Arch Surg. 2009;144(2):128. doi:10.1001/archsurg.2008.541

While volunteerism and short-term medical missions have made tremendous contributions to many needy individuals, the real path to sustainable change and capacity building with the goal of reducing the global burden of surgical disease is through critical analysis and committed ongoing partnerships.

Kingham and colleagues present a clear, concise, and succinct method for analyzing the surgical capacity of a single small African country, Sierra Leone. As they eloquently describe, the first step to making a meaningful improvement in the delivery of surgical care is to be able to assess and quantify the current capacity in terms of infrastructure and workforce in a reproducible and reliable manner. The authors nicely demonstrate the use of the World Health Organization's simple but rigorous assessment tool for achieving this result. They also highlight the staggeringly adverse conditions in which our African surgical colleagues struggle to provide basic surgical care for common disorders such as appendicitis, incarcerated hernias, and obstetric complications.