Although great advancements have been made in global health over the past decades,
progress has not been equivalent across the world. For example, the surgical burden
(number of surgical cases per capita) remains highest in low- and middle-income countries
(LMICs—a term used by The World Bank to classify countries on the basis of their gross
national income), where there are frequently fewer surgeons per capita. Surgical outreach
is on the rise, with the United States sponsoring more than 2,000 trips annually to
LMICs to help address the mismatch in per capita surgical cases to per capita surgeons.
These trips, however, are typically short-term in nature and effect and can have unintended
consequences. In contrast, capacity building focuses on bidirectional partnerships
to educate and empower individuals and organizations such that their care for the
local community is enhanced. Capacity building is a priority of leading organizations
(including the World Health Organization) but has often been absent in orthopedic
and hand surgery outreach. We detail the evidence supporting the transition from short-term
mission-based trips to that of capacity building, what we can learn from other specialties
about capacity building, and how we can measure and build capacity to improve health
in LMICs using our partnership with Costa Rican hand and upper-extremity surgeons
as an example.
Key words
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Article info
Publication history
Published online: August 29, 2022
Accepted:
June 27,
2022
Received:
March 18,
2022
Footnotes
This work was supported by a National Institutes of Health K23AR073307-01 and Orthopaedic Research and Education Foundation award (RNK). The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. No other authors have any conflicts of interest related to this research, and no benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
