After a 15-year-quest to obtain the necessary resources, equipment and team, Cinterandes was established in 1994, and has now been successfully delivering surgery in remote areas for over 20 years, completing over 7,500 operations.
The village-based approach to delivering surgery may work better in certain environments than others and should be considered along with other strategies for further research.
The operating model depends upon delivering surgeries at high volume – the surgeons there are ten times more productive than surgeons elsewhere in the country.
There is an established body of linguistic knowledge about such things as eliciting patients' concerns, framing discussions about whether to have surgery, delivering bad news, perceiving a patient's indirect expression about reluctance to take medication and many other medical subjects.
In Thailand a successful project in 2008 delivered ear procedures via a mobile surgery clinics and in India a mobile clinic was funded to deliver cataract surgery in remote areas.
Traditionally, programmes have focussed on training ophthalmologists to deliver cataract surgery.
This is reinforced in the earlier example of the podiatric surgeons successfully competing with orthopaedic surgeons to deliver foot surgery by using explicit indicators of quality and efficiency.
The tool has already been used in several developing countries to confirm enormous deficiencies in their capacity to deliver essential surgery and anesthesia care.
The WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment.
Results Among the 585 women who had undergone bariatric surgery and had a delivery, 269 delivered before surgery and 316 delivered after surgery.
