Factors Affecting Access to Free Surgical Care in Global Surgical Crisis

Abstract

Introduction: Non-governmental organisations (NGOs) and charities play a crucial role in addressing the health inequalities and global surgical crisis that low- and middle-income countries (LMICs) face by providing free surgery. However, barriers to accessing free surgery persist. Barriers to Access of Surgical Care Even with free surgery, patients face indirect costs such as travel, accommodation, and taking time off work, forcing them to borrow money or sell possessions. NGOs cater to populations reliant on free surgical interventions, meaning unplanned costs are more likely to push these patients into financial ruin than those treated at local hospitals. Geographical challenges exacerbate this issue. Rural populations in LMICs are isolated from surgical facilities due to limited infrastructure and poor transportation. Elderly, dependent, or physically impaired patients may not endure these long and arduous journeys. Mercy Ships and Decentralised Case-Finding Strategies Mercy Ships removes the first barrier to surgery by providing free procedures in West Africa. To address access challenges, they have conducted a decentralised selection strategy targeting underserved populations in remote towns. Moving from concentrating patient assessment in cities and capitals to collaborating with local ministries of health allows nursing teams to travel to rural communities and ensure equal access to surgical services. Patients are then triaged near their homes, and transport, accommodation, and food are fully covered. Conclusion(s): NGOs like Mercy Ships deliver life-saving care to the most vulnerable, but free surgery alone cannot eradicate access barriers. Enforcing systemic changes and sustainable development is crucial for accessible healthcare in LMICs.Copyright © 2025