Surgical case patterns and procedures performed in patients attending the Aloha Medical Mission in Nepal: a cross-sectional study.

Abstract

<h4>Background</h4>Nearly 5 billion people lack access to essential surgical and anesthesia care, with low- and middle-income countries disproportionately affected. In Nepal, where 78.3% of the population resides in rural areas, access to surgical services is scarce due to surgical expertise shortage, limited infrastructure, and geographical barriers. Aloha Medical Mission (AMM), a Hawaii-based nonprofit, conducted an 11-day surgical camp in Dhankuta, Nepal, in 2018.<h4>Objectives</h4>To analyze the range and volume of surgical conditions among patients who underwent procedures during the AMM in Nepal.<h4>Methods</h4>This was a retrospective, cross-sectional study of the AMM in 2018 at the <i>Dhankuta</i> district, where we analyzed recorded data on the sociodemographic profiles of patients, diseases, and surgical procedures. All patients who underwent surgical intervention during the mission were included. Ethical clearance was obtained. The data were reviewed and entered into Excel and analyzed using Easy R version 1.15.<h4>Results</h4>During the mission, 161 minor surgeries and 94 major surgeries were performed. The most common age group was 15-59 years. The most common diagnoses were hemorrhoids (47.2%)and lipoma (18.6%). Hemorrhoid banding (47.2%) was the most frequently performed procedure under minor surgery. Mesh repair (25.5%), open cholecystectomy (21.3%), herniotomy (17%), and hysterectomy (14.9%) were the most common procedures under major surgery.<h4>Conclusion</h4>Men in the productive age and the working class are affected by surgical conditions, highlighting the unmet need for surgical care in Nepal's productive population. Likewise, the higher rate of major surgeries in children highlights limited local expertise for these cases.