Africa has millions of people who lack access to essential surgical care. From children born with cleft lips to burn victims left untreated, these scars tell stories of a health care system stretched to its limits.

Sub-Saharan Africa bears the weight of an acute surgical care crisis, with 93% of the population unable to access the reconstructive procedures they desperately need.

In a region where burns, congenital deformities, and trauma-related injuries are common, the shortage of skilled surgeons and medical infrastructure compounds the suffering, leaving a vast majority without hope for healing.

"Many [African] countries face severe shortages of health care professionals and limited access to surgical facilities," Dr. Paa-Ekow Hoyte-Williams, director of Medical Affairs at RESTORE Worldwide, told DW. He said the gap between the need for surgical care and available resources is enormous, adding that these deficits lead to preventable disabilities and, in some cases, death.

Rural areas are most affected

Hoyte-Williams noted that the crisis is especially pronounced in rural and underserved areas across the African continent.

"The most disadvantaged groups are usually the poor people and those living in rural and remote areas, women and children. If you take the recent missions held in the central of Kumasi [inGhana], we had people traveling as much as 900 kilometers (560 miles) to assess the free surgical service."

The challenges are compounded by the exodus of trained professionals. Many surgeons trained in reconstructive surgery are drawn to work abroad, where resources and working conditions are better.

"There aren't enough reconstructive surgeons in Africa," Hoyte-Williams admits.

Rural areas in East Africa face similar challenges, particularly in countries like Kenya and Uganda, where large segments of the population reside in remote areas with little access to health care.

In Kenya, for instance, patients from marginalized counties like Turkana often have to travel hundreds of kilometers to reach the nearest referral hospital. The lack of specialized surgeons in these areas makes reconstructive surgery nearly impossible for many.

In Nigeria, Africa's most populous nation, the shortage of reconstructive surgeons is also felt across the country. With a population exceeding 200 million, only a handful of specialists are available, and they are predominantly concentrated in urban centers like Lagos and Abuja.

This leaves rural communities in states such as Borno and Yobe vulnerable and helpless, forcing patients to rely on costly trips to major cities or forego surgery altogether.

Efforts to build local capacity

Hoyte-Williams shared the importance of investing in local surgical education and training programs to address this shortage.

"Establishing our own educational training facilities will go a long way to help," he said as he urged for more government commitment.

One solution lies in local training initiatives to boost the number of surgeons in any given country.

"If we aim to address this, we really have to invest in local surgical education and training programs," Hoyte-Williams added.

Nana Bediako Brogya, president and founder of Brogya in Ghana, also highlighted the challenges patients face when seeking reconstructive surgery.

But it's not all doom and gloom. In South Africa, collaborations between public hospitals and private health care providers have supported efforts to build capacity.

Programs like surgical fellowships offered at institutions like Groote Schuur Hospital in Cape Town allow young surgeons to gain hands-on experience.

These initiatives are complemented by outreach programs targeting marginalized rural provinces, ensuring more equitable access to specialized care.

Huge financial burden

Brogya also noted another main challenge that stems from the difficulties of accessing surgical care is the high cost of procedures.

"The financial resources required to cover surgical fees, post-operative care, transportation, and accommodation are substantial," he explained. He suggested addressing these challenges requires a multi-faceted approach, including better funding and infrastructure.

Similar challenges are seen inEthiopia, where families in rural regions often sell livestock or land to afford life-saving surgeries.

With limited financial assistance programs, many patients are left without options, worsening their conditions.

Hope for the future

Despite the challenges, Brogya remains optimistic about the future.

"I believe things are getting better," he said. "There have been a lot of plastic surgeons on training who I think are going to save a lot of lives, though there's more room for improvement. There should be more resources to equip them to enable them to deliver."

Africa's lack of surgical care significantly impacts the continent's socioeconomic development.

This, in turn, perpetuates poverty and hinders overall development, Hoyte-Williams believes there are ways to reverse this trend.

"Our aim is to address both the immediate needs of the patients and the long-term need for sustainable surgical care," Hoyte-Williams said.

"I'm very positive. If you look at the National Health Insurance policy in Ghana, in particular, the funding is not from the premiums. There's a health insurance levy... This should generate enough funds to be able to cater for the surgical needs of the population."

The growing number of surgeons in training and the commitment of organizations like RESTORE Worldwide and Brogya provide hope for a brighter future.

However, sustained investment and government commitment are crucial to bridging the surgical divide across the continent.

Brogya noted that addressing the surgical care crisis is a humanitarian imperative and a crucial step toward achieving sustainable development in Africa.

Countries like Kenya and South Africa are exploring these solutions, which, if scaled, could significantly reduce the disparity in surgical care and ensure timely interventions for those in need.

Edited by: Chrispin Mwakideu