title: An international surgical collaboration: humanitarian surgery in Brazil.
abstract: Brazil is the fifth most populous country in the world with widespread regional and social inequalities. Regional disparities in healthcare are unacceptably large, with the remote and poor regions of the north and northeast having reduced life expectancy compared to the south region, where life expectancy approaches that of rich countries. We report our experience of a humanitarian surgery mission to the Amazonas state, in the northwest part of Brazil.
  
  
  
  In August 2014, a team of seven consultant surgeons, and two trainees with the charity 'International Hernia', visited three hospitals in the Amazonas state to provide hernia surgery and training.
  
  
  
  Eighty-nine hernias were repaired in 74 patients (female = 22, male = 52) with a median age of 44 years (range 2-83 years). Nine patients underwent more than one type of hernia repair, and there were 9 laparoscopic inguinal and ventral incisional hernia repairs. Local doctors were trained in hernia repair techniques, and an International Hernia Symposium was held at the University of the State of Amazonas, Manaus.
  
  
  
  The humanitarian mission provided hernia surgery to an underserved population in Brazil and training to local doctors, building local sustainability. Continued cooperation between host and international surgeons for future missions to Brazil will ensure continuing surgical training and technical assistance.
authors: Division of Medical Sciences and Graduate Entry Medicine, Faculty of Medicine and Health Sciences, School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Uttoxeter Road, Derby, DE22 3DT, UK. mzxad@nottingham.ac.uk.
authors: A
authors: A
authors: De Rosa
authors: General Surgery of Gastroenterology Centre, Samaritano Hospital, Sao Paulo, Brazil.
authors: A
authors: A
authors: Meyer
authors: General Surgery Department, Education and Research Institute, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil.
authors: A P
authors: AP
authors: Seabra
authors: Ospedale San Giovanni Bosco Chirurgia Generale e d'urgenza Day Surgery, Napoli, Italy.
authors: A
authors: A
authors: Sorge
authors: General surgery, The Townsville Hospital, Townsville, Queensland, Australia.
authors: J
authors: J
authors: Hack
authors: Hospital Carlos Macieira, São luis, Maranhão, Brazil.
authors: L A
authors: LA
authors: Soares
authors: General surgery, FCECON DEP ONCOLOGIC SURGERY, Manaus, Brazil.
authors: S
authors: S
authors: Chalub
authors: Gaffree Guinle University Hospital of Federal State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors: F
authors: F
authors: Malcher
authors: Department of Surgery, Peninsula Medical School, Plymouth, UK.
authors: A
authors: A
authors: Kingsnorth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery*; D059685:Herniorrhaphy / Q000193:education; D006801:Humans; D007391:International Cooperation; D008297:Male; D008493:Medical Missions; D008875:Middle Aged; D012066:Relief Work; D013526:Surgical Mesh; D055815:Young Adult
keywords: Hernia surgery; Humanitarian surgery; International collaboration