Surgeons in Leeds are building new networks to test low-cost surgical technologies in Sierra Leone and India, where rural communities often lack basic equipment and trained staff. This matters because five billion people worldwide lack access to safe, affordable surgery when they need it. The problem is not just a shortage of surgeons—it is also a shortage of tools that work in places with unreliable power, few spare parts, and limited specialist training. The team will first map exactly what surgical needs are going unmet in rural Sierra Leone and India, then develop and test technologies—such as simpler wound-closure devices, portable anaesthesia equipment, or rugged surgical instruments—that could be manufactured and maintained locally. If successful, the research could produce a toolkit of proven, affordable surgical technologies that other low- and middle-income countries could adopt. It would also strengthen local research networks and training programmes, so that solutions are not imposed from outside but developed with the people who will use them. The project builds directly on existing NIHR trials in robotic surgery and surgical technology evaluation at Leeds, but shifts the focus from high-tech innovation to practical, scalable solutions for the settings that need them most.
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The University of Leeds (UoL) is a research-intensive university, voted University of the Year in 2016. The Faculty of Medicine and Health (FMH) has a research strategy that promotes excellence in Clinical Trials, Social Sciences, and Biomedical Technologies. It has a strong commitment to global health through the Nuffield Centre for International Health and Development, including an 11-year DfID-funded programme in Africa and Asia. Engineering in Leeds is a particular strength with the Faculty rated in the top 10 in the UK and top 100 in the world. The University’s partner NHS organisation is Leeds Teaching Hospitals NHS Trust (LTHT), the 2nd largest healthcare provider and 3rd largest Major Trauma Centre in the UK. Surgery in Leeds has an international reputation for excellence in research and NHS service provision. Surgical Technologies is a central tenant of research, supported by strong collaborations with engineering and formalized in the EPSRC Leeds Innovation in Surgical Technologies (LIST). Close collaborations with Leeds Clinical Trials and Research Unit (CTRU) and Applied Health Sciences bring expertise in clinical evaluation of surgical technologies. The strength of this collaboration is evidenced by a portfolio of NIHR trials: MRC/NIHR GLiSteN, HTA/NIHR SaFaRI, MRC/NIHR IntAct, and MRC/NIHR ROLARR trial - a pan-World randomised evaluation of robotic surgery for rectal cancer, and the award of Royal College of Surgeons of England Surgical Trials Centre in 2016. This is complemented by NIHR infrastructure - Leeds boasts both an NIHR Healthcare Technologies Co-operative (HTC) and an NIHR Diagnostic Evaluation Centre (DEC) – which brings national academic and industry engagement. Programme of research. We will focus on 2 LMICs, Sierra Leone and India, chosen because of the strength of existing connections and the pressing need to address surgical inequalities. India has a more developed healthcare system than Sierra Leone, but both countries face similar challenges, particularly in rural communities, from lack of resource, expertise and infrastructure. General Surgery, Emergency Surgery and Trauma Surgery are priority areas. Through an integrated research programme we will identify barriers to surgical care and unmet surgical needs, develop and implement technological solutions, and evaluate the benefits for wider adoption. Our research aligns to priority areas of the global health agenda, including: strengthening health systems and equitable access; harnessing knowledge, sciences and technology; strengthening governance, leadership, and accountability. It aligns with the Lancet Commission on Global Surgery to provide all people with access to safe, high quality surgical care, with financial protection. Research strategy WS1: Building networks. UK Lead: D. Jayne. We will work with LIMC leads to form strong links to local health networks, connecting local researchers, healthcare providers, and policy makers with UK collaborators. Our main partner in Sierra Leone will be CapaCare, a Norweign-based NGO that runs a surgical training programme. Other NGOs active in healthcare are Medicos Del Mundo, and Scotia Aid. Engineers without Borders (EWB) in Sierra Leone will prove useful allies for our engineers. Uni. Sierra Leone and Dept. Surgery, Connaught Hospital, Freetown (Dr TB Kamara, HoD), will provide access to local researchers. In India, our partner organisations will be the Lancet Commission Centre for Innovation Excellence at Karunya University, and PSG Institute of Medical Science and Research (Dr B Vinod). Our engineers have research collaborations and joint teaching/exchange programmes with PSG College of Technology and Kamaraguru College of Technology in Coimbatore – these local research institutions have a tele-medicine link through J Gnanaraj. We will establish robust lines of communication with both institutions and their networks. WS2: Defining unmet surgical needs and health syst
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