Our impact

Between them, the two children’s operating theatres created by ARCHIE Global Surgery in Uganda deliver safe surgery to around 1000 children every year.

Delivering positive change for children and their families

By Professor George G. Youngson,

Emeritus Professor, Paediatric Surgery, University of Aberdeen
ARCHIE Trustee and Chair of the International Development Committee

As the most vulnerable group of patients, children face the greatest problem in accessing surgical care globally. In most of the world’s poorest countries, children make up more than half of the population and 85% are expected to require an operation of some kind by age 15. Today, approximately 2 billion children across the world have no access to that surgical care.

Children’s surgical needs have been neglected and their preventable deaths remain uncounted. While the global child health movement has made great strides tackling communicable disease ( such as TB and malaria), surgical conditions remain untreated. Congenital anomalies, (half of which are treatable surgically) are increasing, however, only a tiny fraction of these curable conditions are currently treated by surgeons. Curable cancers in children advance untreated, or at best partially treated, across the world’s poorest nations. More children die of injuries than of HIV, TB and malaria combined. Many would survive if they had  access to surgery.

When available, operating time is limited, with adults preferred for use of these limited spaces. Indeed, there is poor public awareness in many countries that children require surgery at all, and some clinicians and parents avoid anaesthesia in children for fear they won’t survive. Many communities and families confronted with a child with a congenital condition lose hope and may abandon the child. At best, families often separate or experience even more poverty. Resources essential for children’s surgery have been omitted in planning global surgical services because “children aren’t a priority”. Additionally, the children’s surgical workforce is limited and existing infrastructure ill-equipped to care for children.

Against this oppressive background, ARCHIE Global Surgery was created to deliver real outcomes and  begin the task of tackling the global disparity in treatment. It had to start somewhere – why not with ARCHIE?

Naguru Hospital, Kampala, Uganda

In a country with 22 million children, this was the first children’s operating theatre to be established by ARCHIE Global Surgery and is currently the only facility for children’s surgery in Kampala.  It is heavily used by both the local paediatric surgeons and also visiting teams from Canada and USA.

ARCHIE Global Surgery continues to maintain this operating theatre and at the present time there are equipment replacements and upgrade maintenance required on a number of items because of the continuous use of the facility.Additional equipment has been provided to carry out keyhole surgery and urological surgery on children (neither of these possibilities existed prior to the unit being opened) and a critical care area allows ventilator support of newborn babies after major reconstructive surgery.All these initiatives have been highly successful; the department is expanding in its staffing numbers (now 4 paediatric surgeons-previously one surgeon at the time of the opening of the operating room).It is currently providing for all neonatal surgery, all children’s cancer surgery, all congenital abnormalities in children and all routine paediatric surgical emergencies.

Ferguson Operating Theatre Suite, Mbarara, Uganda

As in the case of Kampala, this ARCHIE Global Surgery operating theatre is heavily used and is the only operating facility in south-west Uganda for children,-  an area with the same population of Scotland. This theatre was funded by the Scottish/American TV host and comedy writer – Craig Ferguson and his wife Megan.  It is increasingly being sent referrals from adjacent Burundi which has no dedicated children’s surgical facility.  It remains dependent on the one surgeon but also benefits from overseas visiting surgical teams from UK and USA. It is able to contend with all degrees of complex surgery as well as the high-volume straightforward elective surgery that is needed.  It is being well supported by the hospital with approximately 600 cases being treated annually by one surgeon.

Between them, these two facilities are delivering safe surgery to over 1000 children every year. This is real, life-saving and life-changing action that has begun to address, albeit ever so slightly, the disparity in equality of access of care.