Global Surgical Outcomes

Changing lives.

Most surgical missions never find out what happened to their patients. We built a system to change that.

Surgery without follow-up is surgery without accountability

Every year, NGOs perform hundreds of thousands of surgeries in low- and middle-income countries. The patients go home. And in most cases, nobody ever checks on them again.

18%
Post-operative complication rate across 25 African countries in the largest-ever continental surgical outcomes study — most never detected without follow-up
Biccard et al., African Surgical Outcomes Study (ASOS), Lancet, 2018
94%
Surgical mission participants who strongly recommended systematic outcomes reporting — yet almost no organization has a system to do it
Survey of surgical mission teams, ScienceDirect, 2020
<5%
Post-operative follow-up rate for surgical missions in rural Sierra Leone before a dedicated protocol was implemented
Padmanaban et al., American Journal of Surgery, 2021
27%
Typical long-term follow-up rate achieved by NGOs in sub-Saharan Africa — considered a success
Padmanaban et al., Journal of Surgical Research, 2020
403
Surgical NGOs identified operating in low- and middle-income countries; most do not systematically report long-term outcomes
Surgical NGOs study, PubMed, 2016
16%
Patients in one landmark Ghana study who experienced post-surgical complications — complications that would go undetected without follow-up
Padmanaban et al., Journal of Surgical Research, 2020

"Reporting on outcomes and long-term follow-up was strongly recommended by 94% of surgical mission participants — yet the field still lacks a system to do it."

— Survey of surgical mission teams, ScienceDirect, 2020

The barriers are real.
So is the cost of ignoring them.

🗺️
Distance & Geography

Patients in rural Sierra Leone travel hours on unpaved roads to reach a hospital. Travel times over 2 hours are associated with doubled loss-to-follow-up rates.

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Unreliable Contact

Phone numbers change constantly. In one Dominican Republic study, 19% of listed numbers were incorrect. Another site had 65% incorrect numbers.

Source: Filipi et al., Hernia, 2025
💰
Cost & Opportunity

In West Africa, patients face a direct choice between food for their families or transport to the clinic. 79% of patients in rural Ghana cited cost as their primary barrier to receiving definitive surgical care before their operation.

Source: Padmanaban et al., Journal of Surgical Research, 2020

The evidence shows a path forward

Three peer-reviewed studies — including the foundational work of Dr. Charles Filipi, whom FOCUS honors — have already demonstrated what works. The answer combines community trust, local partnerships, and mobile technology.

Ghana

Using mobile phones to follow up patients after surgical missions is feasible and effective. 86% of patients reported complete satisfaction with their surgeries. Average follow-up: 18 months.

Padmanaban et al., Journal of Surgical Research, 2020
Sierra Leone

A community-based follow-up protocol — combining patient education, tribal leader engagement, and mobile phone tracking — raised follow-up rates from under 5% to 97%.

Padmanaban et al., American Journal of Surgery, 2021
Dominican Republic

The longest-ever follow-up of hernia repair in a low-income country: 52–60 months. Local surgeons trained by Dr. Filipi's method achieved a 1.9% recurrence rate — better than international expert teams.

Filipi et al., Hernia, 2025

We built the infrastructure
the field has been asking for

🔁
Five-Year Patient Tracking

FOCUS tracks every patient for five years via SMS and WhatsApp — the standard the research community calls essential but almost no NGO achieves.

🤝
Partner-First Model

FOCUS doesn't deliver surgery directly. We support local ministries and NGOs who do — providing the outcomes infrastructure they lack.

📊
Real Outcomes Data

Every mission generates structured, longitudinal data. Recurrence rates. Complication rates. Patient satisfaction. Returned to work. All tracked. All reported.

🎓
Built on Proven Science

FOCUS was founded in honor of Dr. Charles Filipi, whose peer-reviewed research in the Dominican Republic produced the longest follow-up data ever reported for hernia repair in a low-income country.

In Memoriam

Honoring Dr. Charles "Chuck" Filipi

FOCUS was founded in memory of Dr. Charles "Chuck" Filipi — surgeon, teacher, and pioneer in global hernia care. His work with Hernia Repair for the Underserved produced decades of evidence that high-quality surgical care and rigorous outcomes tracking are both possible and necessary in the world's most underserved places. FOCUS carries that mission forward.

Join the mission

Organizational
Surgical Partners

Does your NGO or ministry perform surgical missions in low- and middle-income countries? FOCUS provides the longitudinal tracking infrastructure you need to measure impact, report to funders, and improve patient outcomes — at no cost to your team.

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Financial
Donors

Your gift funds the systems and people that keep patients connected to their care for five years after surgery. Every dollar goes toward tracking, follow-up, and the data infrastructure that makes accountability possible.

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Clinical
Volunteer Surgeons

FOCUS is building a network of surgeons committed to rigorous, accountable global surgical care. If you perform international surgical missions and want your outcomes tracked and reported, we want to hear from you.

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