“Children’s Access To Safe, Timely And Affordable Surgery Shouldn’t Depend On Where They Live”: Experience From An Inaugural Pediatric Surgery Department At A Regional Hospital In Northern Uganda”.

Background: Northern Uganda is the most underserved region, with surgical services for children relying on annual camps organized by oversea surgeons. Many children requiring surgical care in northern Uganda go unnoticed and untreated because of lack of dedicated pediatric surgeons and appropriate equipment necessary to offer this highly specialized services. Because of long distance to Mulago Hospital where definitive surgical care is provided, many of the parents opt to stay home and wait for surgical camp even when their children are referred for emergency care. Children referred with emergency surgical needs die without being attended to. Late access to surgical care for children can dramatically decrease their chances of being fully independent in life and hence unable to reach their full potential. Objective: To improve surgical access for children in underserved region of northern Uganda Methods: We obtained approval from the management of Lira regional referral hospital and preliminary organogram was formed to operationalized the department. Sensitization of the local community was done through radio talk shows and outreaches. Days were located for outpatient clinics and theatre. We started operating from May to December 2024. Socio-demographics, clinical presentation, management, and outcomes were prospectively collected and analyzed using Microsoft Excel and STATA software programs. Results: 843 children were recruited in the study, in the age group between 1 day to 17 years. 590 (70%) cases were male and 253 (30%) were female. 319 (37.8%) cases were operated, of which 271 (85%) were elective cases and 48 (15%) were emergencies. Anorectal malformation contributed the highest cases operated with 44 (13.8%) followed by inguinal hernia, 27 (8.5%). Three cases developed surgical site infection following laparotomy for intussusception. We registered 2 deaths. Conclusions Northern Uganda is underserved in terms of pediatric surgical services and still with a lot of pediatric surgical needs to be attended to. With these high numbers, a permanent solution needs to be established to support pediatric surgical needs in this underserved region. Many children will receive timely, affordable and safe surgical help and above all we hope to restore hope to these children and their family.