Lasting impact: insights from a surgical mission-based mentoring training programme in the Republic of Congo.

The global shortage of surgeons, anaesthetists and obstetricians is significant, especially in low and middle income countries (LMICs). A significant amount of LMIC surgical volume is provided by surgical missions and non-governmental organisations (NGOs) who are often well resourced, making them ideal environments for training. However, there are few publications addressing how to train in this setting, or the long-term impact of such training. Mercy Ships operates the largest non-governmental hospital ship in the world, the Africa Mercy , serving LMICs at the invitation of their President by providing free surgery and training for the surgical workforce. Mercy Ships developed and offered a comprehensive training programme across surgical specialties and disciplines in the Republic of Congo, 2013-2014. In this analysis paper, we present our experiences in developing and implementing the training portion of the programme. We also present the findings of an evaluation of the programme, which show a sustained positive impact and lasting change on personal and organisational practice 12-18 months post-training. We also make recommendations to NGOs and surgical mission organisations seeking to augment the impact of surgical missions with effective surgical training programmes.