Global Perspectives in Plastic Surgery: View of Plastic Surgeons From Uganda

Uganda, an East African country with a population of approximately 46 million, has 72.62% of its people living in rural areas. Plastic and reconstructive surgery was historically delivered by visiting surgical teams, which, although impactful, faced limitations in follow-up and patient reach. Uganda has only 22 trained local plastic surgeons, mostly in urban private practice. Few work in public hospitals, limiting access to reconstructive care for the country's largely rural population.

A cross-sectional survey of 35 participants (plastic surgeons and trainees) was conducted using self-administered questionnaires across teaching and nonteaching hospitals in Uganda. The study examines the current gaps in reconstructive surgical care and possible solutions specific to Uganda.

Among 17 practicing surgeons, most were men (76.5%) and based in urban areas (94.1%). Nearly half (41.2%) had 6-10 years of posttraining experience, and all (100%) reported a mixed reconstructive and aesthetic practice. There is a high reconstructive burden due to acute burn and burn complications, congenital anomalies, road traffic accidents, commonly from commercial motorcycles known as boda bodas, and an increasing rate of cancer. Despite the small number of surgeons and their desire to train more, a whole 53% are working in nonteaching hospitals. Of the 18 senior plastic surgery residents, 72.2% were men, with the majority in their fourth year of training.

Establishing training hubs and implementing retention strategies for plastic surgeons, while strengthening regional hospital infrastructure, is essential for improving equitable access to quality plastic surgical care in Uganda.