Abstract
It is often said that the majority of surgery in Africa occurs in cities because the surgeons prefer to live in the cities. This is certainly true in Malawi where all the country's practising surgeons live in the four main towns. We have recently reported (1) on the low level of surgical activity in district hospitals despite several new district hospitals being built with multiple theatres, and international encouragement from the World Health Organisation to perform surgery at the district level (2). Undoubtedly lack of resident surgeons is a major factor, but another possible factor is the availability of surgical facilities. We decided to investigate the facilities available at districts in Malawi.
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