Two billion people worldwide do not have access to safe, timely and affordable surgery. And around double the number of people die from injuries that could be treated by surgery than die from HIV/Aids, tuberculosis and malaria combined. The magnitude of this problem was not fully appreciated until recently, when research established the significant burden of surgical conditions. Many initiatives are now trying to combat this.

Access to surgery is a major problem in Ecuador, home to the Andes, the Amazon River and rainforest. Many of those in poorer and remote areas cannot travel to seek surgical care in larger cities for many reasons, including the cost of travel and the impact of leaving their jobs and families at home. Dr Edgar Rodas, Ecuador's general surgeon and previous minister of health, had a vision to deliver surgery through a truck converted into a mobile operating theatre.