The Hidden Crisis on Our Doorstep

We are living in a time of immense healthcare challenges. Right now, 5 billion people lack access to surgical care—a crisis that results in 18.6 million preventable deaths each year. That’s more than HIV, tuberculosis, and malaria combined.

In Sub-Saharan Africa, nearly 30% of the population lives more than two hours away from an emergency public hospital with critical surgical services. But this isn’t just an issue for low-income nations—it’s a global problem.

As my friend and colleague, Bryn Davies, always says:

“It’s not just a problem somewhere. It’s a problem everywhere.”

He shared that in the United States, a country often perceived as having one of the most advanced healthcare systems in the world, there’s a looming shortage of over 50,000 surgeons by 2034. Reading further, I found that In rural America, more than 60% of surgeons are over the age of 50—meaning many are on the brink of retirement. But the new generation of surgeons overwhelmingly prefers to remain in major metropolitan areas, where career opportunities are more lucrative.

This healthcare crisis is unfolding on our own doorsteps. We’ve all felt its impact—doctors have less time for us, hospitals rely on rotating staff, and continuity of care has become a luxury. More than half of clinicians in recent surveys (53%) are facing burnout.The Problem Is Too Big for Humans Alone

The shortage of clinicians and mounting pressures on healthcare systems cannot be solved by human efforts alone. We need to embrace technology—not as a replacement for human care, but as a means to enhance it.

Dr. Leise Knoepp MD, a urogynecologist I deeply respect and collaborate with recently shared some staggering statistics:

• In Louisiana and Mississippi, there are approximately 2.5 million women.

• One-third will develop pelvic floor disorders in their lifetime.

• 10% will require surgery.

• That’s over 250,000 women in need of specialized care—and rising as the population ages.

Yet Louisiana has only 11 board-certified urogynecologists. Mississippi has just five. Many of them are nearing retirement.

To make matters worse, Louisiana has the second-highest poverty rate in the U.S. Patients often drive six hours for surgery, navigating financial hardship, limited transportation, and multiple pre- and post-operative visits—at least five within the first year alone.

This is one specific case, but it’s a microcosm of a much larger crisis. Extrapolate this across states, countries, and medical disciplines, and the reality becomes even more dire. We need a way to decentralize care and bring it closer to where people live through the integration of purpose fit technology. We need a way to be able to connect clinicians, deliver efficiencies and task share in new ways we haven't previously considered.

Change Is Hard, and Fear Slows Us Down

At the same time, we’re moving at breakneck speed through technological and societal changes. But the human mind doesn’t evolve at this pace.

We resist change—especially in healthcare, where trust and human connection are paramount.

Most of us don’t want a cold, sterile, machine-driven future. When we are at our most vulnerable, we crave more human connection, not less. Healthcare is inherently complex, personal, and deeply emotional—and technology must be introduced with care, pragmatism, and humanity.

Tech Is Only as Good as Its Adoption

I’ve spent years investing in and implementing digital technology in emerging and frontier markets. And if there’s one thing I’ve learned, it’s this:

The best technology in the world is useless if it doesn’t fit the environment it’s meant to serve.

Too often, we see shiny, over-engineered solutions designed for pristine hospitals in New York, London, or Tokyo. But what happens when they’re deployed in rural Africa, in a small-town clinic in Nebraska, or in a community hospital in Eastern Europe?

If a piece of equipment requires expensive parts, complex training, or an ecosystem that doesn’t exist, it will simply sit on a shelf, unused.

Beyond logistics, we overlook cultural nuances. Medicine is practiced differently in every country, state, and system. Longstanding habits, no matter how inefficient, are deeply ingrained. Without thoughtful behavioral change strategies, even the most groundbreaking technology will fail to integrate.

Why Change Management Matters

Take Proximie, the digital surgical collaboration software we’ve implemented in East Africa. It took an average of 3-months across various countries before surgeons, nurses, and anesthesiologists truly embraced the technology.

One early adopter—often a single curious clinician—would serve as a champion, bringing their colleagues along at a pace they were comfortable with.

Yet many companies assume that simply offering the latest, most advanced solution is enough. It’s not.

Healthcare is not about the technology. It’s about the people.

This means:

• Recognizing the local environment.

• Understanding real clinical workflows.

• Addressing human needs.

• Addressing resistance to change.

If clinicians are already burned out, the last thing they need is another complicated system with more buttons to press.

If hospitals have high staff turnover, there needs to be ongoing training and support—otherwise, adoption will stagnate.

The Future: Africa’s Opportunity to Leapfrog the West

Most high-income nations are burdened by legacy systems—massive hospital IT infrastructures, outdated national and regional policies, and bureaucratic hurdles.

Africa, however, doesn’t carry that baggage. It has the chance to build pragmatic digital health policy from the ground up, bypassing the inefficiencies of Western health tech models.

But that will only happen if African nations avoid the same mistakes we’ve made—prioritizing scalable, interoperable, and practical policy solutions instead of one-size-fits-all imports from high-income markets.

The Pragmatism of Policy and Implementation

Healthcare systems—whether in rural America, Europe, or sub-Saharan Africa—have not historically prioritized digital infrastructure.

They have more urgent needs: medications, supplies, essential staffing.

But now, as we look to the future, we must prove to health systems why they should invest in digitally enabling infrastructure as everything is moving in this direction.

Traditionally, the gold standard of healthcare impact has been morbidity and mortality rates.

But digital tools don’t fit neatly into this framework. Their impact is often indirect but critical—scaling workforce capacity, improving efficiency, reducing costs, boosting provider confidence, and enhancing safety.

If we want sustainable digital transformation, we need to expand how we define success.

A Call to Action

The global healthcare crisis is not coming—it’s already here.

We are at a crossroads:

• Do we resist technology out of fear, leaving millions without care?

• Or do we embrace innovation in a way that enhances, rather than replaces, human connection?

The answer isn’t blindly trusting technology, nor is it clinging to outdated systems.

It’s about deliberate, thoughtful, human-centered innovation.

Because at the end of the day, this isn’t just a problem for “somewhere else.”

It’s a problem for all of us.

1. Meara, J., Leather, A., Hagander, C., et al. (2015). Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. The Lancet, 386(9993), pp. 569-624. DOI.

2. Eyler, L., Mohamed, S., Feldhaus, I., Dicker, R., & Juillard, C. (2018). Essential Surgery as a Component of the Right to Health: A Call to Action. Human Rights Quarterly, 40(3), pp. 641-662. DOI.

3. Holmer, H., Lantz, A., Kunjumen, T., et al. (2015). Global distribution of surgeons, anesthesiologists, and obstetricians. The Lancet Global Health, 3: S9-11. DOI.

4. Commonwealth Fund. (2024). Louisiana Women's Health Scorecard. Available here.

5. Commonwealth Fund. (2024). Mississippi Women's Health Scorecard. Available here.

6. U.S. Census Bureau. (2024). QuickFacts: Louisiana & Mississippi Population Data. Available here.

7. Holmer, H., Lantz, A., Kunjumen, T., et al. (2017). Global distribution of surgeons, anaesthesiologists, and obstetricians. The Lancet Global Health, 5(2), e81–e93. Available here.