Improvement in global economic conditions in recent decades had produced greater longevity and therefore a greater need for essential surgical services—for people with cancers, broken bones and other traumatic injuries, complications during child delivery, major birth defects, disabling kidney stones and gallstones and hernias. Although there remained some two billion people, especially in rural areas, without access to a surgeon, health systems in all countries were now massively increasing the number of surgical procedures performed. As a result, the safety and quality of that care had
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