Evidence map›Paper›PMID 40528077›Full record

ArticleSurgical endoscopy2025

Establishing environmental sustainability in a resource-limited surgical setting: the design of Kyabirwa surgical center.

Grace Travers, Saul Kibirango, Linda Zhang, Anna Kalumuna, Winfred Nannozi, Ronard Tusiime, Joseph Damoi, Angellica Giibwa, Reetwan Bandyopadhyay, George George and 1 more

Abstract read
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Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Grace TraversDepartment of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1259, New York, NY, USA.
Saul KibirangoDepartment of Surgery, Kyabirwa Surgical Center, Jinja, Uganda.
Linda ZhangDepartment of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1259, New York, NY, USA. Linda.Zhang@mountsinai.org.
Anna KalumunaDepartment of Surgery, Kyabirwa Surgical Center, Jinja, Uganda.
Winfred NannoziDepartment of Surgery, Kyabirwa Surgical Center, Jinja, Uganda.
Ronard TusiimeDepartment of Surgery, Kyabirwa Surgical Center, Jinja, Uganda.
Joseph DamoiDepartment of Surgery, Kyabirwa Surgical Center, Jinja, Uganda.
Angellica GiibwaDepartment of Surgery, Kyabirwa Surgical Center, Jinja, Uganda.
Reetwan BandyopadhyayDepartment of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1259, New York, NY, USA.
George GeorgeGKG Architecture, New York, NY, USA.
Michael MarinDepartment of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1259, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe healthcare industry is a leading contributor to climate change and resource depletion and its footprint is growing given efforts to improve healthcare access worldwide. Low- and middle-income countries (LMICs) are most vulnerable to this environmental degradation due to their relatively weaker infrastructure and lack of resources. This case study describes the infrastructure and procedures that drive environmental sustainability at Kyabirwa Surgical Center (KSC), an ambulatory surgery facility in rural Uganda that has cared for over 25,000 patients since its 2019 inception.

methodsKSC was architecturally designed with the goal of zero carbon footprint, exemplifying how environmental sustainability can be achieved in low-resource settings. In collaboration with a New York-based institution, Ugandan stakeholders constructed the original 8500 ft

resultsFrom 2021 to 2023, KSC obtained only 0.4% of its power and 25% of its water from the town. Excluding installation, this saves KSC an estimated $6,121 in annual operating costs-greater than annual maintenance costs estimated at $5,040. KSC also conserved 11% of solar power produced and 93% of rainwater collected from 2021 to 2023 for future use. Lastly, 71% of procedures were completed under environmentally friendly alternatives to general anesthesia.

conclusionIntegrating sustainability into LMIC surgical care is essential for improving healthcare resilience and accessibility. KSC shows that sustainable surgical models are feasible with innovative design, renewable energy, and potentially cost-effective practices. Scaling these efforts requires global collaboration, particularly support from high-income countries (HICs), to build resilient health systems in the face of climate change and resource limitations.

Indexed as

Conservation of Natural ResourcesFacility Design and ConstructionSurgicentersCarbon FootprintClimate ChangeDeveloping CountriesHealth ResourcesHumansUgandaAmbulatory surgeryEnvironmental sustainabilityGlobal surgeryMedical waste managementResource optimizationSolar powerUgandaWaste reduction

Identifiers

PMID40528077

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.