Conclusions  Results from this governmental initiative to provide surgery in rural district hospitals by general practitioners are promising and encouraging. In the rural district of Dosso, there have been no deaths from elective surgery, and the number of surgical transfers to the regional hospital has drastically diminished. Content Type Journal ArticleDOI 10.1007/s00268-009-0160-xAuthors Rachid Sani, University of Niamey Department of Surgery, Faculty of Medicine Niamey Niger West AfricaBabadi Nameoua, Regional Hospital of Dosso Dosso Niger West AfricaAbou Yahaya, District Hospital Dosso Region Dosso Niger West AfricaIdé Hassane, District Hospital Dosso Region Dosso Niger West AfricaRoua Adamou, District Hospital Dosso Region Dosso Niger West AfricaRenee Y. Hsia, U...