Concerns have been raised that the lack of progress regarding limited surgical resources in low-and middle-income countries (LMICs) would lead to a new crisis. In 2015, it was estimated that there was a shortage of 1.1 million surgical staff disproportionately affecting LMICs. 1 Conditions for smaller surgical subspecialties like urology are even more discouraging: Nigeria, the most populous country in Africa, has one urologist per 3.2 million people. 2 These discrepancies are expected to worsen following the COVID-19 pandemic, which not only halted local medical and surgical care due to preferential management of patients infected with SARS-CoV-2, but also directly affected the personal health and already stretched resources of medical providers. The pandemic also limited international aid that may have been typically provided if it were not for the global shutdown.Global surgical mission groups serve a much-needed purpose in these under-resourced locations. Prior to the COVID-19 pandemic, over 250 000 surgeries were performed by surgical volunteer organizations (SVOs) in LMICs. 3 These organizations play an even more important role in helping expose and train local providers.International Volunteers in Urology (IVUmed) is a surgical mission group conducting surgical workshops in LMICs, while also focusing on creating a sustainable training pipeline. Its aim is to eventually hand over the entire surgical workshop and the training program to local physicians in LMICs so that they can independently expand and support themselves. Before the pandemic, IVUmed was performing 25 missions in 13 countries per year. On average, it provided care for 812 patients, performing 564 cases and training 296 local surgeons at an estimated service value of US$4 204 217.60 annually. As the COVID-19 virus spread around the globe, domestic and international travel came to a halt, as did surgical missions. 4 It has been over two years since the onset of the COVID-19 pandemic and since IVUmed's last workshop. As vaccines were developed and are being deployed, and as LMICs are adjusting to a postpandemic landscape, the question remains of how and when to restart surgical missions in these regions.

THE DISPARITY IN GLOBAL SURGICAL CAREMany low-and middle-income countries (LMICs) face immense health care needs with limited available resources, mainly due to the lack of health care providers in specific regions of the world, leading to global inequalities in medical care access. The World Health Organization (WHO) estimates that over 40% of the countries in the world have less than 10 physicians per 10 000 people, and many Sub-Saharan African countries have less than one physician per 10 000 people [1]. In comparison, the United States has 26.1 physicians per 10 000 people, with similar or higher numbers reported in other high-income countries [2].Unsurprisingly, these health care delivery-related limitations impact surgical care in LMICs, where approximately one third of the world's population lives, yet where only 6% of surgical procedures are performed [3].Surgical need is only growing, with an estimated 30% of the global burden of disease being treatable by surgery [4]. Unfortunately, there is a lack of ability to support these needs, with an overall estimate of 5 billion people without adequate and safe access to surgical care. This is worse in LMICs, where up to 90% of individuals have unmet surgical needs [3]. Inequality in access to surgical care has led to high surgically-preventable mortality and morbidity rates in these lower-resourced countries, with not only obvious implications on population health, but economic repercussions as well. The estimated loss of economic productivity between 2015 and 2030 in LMICs due to poorly developed surgical services is US$12.3 trillion [3].Global humanitarian surgical organizations have attempted to tackle surgical needs in lower-resourced locations, including LMICs. The Current Population Survey estimated that approximately 300 000 people from the United States participated in surgical and non-surgical medical services between 2004 and 2012 [5]. This is likely an underestimation of the true amount of people who have participated, however, as the survey was unable to specifically ascertain volunteer activities and answers typically had pooled responses. With con-