Keywords postoperative Á pediatric Á pain Á RwandaTo the Editor,Research in sub-Saharan Africa has described shortages of pediatric anesthesia airway equipment, medications, training, and personnel. Previous work by our group has shown postoperative pain management of adults in Rwanda, a low income country (LIC), to be inadequate but improving. 1,2 Here, we report results of an initial study on the impact of these conditions on postoperative pain in children.With approval of the ethics committees of the Universities of Saskatchewan and Rwanda and of the hospitals, we conducted a prospective observational study from July 2019 to December 2019 of postoperative pain management in children aged 3-16 yr in the teaching hospitals in Kigali and Butare. We obtained consent from parents and assent from children in their preferred language. Participants were invited in the preoperative holding area and followed in the recovery room and ward until postoperative day 2, when the validated Faces Pain

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