The Shocking Cost Gap: Why the Poor Can’t Afford the Surgeries They Need

To countless women who have suffered from obstructed labor or other complications at birth, a Cesarean Section is a life-saving surgery. Yet despite the relatively low cost of this operation in developing nations, hundreds of thousands of women lose their lives, or live their lives with debilitating and demoralizing conditions like obstetric fistula. Samahope explores the shocking cost differences of these important options around the world, and invites us to do something about it.

At $8,508 per capita, the United States has the most expensive healthcare system in the world.[1] The cost of healthcare in the US has been a hot topic in the news given the high unemployment rate and rollout of Obamacare. Recently, a man posted his outrageous appendix surgery bill online which led to a viral discussion about comparative costs of healthcare in other countries. The gap is quite wide between the cost of surgeries in the US versus low-income countries. Shockingly, the poorest third of the world’s population receive only 3.5% of worldwide surgical operations.[2]

One of the most common surgeries, a C-section, costs an average of $27,866 in the US.[3] The cost of C-sections in developing nations is surprisingly low. According to the World Health organization, a C-section costs an average of $97 in Nepal, $140 in Uganda, $126 in Sierra Leone, $262 in Mexico and $229 in Ecuador. In countries that have a less than 10% rate of this surgery, a full list of C-section costs can be found here. The extremely low costs of these life saving surgeries make it hard to comprehend that up to 273,000 women die annually from pregnancy complications.[4] A study done by Harvard Medical School found that “an estimated 2.8 million Caesarean deliveries would have prevented 59,100 cases of obstetric fistula and 16,800 maternal deaths.”[5]

Fistulas are nearly eliminated in the US and Europe due to use of C-sections as the treatment for obstructed labor. Fistulas are a debilitating and demoralizing condition, and corrective surgery drastically improves and saves the lives of affected women. The average cost for fistula repair surgery and postoperative care is $450 in sub-Saharan Africa and Southeast Asia.[6] An increase in the number of C-sections performed each year in low-income countries would directly prevent the need for fistula repair surgeries.

Another example of a relatively common, high cost surgery in the US is cataract surgery. Of Nepal’s 26.6 million people, an estimated 150,000 are blind, many from cataracts. The average cost of cataract surgery is $115 in Nepal.[7] In the US, cataract surgery can cost $3,000 per eye.[8] A treatment surgery involving the removal of the cataract in one piece and insertion of a lense is both fast and inexpensive. Costs can be as low as $11 for the surgery. With 90% of the world’s blind living in the developing world, this innovative procedure will change the lives of many.[9]

The costs associated with pediatric heart surgery in the US vary wildly across procedures and hospitals. According to the National Center for Biotechnology Information, total hospital costs range from a median of $12,761 for atrial septal defect repair to a median of $55,430 for the arterial switch operation.[10] More complex heart surgeries on children in the US can cost up to $376,555.[11] A major challenge in low-income countries can be the lack of cardiac doctors and facilities equipped to handle these surgeries. Save a Child’s Heart performs heart surgeries on children from 48 developing countries for $10,000.[12}

As a Peace Corps Volunteer working in public health in rural Ghana, I came into contact with  people on a daily basis that had treatable illnesses they simply could not afford to treat. Surgical procedures in the low-income countries could have life-changing impact for patients and their families. I lived in a district where there was one surgeon serving over 100,000 people. Hospital patients had to rely on their families to provide food, which caused severe disruption to economic productivity and education within the family. Given the geographic sprawl of the district, many patients needed to travel 6+ hours to reach the hospital. These many factors combined created large barriers to life saving treatments.

With an overabundance of medical care available at a very high cost, the US faces very different challenges than developing countries with limited access at a low cost. The significantly lower cost of surgeries in developing countries create a low barrier to impact for financial donations to fund surgeries. Many doctors with the desire to serve a lower socioeconomic population lack access to the necessary resources. With Samahope, you can enable these doctors in their mission to perform necessary surgical procedures. You can directly fund a doctor to perform a life-changing surgery for a woman or child in need. Learn more about Samahope’s work at

Cissy DeLuca has a number of years of experience in international development. She worked in public health for 2 years as a Peace Corps Volunteer in rural Ghana. After Ghana, she worked briefly in finance in San Francisco before moving to Indonesia to manage partner operations for While in Indonesia, she started a social enterprise jewelry company to empower women in her community. She has a BA in International Business from the College of Charleston and MBA from INSEAD. She currently works for Google and spends time volunteering for