More Child Surgeries

morechildsurgeries is not a charity it's an impact system

Purpose is to:

Increase the number of children receiving life-changing surgery
Reduce the cost per child over time
Build trust between donors, medical teams, and communities

2022

How the Impact System Works

Step 1 — Identify Child

Through community outreach
Local networks

Step 2 — Confirm Case

Medical validation
Cost + pathway defined

Step 3 — Fund

Donor connected
Clear cost per child

Step 4 — Deliver Surgery

Local hospital
Local + international doctors

Step 5 — Verify (Proof of Care)

3-video system
Public reporting

Step 6 — Follow-Up / Review

Recovery
Rehabilitation
Outcome tracking

2026

Background

In many underserved regions globally (including some countries with developed health systems), millions of children live in conditions of extreme poverty that severely limit access to essential healthcare services, including life-saving surgical care. Children affected by congenital conditions, trauma, treatable diseases, and other medical conditions often face lifelong disability or premature death due to the absence of timely and appropriate surgical intervention.

Global recognition of this challenge was reinforced by the 2015 Global Surgery Summit and the subsequent Lancet Commission on Global Surgery, including the landmark report Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development, led by Dr John G. Meara of Harvard University and Professor Andrew J. M. Leather of King’s College London.

The Commission found that billions of people worldwide lack access to safe, timely, and affordable surgical and anaesthesia care, with the greatest burden borne by low- and middle-income countries. Key barriers include critical shortages in the surgical workforce, inadequate infrastructure, and the significant financial, geographic, and time-related burdens associated with accessing care. For many families, the cost of treatment, long travel distances to surgical centres, and delays in receiving care result in conditions becoming more severe or untreatable.

These systemic challenges contribute to preventable disability and death, particularly among children, and highlight the need for coordinated solutions that expand access while strengthening local health systems and workforce capability.

Specifically, in many rural and low-resource settings, there is limited access to adequately equipped healthcare facilities, a shortage of skilled surgical professionals, and insufficient post-operative care and rehabilitation services. As a result, conditions that are routinely treatable—such as cleft lip, hernias, orthopaedic injuries (including simple fractures), and certain cancers—remain unaddressed, leading to preventable suffering, long-term socio-economic disadvantage, and death.

However there are solutions that are working – one surgery at a time.

Addressing this gap can begin with the provision of an individual surgery, centred on the needs of the child, supported by clear communication (also permissions) with the family, alignment with the local health network, and funding from donors to cover costs.

It requires a simple, coordinated approach between the child and family, community outreach, medical providers (surgeons, rehab nurses and hospitals), and donors – one that can be efficiently initiated, verified, and repeated, thereby strengthening outcomes for the child, the community health system, and the donor experience.

The Program already:

• Improves health systems by partnering with hospitals and healthcare providers to increase surgical capacity and access to safe, timely procedures

• Builds health employment pathways by supporting the development of local healthcare roles, including clinical and non-clinical positions, strengthening community-based health delivery

• Trains, upskills and educates local surgeons and healthcare workers through collaboration with experienced international medical professionals, fostering knowledge transfer and raising standards of care

Through these programs, skilled surgeons and medical teams have been engaged from both local and international contexts, creating an exchange of expertise that strengthens local capability while delivering immediate, life-changing outcomes for children.

Quality surgical intervention has benefits that not only save lives but also significantly improve a child’s ability to participate in education, social life, and future economic opportunities.

It also improves the economic stability of families. As children recover, family members are freed from full-time caregiving responsibilities and can return to productive economic activities, including work and agriculture. At scale, this contributes to stronger communities and broader economic development.

The model also supports the economic viability of emerging health systems by creating sustainable employment opportunities – for example, providing income for community outreach workers, nurses, and supporting the retention of local surgeons who might otherwise leave.

By combining direct service delivery with long-term capacity building, the program • creates sustainable improvements in child health outcomes • employment and education for individual health workers and • contributes to stronger, more resilient healthcare systems.

Model (Simple)

We operate a hub-and-spoke system:

Central (Hub – Rotary – Another Organisation)

Governance
Brand
Donor relationships
Reporting
Standards

Local (Spokes)

Delivery
Community relationships
Medical coordination

Philosophical Framing: There are two competing forces here:

Centralise what must be excellent (governance, brand, donor trust, reporting)

Holds brand, governance, donor relationships
Receives major funding (grants, philanthropy, corporate)
Sets standards, reporting, and systems

Decentralise what must be local (delivery, relationships, culture)

Lean teams (doctors, coordinators, community workers) Use shared systems (finance, reporting, CRM)
Hospitals Governments (maybe) Existing NGOs (to avoid duplication) Community Organisations
Network of Doctors (Businesses)

Why Hub and Spoke

Why Hub and Spoke

Option A — Hub & Spoke (Best Balance)

Structure:

Central entities such as Rotary who can use morechildsurgeries
Tanzania remains a working/training flagship – safe and successful for all
New countries operate as programs under the central entity

Why this works:

Lowest admin duplication (use existing admins)
Strong donor confidence (audited and managed in one place)
Faster setup (no need to register full NGOs everywhere immediately)

Option B — Franchise Model (Higher Autonomy)

In this model, each country operates as its own NGO under licence to the MoreChildSurgeries brand, systems, and model. While this enables local ownership and can support local fundraising, it carries a higher risk of fragmentation, increases setup time and cost, and can create donor confusion if not tightly controlled.

Option C — Partner-First Model (Cheapest to Start)

In this model, no new entities are established initially, with delivery conducted through existing NGOs and hospitals in each country. This enables the fastest and lowest-cost entry with minimal overhead, but reduces control and can make consistency of standards more difficult to maintain.

Structure

MoreChildSurgeries

Sets standards

Does NOT:

Trade
Hold money
Run operations

Operating Charity (Australia – can be anywhere)

Receives donations
Holds funds
Provides governance
Reports to donors

In-Country Programs

Tanzania (flagship)
Ethiopia, Uganda, Nepal, others

We build nothing.

We work with:

Hospitals
Doctors
NGOs
Community organisations

Governance

Single audited entity
Central reporting
Standardised metrics:
- Cost per surgery
- Number of children
- Outcomes

(Simple)

3–5 high-quality individuals:
- Medical
- Financial
- Strategic / business

Surgeons
African operators
Donor representatives

Country Level

NOT heavy boards initially
Instead:
- Program leads
- Reporting into central structure

What NOT to Do (Common Mistakes)

❌ Setting up full NGOs in multiple countries too early

→ Expensive, slow, hard to control

❌ Letting each country fundraise independently use morechildsurgeries

→ Brand fragmentation + donor confusion

❌ Weak agreements with partners – no child safety

→ Loss of control + risk exposure

Visual Model

Donors (AU / Global)
        ↓
Child Surgeries Africa (Australia – CLG + DGR)
        ↓
——————————
↓            ↓               ↓
Tanzania     Kenya           Uganda
Program      Program         Program
↓            ↓               ↓
Hospitals / Local Partners

The Smart Hybrid Model

Flow:

Donations → Australian entity
Funds → allocated to country programs
Delivery → via:
- hospitals
- local teams
- partner NGOs

Key Agreements

Funding Agreements (MoU)
Hospital Agreements
Partner Agreements

Funding Agreements MoU

Between:

Australian entity
Country program / partner

Defines:

How money is used
Reporting requirements
Accountability

With:

Hospitals
Local NGOs
Community
Group of Doctors
Really anything is small and staying small before formalising

Defines:

- Roles
- Responsibilities – medically and financially
- Patient pathways that follow morechildsurgeries set up

Full Surgery Lists

Full Surgery Videos

Full Financials

Scaling with Integrity

Scaling will only work if both the economics improve and the medical outcomes improve.

Equally important, however, is that the core dynamic remains unchanged:

The genuine care for the child, shared between the donor, the community outreach worker, and the surgeon.

This relationship is the foundation of the system.

Many NGOs and businesses lose what made them successful as they grow. They move from thrive to survive, losing the relationships, the clarity, and the purpose that originally drove impact.

MoreChildSurgeries is designed to protect that “magic” — the direct, human connection between:

The child and family
The donor
The community worker
The doctor

Scaling must strengthen this connection, not dilute it.

Scaling Approach

We are evolving from a successful Tanzanian initiative into a scalable platform for child surgery access—designed to multiply impact without multiplying cost

Scaling Approach

Goals

more child surgeries
• growth is only successful if:
Outcomes improve
Costs reduce
And the human connection at the centre remains strong

Key attributes of these goals include:

Verifiability: Progress and outcomes are easily verified by stakeholders, including sponsors and local medical workers, through

three-video process before, during and after surgery.
google sheet number and entry
WhatsApp group
Regular Zoom to discuss children
Monthly receipts and reconciliation program

Relatability: The goals AND communication processes are simple, measurable, and beneficial, making them relatable to sponsors, medical workers, and the children in need.
Commonality: The goals AND communication processes unite donors, doctors, cleaners, children, parents, and the community, fostering shared purpose and collaboration.

Scalability: The program’s success can be replicated and expanded, adaptable to various regions and healthcare settings.

This is Rahman. He had a simple surgery paid for - it changed his life.

Risks and Reality

MoreChildSurgeries operates in complex, real-world environments—both overseas and locally—where outcomes cannot always be perfect.

There will be situations where:

Children do not survive surgery
Funds are misused or misdirected
Miscommunication occurs between families, medical teams, and partners

This is the reality of working in healthcare and aid at scale. Like any business or operating system, mistakes can and do occur.

The goal is not perfection.
Perfection implies no mistakes—and in practice, no mistakes only occur when nothing is being done.

Instead, MoreChildSurgeries is designed to actively manage and reduce risk through its systems.

Proof of Care and Ratings sit at the centre of this approach—providing transparency, verification, and accountability across every case. Through structured verification, reporting, and performance tracking, issues can be identified early, reviewed openly, and addressed directly.

The system is built to:

Mitigate risk where possible
Detect issues quickly
Review and learn continuously
Fix and improve over time

Importantly, it is designed not to stop, but to keep improving—ensuring that more children are helped, more safely, with increasing trust and efficiency.

The measure of success is not the absence of mistakes, but the ability to reduce them over time while continuing to deliver meaningful outcomes for children.

Risks (And How We Manage Them as Best We Can)

We are evolving from a successful Tanzanian initiative into a scalable platform for child surgery access – designed to multiply impact without multiplying cost.

Start

Partner-first
Program model

Then

Expand to new countries

Later

Only create local NGOs if needed
Never commit to large infrastructure

Goal:

Maximise children helped per dollar
Maintain tight governance + strong local delivery
Create a model donors/medical teams can confidently scale into

This is Lobikieki. He was dying. No options. Surgery. 5 years on alive.

2023 Lobikieki's follow up

2025 catch up in Arusha

2025 to school first time

Proof of Care Ratings part of morechildsurgeries

Proof of Care and Ratings are the central tools developed by MoreChildSurgeries to protect the integrity of the program and ensure trust at scale. Every child supported through the system is verified through a simple, transparent process—typically using a structured three-video approach that confirms the need, the delivery of surgery, and the outcome. This creates a clear, real-time line of sight between donor, medical team, and child, removing ambiguity and ensuring that every dollar can be directly connected to a verified result.

Alongside this, a consistent ratings framework is applied across hospitals, doctors, and program delivery partners, based on outcomes, reliability, cost efficiency, and adherence to standards. These ratings allow the system to continuously improve by directing resources toward the highest-performing partners while identifying areas that require support or intervention. Together, Proof of Care and Ratings create a self-regulating system—one that protects children, builds donor confidence, and enables the model to scale without losing quality or trust.

For further detail on the system and its evolution, including the integration of blockchain smart contracts and artificial intelligence to support verification, transparency, and scale, refer to proofofcare.org

Over time, these tools are intended to enhance the Proof of Care framework by enabling automated trust, real-time validation of outcomes, and a more efficient, globally scalable impact system.

Total Donations

Current Surgeries + Waiting List

Current surgeries click here

Current Surgeries What Happens

We fund via % of our income every month – low-cost, high-impact, safe, local, family-permissioned, life-changing surgeries when no other satisfactory option for the child, is available to the family, due to poverty.

Trained surgeons. No one religion, no politics. No further intervention after this one magic life-changing moment.

Given to Sub Sahara Child Surgeries to Jan 2026

$ 0

Full financials click here

$ Spent and How We Pay

1. Work is referred between business

2. Instead of fee, sponsor surgeries

3. Client sign up and work done

4. Paid and %$ go to child surgeries

5. %$ sits in morechildsurgeries a/c

6. Child found who needs surgery

Total Children To Date