When we wrote about Dr. Forster Amponsah in 2016, he was eager to perform surgery but faced many obstacles. "The general electricity is out and our generator is broken down," he told NPR. Has a year made a difference?

"The electricity is better, much better," says Dr. Forster Amponsah at the Koforidua Regional Hospital in Ghana. The surgeon's excitement rushes through the scratchy cellphone connection from Accra. "Now we have a generator that is working. So whenever the electricity goes out now we have our generator." When I profiled him last year, one of his biggest problems was that the power kept going out in his operating theater, making it nearly impossible to deal with a backlog of patients.

"I'm still in the same hospital. I'm still in the same theater where I was with you," Amponsah says. During my visit, there were patients lined up on gurneys in the hallway waiting for surgery. Africa and many other parts of the developing world face a deadly shortfall in surgeons. Global health researchers say general surgery is one of the greatest unmet needs in some of the world's poorest countries. A simple repair of a hernia or an obstructed bowel can transform a patient's life but often hospitals lack the resources or personnel to carry them out.

Amponsah is one of only two surgeons at his regional hospital outside the Ghanaian capital. He also consults with younger medical students and physicians at other public health clinics in the area. Every day there are more patients needing surgery than Amponsah can possibly attend to.

Even as we talk on the phone, more patients are being prepped. "I'm waiting for two cases," he says of the next surgeries he's about to do. "Right now I have a gentleman with a small bowel perforation. And a gentleman with a gangrenous foot. What we call a "wet gangrene" so I have to amputate on him."

One of the biggest problems with the power cuts was how unpredictable they were. At any moment, everything in the surgical ward would come to a halt. The new generator, paid for by an anonymous donor, has helped dramatically, he says.

"We still have quite a few challenges with equipment in the theater," he says of the other machines in the surgical ward. When I was there, several suction machines did not suck, making them useless. Amponsah simply kept trying different machines until he found one that worked. And he's still doing that. "We are doing our best," he says cheerfully about the subpar medical equipment on his ward. He's clearly in a good mood — maybe in part because of that new generator.

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