In 2011, Dr. Paul Firth, an anesthesiologist from Massachusetts General Hospital, began to explore methods for capturing and utilizing clinical data for quality improvement at Mbarara Regional Referral Hospital (MRRH) in Mbarara, Uganda. Partnering with Dr. Stephen Ttendo, head of the anesthesia department at MRRH, Firth obtained funding from the Harvard Milton Fund and from the General Electric Foundation in 2012 and established an electronic medical record database, now known as the SQUAD (Surgical Quality Assurance Database) initiative. Case A discusses the challenges of implementing an electronic medical record system in a public hospital where patient data had not previously been prioritized, and where resources for providing even basic care are limited. Case A explores the process of determining what to measure and how to measure and validate data.

In 2000, Dr. Benjamin Warf, a pediatric neurosurgeon, became the medical director and chief of surgery at CURE Children's Hospital in eastern Uganda. He quickly noticed a high incidence of hydrocephalus among his patients. Frustrated by the lack of options for these patients and by the limitations of shunts in a low-resource setting, Warf pioneered an alternative low-cost, one-time treatment for hydrocephalus using endoscopic techniques. This new approach, ETV/CPC, combined two procedures: endoscopic third ventriculostomy (ETV) and choroid plexus cauterization (CPC). Through rigorous clinical trials, Warf showed that ETV/CPC was at least as safe and effective as ventricular shunts but required much less medical infrastructure and post-surgical maintenance. In addition to his clinical work, Warf started the International Program to Advance Treatment of Hydrocephalus (IPath). He also designed a training program for neurosurgeons from developing countries around the world to learn this new hydrocephalus treatment. After his return to the United States, Warf began investigating the role ETV/CPC might play as a hydrocephalus treatment in both developed and developing countries.