Surgery at Niamey National Hospital in the Republic of Niger is a challenging experience, dangerous even by third world standards where lack of access to properly equipped surgical care is a near universal public health crisis. Niger is among the poorest, and most youthful, countries in the world. Most of the 4000 operations in the hospital’s seven operating suites are on children or teenagers who have been injured in road crashes or as a result of unsafe working conditions.

But operating conditions at the hospital are improving dramatically because of a donation to Lifebox, the BMJ’s Christmas Appeal charity.

Maman Sani Chaibou, the hospital’s lead consultant in anaesthesiology and intensive care, was “very happy” to receive a delivery in March 2012 of a robust, portable, audible, rechargeable Lifebox pulse oximeter costing just £160 (€194; $250). “It has changed my practice by keeping my patients safe throughout their treatment,” he says. “For me, the greatest benefit is that it can follow the patient from the operating room to the …