Purpose: To highlight details and difficulties of management of large goitres in the developing world.Method: This paper presents a retrospective review of patients undergoing surgery for large goitre at the HEAL Africa Hospital (Health, Education, Action, Leadership) in Goma, Democratic Republic of Congo.Results: Dr Neil Wetzig has been involved in training African doctors in goitre surgery since 2003. In northern parts of D R Congo a very high incidence of large goitre exists. Published estimates range from 48–85% and it is suggested that four million people in the north of Congo have large goitres. The types of cases encountered will be discussed, along with the likely causes of endemic goitre, including dietary factors in this community, and the social effect of having a large goitre. Patients undergoing surgery at “HEAL Africa” have a mean age of 44 years, a mean duration of goitre of 7 years and they are predominantly euthyroid range. 88% are female. The difficult circumstances in which this surgery is performed, with poor lighting, poor power supply, poor instruments and limited resources, for example limited suture material, will also be outlined. Details will be pres
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