Meeting a remarkable individual, who performs surgery without formal training, leads doctor Neil Singh to reflect on the growing number of ‘non-physician clinicians’ in poor countries. Can they be a safe and sustainable solution to the global shortage of health workers?

Have you ever seen a house that’s also a hospital? My paternal grandparents’ home is a large, cuboid building in a walled compound, in Bihar, India. At the front is a portico where we spent much of our time during our childhood holidays, sitting on chairs of wood and wicker, while elderly locals would stop by to catch up with my grandparents. I remember that portico floor so clearly: a mosaic of broken shards and off-cuts of marble, set into concrete, a wordless monument against perfection. Against waste.