In 2008, SOS began collaborating with surgeons in Sierra Leone. The first undertaking was an assessment of surgical capacity at all government hospitals. The results showed that the hospitals in Sierra Leone were in poorer condition than hospitals during the US Civil War in 1864.

SOS programs then concentrated on three areas: personnel, training, and equipment and supplies.

For three years, SOS supported the salaries of junior doctors, nurses and support staff at Connaught Hospital.  Three containers of medical and surgical supplies were shipped. Training courses in basic and emergency surgery and in protection from HIV and other blood borne diseases.

Following a massive oil pipeline disaster with 40 deaths, SOS assisted with a mass casualty incident training involving multiple local, national and international participants.

In 2011 a follow up surgical capacity survey was conducted which documented some improvements throughout the country.

In 2012, the Surgeons OverSeas Assessment of Surgical need study was undertaken in Sierra Leone and showed that 25% of the population needed immediate surgical attention and that 25% of deaths might have been avoided with timely access to surgical care. This landmark study was published in the medical journal The Lancet.

SOS maintains strong ties with Sierra Leone and attends the annual West African College of Surgeons meeting as a member of the country’s delegation.

SOS also provided funding for the procurement of locally available items in the effort to address Ebola.