Goal: The purpose of this study is a) To describe a new "system of cooperation" within the same country. b) To report the surgical activities, specialized consultations and academic teaching carried out during these missions. c) To describe the difficulties encountered during missions in rural areas and the bilateral benefits of such missions for the population, the local team and the 2 humanitarian workers. Methods: it's a retrospective study of missions carried out by the same team, covering

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... period of 11 years in 13 regions of Senegal and in Guinea Conakry. Results: During the 61 humanitarian missions there were 5,702 consultations, 637 patients underwent surgery, and 10 postgraduate courses were conducted. The most common pathologies were chronic otitis media (22%) and gastroesophageal reflux (18%). The most common surgical procedures were thyroidectomy (25%), tonsillectomy (17%) and parotidectomy (6%). Otology and rhinology encountered real constraints; complex procedures such as laryngectomy, trans maxillary bucco-pharyngectomy and mandibulectomy were performed. Conclusions: These missions have enabled people living in remote areas to benefit from quality care, highlighted the clear disparity in the distribution of ENT services, and provided medical-scientific teaching to the staff.