
Frugal Surgical Innovations for a Greener Global Health Landscape
By: Gnanaraj Jesudian, Erica W.M. Janszen and Nagulan
References
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DOI: https://doi.org/10.15566/7h408j04 | Journal eISSN: 2167-2415
Language: English
Page range: 211 - 217
Submitted on: Nov 7, 2025
Accepted on: Feb 28, 2026
Published on: Apr 17, 2026
Published by: Global Health Institute at William Carey International University
In partnership with: Paradigm Publishing Services
Keywords:
© 2026 Gnanaraj Jesudian, Erica W.M. Janszen, Nagulan, published by Global Health Institute at William Carey International University
This work is licensed under the Creative Commons Attribution 4.0 License.