The WHO's emergency and essential surgical care (EESC) programme and the Lancet Commission on Global Surgery have emphasised the need for essential surgical service as an "integral, "indivisible, indispensable" part of universal health care. Facilities for the management of open fractures, one of the "Bellwether procedures" as identified by the WHO, should be available within 2 h of reach, where safe effective emergency surgery can be performed. We share our experience from a remote, rural, hilly town in India. Of the three Ms—man, machine, medicine—it is manpower that we find difficult to rectify to provide "safe surgery". In accordance with the report of Lancet Commission on Global Surgery, we have the data to support our needs. It is for the government and non-governmental organisations to rise up and provide the three Ms so that safe, essential surgical services can be carried out even in the remotest parts of India. [ABSTRACT FROM AUTHOR]