Strangulated hernia
This poor man came to the hospital with groin pain. His hernia, which he had for more than 10 years, was incarcerated for 1 week. We immediately took him to surgery and found strangulated bowel. He was septic and died after several days. 

He died from a simple problem that could have easily been corrected-a hernia. Unfortunately, he did not have enough money to get a repair.  This occurs often in the third world but also in the USA. The WHO estimates that one billion people lack access to healthcare-one seventh of the world's population. 
The dark reddish, black areas are dead intestine

There is no health insurance in the third world. In some countries, and even in a few parts of Nigeria, the government will pay for healthcare. But there are often long delays. In most of Nigeria, health care is paid for out-of-pocket. If there is nothing in the pocket, then there is no health care.