Background: Percutaneous nephrostomy can be an effective means of preventing irreparable renal damage from obstructive renal disease thereby providing patients with more time to access treatment to remove the source of the blockage. In sub-Saharan Africa, where there is limited access to treatments such as dialysis and transplantation, a nephrostomy can be life-saving. Training this procedure in simulation can allow trainees to develop their technical skills without risking patient safety, but still requires an ex-pert observer to provide performative feedback. In this study, we evaluate the feasibility of using video as an accessible method to assess skill in simulated percutaneous nephrostomy. Methods: Six novice urology residents and six expert urologists from Ouakam Military Hospital in Dakar, Senegal performed 4 nephrostomies each using our setup. We computed motion-based metrics for each trial from the predicted bounding boxes of a trained object detection network and compared these metrics between novices and experts. Results: We were able to measure significant differences in both ultrasound and needle handling between novice and expert participants. Additionally, we could measure performance changes within each group over multiple trials. Conclusions: Video-based skill assessment is a feasible and accessible option for providing trainees with quantitative feedback in sub-Saharan Africa.