Background: Obstructive renal disease is a critical health issue in sub-Saharan countries such as Senegal, necessitating interventions like percutaneous nephrostomy. Unfortunately training for ultrasound-guided procedures such as nephrostomy is limited in Senegal due to the limited availability of physicians to provide feedback to trainees. This work investigates the feasibility of using the open-source platform 3D Slicer to evaluate technical skill in percutaneous nephrostomy in Senegal. Methods: Six novice urology residents and six expert urologists from Ouakam Military Hospital performed four trials of percutaneous nephrostomy each on a low-cost phantom. An electromagnetic tracking was used to track the motion of the ultrasound probe and needle during each trial. Finally, the Perk Tutor extension of 3D Slicer was used to calculate skill assessment metrics that have been previously validated for other ultrasound-guided procedures. Results: Skill assessment metrics were successfully computed using Perk Tutor. The computed metrics showed a significant difference between novice and expert physicians and the novice physicians showing marked improvements across the four trials. Conclusions: The tracking-based metrics computed using Perk Tutor effectively distinguished skill levels and measured performance enhancements between novice and expert physicians practicing percutaneous nephrostomy. This open-source platform provides an accessible option for automating skill assessment in low-resource countries such as Senegal.