Mission to Nalerigu Baptist Medical Centre

October 2013

Ghana was a very beautiful country.  The people were very welcoming, we really felt like at home. The capital Accra is a big nice city.  Almost all of the people speak English.

The surgical team comprised two consultant surgeons (Prof Guido Schuermann, Germany and Mr Chris Oppong –Lead, UK), two registrars (Ahmed Elmeghrawi, Germany and Miriam Adedibe, UK) and a nurse Kristina Horvath from Switzerland.  Prof Guido was accompanied by his wife. Dr Zainab Alhassan, a surgical trainee from Komfo Anokye Teaching Hospital, in Kumasi Ghana, was sponsored under a new Operation Hernia Ghana Fellowship scheme to join the team for training.

Travel:

Most of us travelled on Portugal Airlines PTA and stopped over in Lisbon before connecting to Accra, Capital of Ghana.  Mr. Chris Oppong and Miriam had arrived few days earlier.

We were met at the airport by Mr. Oppong and stayed overnight at the Baptist Guest House. The next morning we flew to Tamale in Northern Ghana and from there went by hospital 4-wheel drive to Nalerigu a journey of a couple of hours. Most roads were mostly tarred but one had a bumpy segment that was not tarred.

Hospitality:

We were warmly welcomed by the Manager of the Guest House in Accra. The accommodation was basic but comfortable. All our needs were met.

In Nalerigu Baptist Medical Centre we were housed on the hospital grounds in comfortable houses set in a picturesque setting of trees. The houses were well furnished.  It was a pleasant surprise. The food was delicious, available at three times daily, breakfast (serve yourself), lunch & dinner.

Theatre staff:

There were at least 4 trained nurses and 2 auxiliaries. We had 2-3 anesthetists each day. They offered a good service. All the staff were competent. The anesthetists were skilled in spinal anaesthesia and were committed to quality patient care. The staff  were very cooperative and helpful. The intensity of work we asked for was demanding, but they tried to cope. Most of our days ended after 4 pm. Perhaps the scene was set for such cooperation by an engaging speech made by Mr Chris Oppong and Prof Guido when we met the all theatre staff at the beginning of the mission.

Facilities:

2 theatres, one minor surgery room, one changing room, the sister's office, a stock room, a sterilization room with one autoclave. One of the theatres was very large and was split into two theatres when required, e.g. when they had a Caesarean section. Each theatre had the following facilities:

  • Theatre table: old but functioning.
  • Anaesthesia machine: we didn't use it, because of lack of oxygen cylinder.
  • Monitor: which was modern.
  • Ceiling theatre lamp: in only one theatre.
  • Standing lamps which had poor focus.
  • Air conditioner worked in both theatres.
  • Diathermy machine: in both theatres.
  • Surgical instruments & supplies: were adequately provided.

All theatre gowns, surgical drapes and gloves were provided by the hospital.

 

Outcome:

We operated on 44 patients and performed 46 procedures. This is a credit to the theatre staff for being willing to work hard to ensure that no patients were cancelled because of theatre time. All hernias were graded using Kingsnorth Grading and all operations were entered into Operation Hernia Database.

All hernia repairs were performed with affordable mesh, and all patients received perioperative antibiotic-prophylaxis (one single shot at induction), then regularly for 5-7 days. Most of the operations were done under spinal anaesthesia (apart from two inguinal hernias in which the repair was done under local anaesthesia).

Training:

For the first time Operation Hernia sponsored a local surgical trainee on a new scheme called the Operation Hernia Ghana Fellowship. The purpose of the scheme is to fund Ghanaian doctors to join Operation Hernia missions to gain more experience in Mesh Repair.  The scheme was pump primed by a generous donation from Prof Guido Schuermann and was very successful. Operation Hernia is grateful to Prof Schuermann.

Social:

We could find time to visit Tamale’s famous traditional market, we all bought worthy beautiful gifts, souvenirs, etc.

On the last day in capital Accra some visited the national museum, where we were informed about the dark history of slavery in Africa.

We spent some time on the Atlantic Ocean beach, where we experienced riding horses. We also tried out some of the delicious dishes e.g. chili Fufu in one of the Ghanaian restaurants

 

Achievements:

  1. 44 operations performed in 5 working days.
  2. Mesh-repair of hernias (more effective treatment) under antibiotics cover.
  3. Training one local surgeon in mesh-repair.

 

Thanks

We would like to thank Dr Lisa Morhman the American surgeon, who delayed her departure to the US in order to supervise the mission. Our thanks also go to Mr Edward Addai, the hospital administrator for his hospitality.

 

The great success was mainly possible because of the incredible teamwork. Every team member participated fully in all the activities. There was an early start in the morning for post-operative ward rounds, followed by assessing the new cases and then operating all day long and into the evening.

We will be back.............

 

For operation hernia Nalerigu 2013

 

Dr.Ahmed Elmeghrawi.