Missions

TEAM REPORT FROM NALERIGU MISSION:  NOVEMBER 7-14, 2015

This was a good mission to the Baptist Medical Centre at Nalerigu in Northern Ghana. This mission was significant for the fact that the second Guido-Cordula Fellow, Dr Mohammed Bukari was a member of the team.

 

Team Leader: Chris Oppong

Members: Nazzia Mirza (Consultant Surgeon), Sandra Stanton (Theatre Nurse), Dr Mohammed Bukari (Surgical Registrar at Komfo Anokye Teaching Hospital).

 

Travel November 7, 2015

The team stayed overnight at the Baptist Guest House in Accra.  The hour’s flight to Tamale, Ghana’s northern city, on the following day was seamless.  This was followed by a 2-3 hour journey to Nalerigu in a hospital 4Wheel Drive vehicle. The road was in parts very bumpy!!!

 

Accommodation and food

We were provided with very good accommodation. Food was provided by a local chef who would do extremely well on the UK “master chef” TV programme.  The accommodation is set in a leafy area of the hospital compound which also houses hospital staff.  The morning walk from our accommodation to the hospital was an enjoyable experience. Wi-Fi was available in the “business office” but there were some issues with the network

 

Theatre Sessions

We met with the whole of theatre team. This was to affirm each member of the theatre team and share our ethos for the week: team work to deliver quality treatment to as many patients as we can manage with compassion and efficiency.  We were all encouraged to wear name bands to help with integration of the team and to break down barriers. The WHO check list was used in parts. The whole team worked as a family. The nurse anaesthetists were excellent. The theatre lead and all the staff were very cooperative.

 

Training

The Fellow, Dr Bukari, was trained in mesh repair and performed 15 procedures independently in addition to 5 procedure performed assisted by a Consultant as part of his training.

 

Outcome

Total number of procedures performed was 49 (Hernias 43, including 11 herniotomies in children (26% of hernia patients);  Hydrocoeles 4;  Lipoma 1; with one return to theatre. Many more patients would have attended for surgery with improved communication and organization.

 

Post-operative complications

We had only one early complication. A poorly nourished adult male became septic after repair of a large scrotal hernia. He was returned to theatre for evacuation of scrotal haematoma and made a good recovery.

 

Debrief

A most important final event was a closing debrief meeting of all theatre staff and medical staff, including the Medical Director. There was an open, honest feedback from both the hernia team and the theatre staff. The highlights of the feedback were the following points:

1.     The hard work of all team members was acknowledged and commended.

2.     There is a need to improve communication with all hospital staff during the planning stages of future missions. This will facilitate better recruitment of patients.

3.     Theatre requirements could be more effectively communicated to hernia team.

4.     Decontamination and sterilization of diathermy pencils and cables was reviewed.  It was agreed the pencils and cables would be cleaned with antiseptic and sterilised in antiseptic solution until required for surgery.

5.     The hernia team thanked all the theatre and medical staff for the support received.

6.     A group photograph was taken to remember the mission.

 

Chris Oppong

Consultant Surgeon and Chairman, Operation Hernia