Leighton Hospital Team Report Carpenter, Ghana

Fifth Mission - November 2010

Magdi Hanafy, Perry Board, Janet Burrows, Sara Watson, Katy Griffiths, Natalie Weeg, Cristina Frezzini. Ali Stout, Dee Richards and Julie Green (Plymouth).

Leighton Team, Carpenter
Leighton Team, Carpenter

The team has been preparing for this mission for over a year. Tens of boxes filled with donated and purchased medical equipment were collected and distributed in 25 boxes to fly with us this year.
We received support this year for the team and Mission from:
- Leighton Hospital: Vaccination booster doses again, Annual/Study leave, Letters of support to Customs & Excise from CE, Posters from PGMC. Main Theatre (PAT), Treatment centre (Dawn), Orthopaedic Theatre (Jackie), Linen room, Occupational Health, Pharmacy...etc.
- South Cheshire Hospital Theatre & CEO.
- Residential Homes (Vera)
- British Airways. Waiving fees for 12 extra Bags as well as special fares for the team.
- BARD and Ethicon. 150 Free meshes and sutures.
- Eschmann: two little sisters autoclaves.
- Previous recognition of our work by Surgery and Cancer Department The Judges Award .
- Each and every person who kept wishing us good luck.
- Sallis Healthcare Ltd 27/01/2009 200 scrotal supports
- Mr Bill Love 05/02/2009 Donation of surgical instruments to the Ghana Project.
- Manchester Netcare Hospital. Theatre equipment on closing down.

Team loading the equipment
Team loading the equipment

Departure: 
Always efficient and on time, the team arrived in two minibuses to my home at 7:00 am sharp. All the boxes were loaded in ten minutes, 25 of them, and off to the airport. BA as usual opened two counters for us this time and did not weigh any of the items as the weight was already written on each box. We have already paid for three more bags over our allowance which was generously increased by BA from 10 to 22 bags. Half of the stress was relieved when all check in was completed without problems including the two autoclaves. We flew to Heathrow Airport terminal five on the last voyage of a Boeing 757. The crew was proud of its twenty five years service.

At terminal five we met the Canadian team and the rest of the British team from Plymouth and Margate (Ali Stout, July Green, Sarah Hastead and Natalie Weeg). Hugs and kisses and photographs. Last year did not seem to be that far away. We were all looking forward to this year knowing we have a lot to do. The Canadian team was led as usual by Dr Jennifer Wilson, a GP from Toronto who is a brilliant doctor and leader, as well as a mother of five; the youngest are six year old twins. She introduced us to the new members of the Canadian team. We did the same. We also met the British team from the south going to Takoradi, led by Chris Opong a colorectal surgeon from Plymouth and one of the pioneers of Operation hernia.

Arrived to Accra: 
In Accra airport Chris Oppong waved his magic stick and the customs and excise officers parted on either side to let the queue of 50 volunteers through with 155 boxes and bags full of equipment without inspection. Our trucks and buses were waiting for us outside the terminal. We went to the hotel in Accra where we spent the night after a quick dinner. The next morning we were up at six a.m., had breakfast and started our journey to Carpenter, taking 12 hours including three stops.

Arrived to Carpenter: 
We arrived in a big compound next to the village. Dr and Mrs Mensah and the local team had prepared our accommodation AND OUR DINNER. We stayed this year in Akwaaba house. A compound with African style huts, security and all facilities in constant supply, electricity, water, and an open air shower etc. We went to our rooms. Each one had two beds, each with a mosquito net and a fan. Rooms and toilets were clean. The area was calm. It rained twice on that day.

Preparing for work: 
We had been communicating with the Mensah s long before this year s mission. As a result each theatre was already prepared with a new air conditioner, new lights, operating tables in place as well as enough tables for equipments. We started opening the boxes and distributing the equipment to both theatres. We gave Mrs Mensah, three boxes of children s school equipment, 50 footballs and toys we brought as gifts to the community. We started screening patients and listing them for an appropriate operation, i.e. local or general, and started operating immediately.

From the first morning, Professor Giampiero Campanelli and his assistant Dr Marta Cavali from Milano, started in Brenda s theatre with a Local Anaesthetic list. Perry, Ira and Katy were preparing David s theatre for General Anaesthesia, but still allowed me (Magdi Hanafy ) and Natalie Weeg to use the theatre for a few local cases. This time as well we have been blessed with an outstanding team of operating nurses, from Plymouth and Leighton, as well as Ali Stout the inpatient and recovery sister.

Start Working: 
Patients were waiting for us under the tree early next morning. A quick ward round, yesterday s patients were seen and discharged, new patients were allocated to their rooms, Alison started to excel as a ward sister, in organising the local helpers and the flow of patients. Theatres were prepared by Julie, Sara, Dee, Sarah Hasted and Janet. We started a General Anaesthetic list for children.
We performed 26 procedures on 20 patients on that day. Afterwards, we started screening patients for the next day and allocated lists for both theatres. By the end of the first week both Professor Campanelli s team and my team had managed to operate on 100 patients.

Surgical team in action
Surgical team in action

Drama on the second week. 
We were only two main surgeons in the first week. Professor Campanelli and Marta flew back to Milano on Friday afternoon after operating on three patients in the morning. I had to continue the rest of Friday and all Saturday on my own operating in two theatres. We were expecting plenty of surgical support on the second week. Mr. John Chester from Devon, Mr. Richard Dalton from Plymouth, Cristina Frezzini the medical student from Sheffield, were all travelling from London on Saturday and expected to arrive in Carpenter on Sunday night. Chris Oppong having finished a week s work in Takoradi in the South was scheduled to meet the team coming from London in Accra and join them with the travel to Carpenter. The flight from London was cancelled due to engine failure and the first available flight was 48 hours afterwards, on Monday. John Chester cancelled his trip as it was not worth the effort to travel all that way for only two days operating.

Chris had to travel alone to Carpenter and arrived early Monday morning. Still he wanted a full list on Monday and I found myself operating on Monday and Tuesday with Chris rather than helping the Canadians in the villages.

Visiting villages with the Canadians: 
Because of that the surgical team could not contribute this year to the usual efforts of joining the Canadian team in their trips to the villages (except for Sarah Hasted). We managed to sneak out of theatre for an hour or two when the clinic was in the compound for the Carpenter people. The Canadians were sending referrals all the time for us to treat or give an opinion. The Canadian team was prepared for the invasion by all the local population with and without any illnesses. But many of them have already been triaged by David Mensah, so those with genuine complaints were allowed to be examined. Medical, dental, tropical, infections and common diseases were all seen, and treated with the help of effective supporting teams of lab technicians, physiotherapists and pharmacists. At the end of the day, we gathered to be greeted by the chiefs who offered us gifts of vegetables and a ram as a token of their gratitude.

Conclusion: 
Yet another Life Changing Experience . The life of both providers and recipients of care will never be the same again. This mission has seen our reputation extended not only to neighbouring villages but also people started arriving from Côte D Ivoire and Burkina Faso. The lists of patients for next year and the year after are already full. The idea of building a permanent Hospital is brewing.

The following table shows a comparison between last year and this year's work.
Surgical team of GB       2009   2010
Number of procedures     191    206
Number of patients          151    160
Number of days                8.5     10
Number of surgeons   2-3/day 1-2/day

God Bless you

See you next year

Magdi Hanafy
Leighton Hospital Crewe, Cheshire, UK.